SENIORS_HEALTH CARE_ INTERNET_ PRESCRIPTION DRUGS_ PROVIDERS_SENIORS_HEALTH CARE_ INTERNET_PRESCRIPTION DRUGS_ HEATH CARE PROVIDERS_SENIORS HEALTH CARE_INTERNET_ DRUGS_PROVIDERS_SENIORS HEALTH CARE_PRESCRIPTION DRUGS_HEATH CARE PROVIDERS_ Key Finding s Fr om a Nat ion al Surve y o f Older Amer icans Kai ser Fam ily Founda tio n Januar y 2 00 5 e-Health and the Elderly: How Seniors Use the Internet for Health Information A C K N O W L E D G E M E N T S Res earch direc ted by and repor t written by: Victoria Rideout, M. A., v ice p resident and direc tor, Program for the Study of Ente rta inment Media and Heal th, in collaboration wit h Trici a Neuman, S c.D., vice pres ident and d irector, Medi care Policy Projec t, Michelle Kitchman, Ph. D., Senior Poli cy Analy st, Me dicare Polic y Project and Mollyan n Brodie, Ph.D., vice president a nd di rector, Public O pinio n and Medi a Res earch Program, Kaiser Famil y Foundation . Layout and design by: Leahandah S oundy Additional graph i c s by : Theresa Boston T A B L E O F C O N T E N T S Intro duc tion 1 Methodology 2 Key Findin gs 3 Conclusion 11 Sur vey Toplines 14 I N T R O D U C T I O N Over the past ten years, the Internet has emerged as an integral part of the l ives of ma ny Ame ricans, transforming the way in which t hey get information and co mmunicate with others. Ever since the bir th of the Intern et, consumers and health advocates alike have focused on its potent ial as a speedy a nd convenient resource for health information, and as a tool fo r managing care. Indeed, studies have s hown that looking for healt h information has been one of the most popular onlin e activ it ies among adults, and even among adolescents, w ho are jus t as likel y to h ave res earched a health topic as to have downloaded music or played games online. 1 Making sure all Americans h ave access to timely, reliable information about h ea lth and health ca re has l on g been a goal of pub li c health advocates, gover nment officials, and the medic al com munity. This goal i s especially impor tant for seni or s, who f ace a greater number of health conditions a nd use pre scription drugs a nd health care s ervices at a far higher rate than younger adults. But the onlin e behavi or of seniors has not been studied as closely as t hat of other age groups. For seniors, the Intern et could have a parti cularly signifi cant impact. Wh ether it’s looking for info rm ation about specific illnesses or cond it ions, explor in g treatment option s, co mparing prescription drug p rice s, searching for h ealth providers, or following he alth policy debates, se niors are among the mos t avid consu mers of health in format ion. The Internet could a lso play an impor tant role in helping seniors to live independently and stay conn ected to family, f riends, and health professionals. In addition, ma ny p ol icy makers are increasingly hopeful that senior s will use information on sites like Medica re.gov to compare the benefits of p rescript io n drug discount cards, evaluate plan benefit s, and explo re nursing home op tions in their commun ities. Moreove r, many env is ion refo rms that would require seniors to be more a ctively engaged i n choosing health plans, using Intern et sites to assess benefits, premiums, a nd qualit y information. Older America ns’ Use of t he Interne t 50-64 year-olds 65 and older Percent who: Have ever used a computer 76% 42% Have ever gone online 70% 31% Have a computer at home 73% 41% Have Internet access at home 64% 33% Among those who have ever gone online, percent who: Go online every day 51% 46% Go online 1-5 times a week 36% 39% Go online 1-2 times a month 8% 8% Go online less than once a month 5% 7% Go online most often from home 68% 84% Go online most often from work 25% 8% 1 e-health_and the elderly I N T R O D U C T I O N Of course, there are a lso potential downsides to reliance on the Internet for hea lth information. S ome sites may provide inaccurate or incomplete information, and consumers who f ail to con sult their providers may endanger thei r health. Many Internet users ne gl ect to check the sou rce of health in format ion they find o nl ine, and some may be undul y influenced by adver tising and marketing. So me users may become confused by te chnologies they c annot reli ably nav igate, and it is always pos sible that scam artists may tr y to prey on the elderly onlin e with false inform ation or unsafe product s. This repor t provides the first close look at how seniors use the Internet for he alth information – and how that may c hange in the years ahead as the baby boom generati on gets older. 2 As the Internet revolu ti on has spread across Am erica, have seni ors been caught up in the explosion, or a re most ol der Americans too unf am iliar with new technology (or too restric te d by fixed incomes ) to go online? And what a bout those senior s who are online – what role is the Internet playing in t heir lives as a source of health information? How many use the Net to look for i nf ormati on on doc to rs, researc h prescr iption drugs, find provi ders, ma nage their weight, follow health polic y news, or look up the latest cancer treatments? The answers to al l of these questi ons have impor tant implications f or providers, policymakers, an d public health a dvocates, a nd it is hoped th at the findings discussed b elow w ill be a first step i n providing th os e answer s. 1 Kaiser Family Foundation, Generation Rx.Com, 2001. 