Tracking Healthy People 2020 Internet, Broadband, and Mobile Device Access Goals: An Update Using Data From the Health Information National Trends Survey

Abstract

Background: As the year 2020 approaches, there is a need to evaluate progress toward the United States government's Healthy People 2020 (HP2020) health information technology and communication objectives to establish baselines upon which Healthy People 2030 objectives can be based.

Objective: The aim of this study was to use the National Cancer Institute's (NCI) Health Information National Trends Survey (HINTS) to benchmark progress toward HP2020 goals related to increasing internet access using broadband, and to assess the state of the digital divide for various sociodemographic groups.

Methods: We merged and analyzed data from 8 administrations of HINTS (2003-2017). Descriptive statistics were generated, and predicted marginals were calculated using interaction terms between survey year and selected sociodemographic variables of interest, including age, sex, race and ethnicity, income, education, and geography (rural versus urban), to test for differential change over time.

Results: The number of users having access to the internet increased between 2003 and 2014 (63.15% [3982/6358] to 83.41% [2802/3629]); it remained relatively steady from 2014 to 2017 (81.15% [2533/3283]). Broadband access increased between 2003 and 2011 (from 32.83% [1031/3352] to 77.87% [3375/4405]), but has been declining since (55.93% [1364/2487] in 2017). Access via cellular network increased between 2008 and 2017 (from 6.86% [240/4405] to 65.43% [1436/2489]). Statistically significant disparities in overall internet access were noted in the predicted marginals for age, sex, race and ethnicity, income, and education; for age, sex, income, and geography for broadband access; and for age and sex for cellular network.

Conclusions: The targets set forth in HP2020 were met for overall internet access and for internet access via cellular network; however, the target was not met for internet access via broadband. Furthermore, although the digital divide persisted by sociodemographic characteristics, the magnitude of many disparities in access decreased over time.

Keywords: Healthy People 2020; digital divide; internet.

Figure 1

Percentage of US adult population with access to internet (out of all respondents), access to internet via broadband (out of respondents with internet access), and access to internet via cell phone (out of respondents with internet access), Health Information National Trends Survey (HINTS) 2003-2017. Survey question on accessing the internet through a cellular network not included in HINTS 1 (2003) or HINTS 2 (2005) survey administrations.

Figure 2

Trends of having internet access based on responses from the National Cancer Institute’s Health Information National Trends Survey administrations between 2003 and 2017. (a) Predicted marginals by sex. (b) Predicted marginals by age. (c) Predicted marginals by race and ethnicity. (d) Predicted marginals by education. (e) Predicted marginals by income. (f) Predicted marginal by geography. All models adjusted for sex, age, race and ethnicity, education, income, and geography. NH: non-Hispanic.

Figure 3

Trends of having internet access via broadband based on responses from the National Cancer Institute’s Health Information National Trends Survey administrations between 2003 and 2017. (a) Predicted marginals by sex. (b) Predicted marginals by age. (c) Predicted marginals by race and ethnicity. (d) Predicted marginals by education. (e) Predicted marginals by income. (f) Predicted marginal by geography. All models adjusted for sex, age, race and ethnicity, education, income, and geography. NH: non-Hispanic.

Figure 4

Trends of having internet access via cell phone/mobile based on responses from the National Cancer Institute’s Health Information National Trends Survey administrations between 2008 and 2017. (a) Predicted marginals by sex. (b) Predicted marginals by age. (c) Predicted marginals by race and ethnicity. (d) Predicted marginals by education. (e) Predicted marginals by income. (f) Predicted marginal by geography. All models adjusted for sex, age, race and ethnicity, education, income, and geography. NH: non-Hispanic.