Racial and ethnic differences in self-reported telehealth use during the COVID-19 pandemic: a secondary analysis of a US survey of internet users from late March

J Am Med Inform Assoc. 2021 Jan 15;28(1):119-125. doi: 10.1093/jamia/ocaa221.


Objective: Widespread technological changes, like the rapid uptake of telehealth in the US during the COVID-19 pandemic, risk creating or widening racial/ethnic disparities. We conducted a secondary analysis of a cross-sectional, nationally representative survey of internet users to evaluate whether there were racial/ethnic disparities in self-reported telehealth use early in the pandemic.

Materials and methods: The Pew Research Center fielded the survey March 19-24, 2020. Telehealth use because of the pandemic was measured by asking whether respondents (N = 10 624) "used the internet or e-mail to connect with doctors or other medical professionals as a result of the coronavirus outbreak." We conducted survey-weighted logistic regressions, adjusting for respondents' socioeconomic characteristics and perceived threat of the pandemic to their own health (eg, no threat, minor, major).

Results: Approximately 17% of respondents reported using telehealth because of the pandemic, with significantly higher unadjusted odds among Blacks, Latinos, and those identified with other race compared to White respondents. The multivariable logistic regressions and sensitivity analyses show Black respondents were more likely than Whites to report using telehealth because of the pandemic, particularly when perceiving the pandemic as a minor threat to their own health.

Discussion: Black respondents are most likely to report using telehealth because of the COVID-19 pandemic, particularly when they perceive the pandemic as a minor health threat.

Conclusion: The systemic racism creating health and health care disparities has likely raised the need for telehealth among Black patients during the pandemic. Findings suggest opportunities to leverage a broadly defined set of telehealth tools to reduce health care disparities postpandemic.

Keywords: COVID-19; digital divide; digital inequality; racial and ethnic disparities; structural racism; telehealth.

MeSH terms

  • Black or African American / statistics & numerical data
  • COVID-19*
  • Ethnicity
  • Healthcare Disparities / statistics & numerical data*
  • Humans
  • Internet
  • Logistic Models
  • Pandemics
  • Racial Groups
  • Racism
  • Self Report
  • Surveys and Questionnaires
  • Telemedicine / statistics & numerical data*
  • United States