2 For an excellent overview of s e n i ors’ use of the Internet, see Pew Internet and Ameri c a n Life Pro ject, Older Americans and t h e Internet, March 25, 2004. 2kaiser family foundation_january 2005 M E T H O D O L O G Y e-Health a nd the Elderly is a nation ally representative, random digit dial telep hone su rvey of 1,450 adults age 50 and old er, in cluding 583 responde nts age 65 and older. The sur vey was desi gned and an alyzed by st aff at the Kaiser Family Fou ndatio n in consu ltatio n with Princeton Sur vey Re search As sociates (PSRA), with f ieldwo rk conducte d by PS RA. The inter views were cond uc ted from Ma rch 5 – A pril 18, 20 04. The margin of sam pling error for the com plete se t of weig hted d ata is +/- 3%, an d for those ag ed 65 and o lder it is +/- 4%. For results ba sed on smal ler subsets of respo ndents the ma rgin of e rror is h igher. Note that sampli ng er ror is on ly one of m any po tentia l sources of er ror in th is or any other p ublic opini on poll. INTRODUCTION 1. Less than a t hird of all seniors h ave ever gone online; in fa ct, fewer than h alf have ever u sed a computer. • Thir ty-one pe rcent of seniors 6 5 and older have ever gone online to use the Intern et or e -mail (27% have used the Internet, 4% have use d e-m ai l only). • Four in ten (42% ) seniors have e ver used com pu ters. • Among seniors w ho have never been onlin e, or who only go onlin e very in frequently, the major reasons cited include never having learned how (4 4%), and that “it’s too complic ated” (33% ). 2. O ver the next d ec ade, as baby boom er s and other adults get ol de r, the propor tion of seniors using th e Internet is likely to increase dr amat ic ally. • Sevent y percent of 50-64 year-olds have gone online to use the Internet or send e -mail (67% to us e the Intern et, 3% f or e- ma il only). • Two-thirds (64%) have Internet a ccess at home.                Going online in the future While Internet rates among seniors are likely to increase significantly as baby boom- ers (who are already online in much higher numbers) join the ranks of senior citizens, those who are not already online don’t seem inclined to change. Among all seniors who have never gone online (69%), only 9% say they would like to start using the Internet or e-mail. Likewise, very few of those older Americans who do not currently have Inter- net access at home expect to get it in the next year or two (3% of seniors). Seniors who don’t go on- line (or only go online infrequently) say there are services that would make them more likely to do so, including a toll-free help line they could call if they ran into technical difficul- ties (21%), free classes to help them learn more about computers and the Internet (20%), financial assistance (16%), and a volunteer to come help them with their technical problems (15%). K E Y F I N D I N G S 3 e-health_and the elderly K E Y F I N D I N G S 4kaiser family foundation_january 2005                                           3. T he re i s a substantial d igital divide a mo ng seniors bas ed o n income, educati on , age, a nd gender. • Seniors w hose annual house hold income is under $20,000 a year are much less likely to have go ne online (15%) th an those with incomes between $20- 49,000 (40%) or those with incomes o f $50,000 a year o r more ( 65 %). • Most seniors fa ll into this lower income category: 64% of all se ni ors on Medicare have an annual income under $20, 00 0 a year, while just 8% have an income of $50,000 a year or more. • Likewi se, seni ors with only a h igh school degree or less are much less likely to have gone online than those with so me col lege or a college deg ree (18% v. 45% v. 60 %). • Older seniors ( 75 and older) are much le ss likely than 65-74 year-olds to have go ne online (18% v. 41%). • Among seniors, men are more likely t han wome n to have gone on line (38% v. 25%). KEY FINDINGS 4. Th e Inte rnet is already a s ourc e of health informat io n fo r one in five senior citi zens. However, seniors still rel y much more on tradit io nal media such as T V and newspapers for he al th informat io n. • One in fi ve (21%) s eniors (65 or over) have gone online to look up h ealth information. Jus t 3% say they go onlin e for health inform ation at lea st once a week or more, 4% say once or t wice a month, and 14% say less often than that. On ly 8% of seniors say they get “a lot” of health information onl in e. • TV an d books are the media senio rs are m os t likely to turn to for health inf ormati on (21% get “a lot” of health inf or mati on from ea ch of these sources), followed by ne ws papers (17%), mag azines (14%), the Internet (8%), and radi o (5%). • For 50-64 year-olds, the Internet has actually surpassed TV and books as a s ource of “a lot” of health inform ation (2 4% v. 21% e ach for TV and books), followed by magazines (15 %), newspapers (12%), and radio (4 %). • Given the economic divide i n Internet use among seniors, it is not surp rising that there is a significant divid e in seniors’ use of t he Inter net for health in fo rmat io n. Only 6% o f seniors with incomes under $20 ,0 00 a yea r have gotten health information online, compared to 32% of those wi th incomes bet ween $20 -4 9,000 and 43% of those with incomes of $50,00 0 a year o r more.               