The Internet is a familiar tool of everyday life and an important source of information, including on health. Except, that is, for those who find themselves stranded on the wrong side of the "digital divide." Now, researchers warn that older Americans who are not online could be sidelined as the Internet's role in providing health information grows.

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Among elderly Americans, those with low health literacy were the least likely to use the Internet, according to the latest study.

Helen Levy, an associate professor at the University of Michigan School of Public Health in Ann Arbor, led the first ever study to show that older people's health literacy also predicts how and if they use the Internet.

She and her colleagues report their findings in the Journal of General Internal Medicine.

Prof. Levy says like any innovation in health care, health information technology brings with it not only significant benefits, but also the risk that the benefits may not be shared equally.

She and her team wanted to investigate this further, especially as more and more resources are being invested in health information technology in the US - for example, in electronic medical records.

They wondered, since nobody had explored it yet, whether the elderly are able and willing to make full use of the new technology. Is there a link between elderly people's level of understanding about health - their health literacy - and their use of the Internet to find information?

Low health literacy may impede use of online health resources

The answer could be important to policymakers and strategists, since, as Prof. Levy warns:

"Low health literacy may attenuate the effectiveness of web-based interventions to improve the health of vulnerable populations."

For their study, the team analyzed data from 1,400 participants who took part in the 2009 and 2010 Health and Retirement Study, a nationally representative survey of over 20,000 Americans aged 65 and over.

The survey participants had answered questions about how often they used the Internet, and in particular, how often they used it to find health and medical information.

The participants had also completed assessments of their health literacy - by completing the revised Rapid Estimate of Adult Literacy in Medicine questionnaire. And they had also rated how confident they felt about filling out medical forms.

The results showed that among elderly Americans, those with low health literacy were the least likely to use the Internet. And when they did use the Internet, it was not usually to search for health information.

The researchers found that 31.9% of the participants with a high level of health literacy used the Internet to get information about health, compared with only 9.7% of those with low health literacy.

Health literacy predicts what elderly people do once they are online

The team says health literacy appears to be a significant predictor of what elderly people do once they are online.

They also found that a person's level of health literacy is a stronger predictor of whether they use the Internet to find health information than their level of cognitive functioning.

Prof. Levy says their findings suggest as we increasingly expect patients to go online for health information, then we need to improve health literacy among older adults to prevent a widening of the digital divide in this group.

Meanwhile, Medical News Today recently learned of a series of studies in The Lancet that warn the health of the world's aging population is at risk unless more effective strategies are implemented to reduce chronic illness and poor well-being in the over-60s, who are expected to total 2 billion by 2050.