Digital exclusion during the COVID-19 pandemic in the English Longitudinal Study for Ageing population

Problem

Older adults still form a large proportion of the digitally excluded population in the UK. The coronavirus pandemic accelerated the use of digital technology within the NHS, especially within general practice. As the NHS long-term plan commits to provide most people a digital first primary care by 2023/24, many of these technological changes are likely to persist in the future. This transition could exacerbate existing inequalities in access to healthcare if the digitally excluded population are overlooked. This study aims to clarify whether digital inclusion changed in adults over 50 years of age during the coronavirus pandemic using data from core members within the English Longitudinal Study for Ageing.

Approach

Descriptive analysis of three consecutive weighted cohorts was performed from Wave 9 (June 2018- June 2019) and COVID-Wave 1 (June- July 2020) from the cohort study, the English Longitudinal Study for Ageing. Digital inclusion and internet use for health was measured by analysing self-reported responses about participants frequency and pattern of internet use. Samples were stratified by age, gender, and net financial wealth.

Findings

A significant proportion of core members in Wave 9 (17.9%, n=7289) and COVID-Wave 1 (15.4%, n=5825) never use the internet and are thus ‘digitally excluded’, consistent with previous research on digital exclusion in the United Kingdom. Women, increasing age and poorer financial wealth were all associated with higher rates of digital exclusion. Similarly, these three groups also used the internet less frequently to access health information. 48.3% of frequent internet users and 13% of occasional internet users increased their internet use since the start of the pandemic. This suggests a widening of levels of digital inclusion in this population. Furthermore, older respondents were least likely to increase their internet use since the start of the pandemic, with 46.4% of respondents aged between 50 and 54 and 14.24% of over 85s increasing their internet use. Smaller disparities were also found between the poorest (34.7%) and wealthiest (44.3%) quintiles reporting increasing internet use during the pandemic. However encouragingly, a greater proportion of women (40.4%) than men (33.2%) reported increasing their internet use since the start of the pandemic.

Consequences

Overall, this study suggests that while digital inclusion has improved in this population compared to previous cohorts; a large proportion of the older population, especially at the highest age stratifications remain digitally excluded. Existing disparities in access to healthcare could widen especially as we realise the NHS long-term plan’s ambitions to provide a digital-first primary care. This suggests targeted efforts to provide non-digital alternatives or support the acquisition of digital skills and infrastructure could be considered to prevent exacerbating existing health inequalities and creating a technological “inverse care law”.