KEY FINDINGS 5 e-health_and the elderly 6kaiser family foundation_january 2005 Keeping in touch One of the intangible poten- tial benefits of the Internet is helping socially isolated seniors keep in touch with family and friends. In or- der to get a sense of the role e-mail and the Net are playing in seniors’ lives, the survey asked those who have ever gone online how central these experiences are to them, and how much they have helped them stay in touch. Among those se- niors who go online, about a third say they consider e- mail (34%) and the Internet (33%) “an important part of their life that they wouldn’t want to do without.” About half (56%) of seniors who use e-mail say it makes it “a lot” easier for them to stay in touch with family and friends. 5. Many senior s do n’t trust th e Internet as a sou rc e of health i nformation; bu t fo r 50 -64 ye ar -ol ds, the Internet is even more trusted tha n other more traditional m ed ia. • Nearly half (46%) of all seniors s ay the y wouldn’t trust the Internet “at al l” to provide accurate information about i mp ortant health issues. Fewer than one in ten sen iors (8%) say they would trust the Internet “a lot,” and 18% say they would tru st it “so me.” • At t he same time, however, seniors a lso show a hesitation to trust any media to provide accurate information about i mp ortant health issues: 15% say they would trust books “a lot,” 11 % would trust TV a lot, 9 % magazines, 8% the Internet, 7% newspapers and 5% would trust radio a lot. • By comparison, adults ages 50-64 are much more likely t han seniors to trust th e Intern et: 58% trust it “a lot ” or “some” to provid e accurate infor mation about impor tant health is sues, compared to 26% of seniors; 1 9% trust it “a lot” (compared to 8% for seniors). • In fact, 50-6 4 year-olds a re more likel y to trust the Internet “a lot ” (19%) than any other medium except books ( 28 % say they trust books “a lot,” 10 % magazines, 9% television, 7% newspapers, and 4% ra dio). 6. Older Am er ic ans s ay doc tors are not en couraging them to use the I nter ne t fo r health information or to communic ate wi th provi de rs. B ut many say that drug compan ie s and other healt h marketer s ar e using the I nter ne t to m arke t to t he m. • Only 9% o f 50-64 ye ar- ol ds and 5% of seni ors say their doc tor has ever asked i f they have access to the Internet or go onli ne. • Just 3% of 50 -6 4 year-olds a nd 1% of seniors say a doc tor ha s ever recommended a p ar ticular health or medical We b site to th em. • Seven percent of 5 0-64 year- olds and 2 % of seniors say they have ever communicated with a doc tor or other prov id er via e-mail. • On the ot he r hand, drug companies and ot hers are using the Net to market health produc ts to older adults. For ty- one percent of all 50-64 year-olds and 15% of all se ni ors have received e -mail s advertisi ng drugs, supplements, or other medica l produc ts. • Looking ju st at those seniors who h ave eve r used e -mail, 7% have communicated with a doc tor or other prov id er via e-mail, while a total of 54% have rece ived e -mails ad vertising either drugs, supplements, or other medic al products.                          KEY FINDINGS 7 e-health_and the elderly [...]... available, the sites are useable, and that sen i o r s a re comfor table navigating their way through th e o n l i n e information world n 13 e -health_ and the elderly SURVEY TOPLINES e -Health and the Elderly: How Seniors Use the Internet for Health Information Princeton Survey Research Associates for the Kaiser Family Foundation N = 1,450 adults age 50 and older (799 ages 50-64; 583 ages 65 and older)... frustrating because it’s hard to find what I’m looking for It’s good because I can get information quickly It helps me feel more informed when I go to the doctor It’s confusing because there’s too much information It’s good because I can get information from a lot of different sources kaiser family foundation_january 2005 30 31 How often do you look to see who provides the health and medical information. .. doctor or other health care provider about information you found online Changed your health insurance plan because of information you found online As I read you some statements that describe people’s feelings about looking for health information on the Internet, please tell me if you agree or disagree with each statement Here’s the (first/next) one… (INSERT READ AND RANDOMIZE) READ FOR FIRST ITEM THEN AS... candidate’s campaign asking for money Some people use the Internet to look for information on many different topics, and others don’t Please tell me if you’ve ever looked for information about each of the following HEALTH CARE topics online (First,) what about… (INSERT; READ AND RANDOMIZE)? (READ AS NECESSARY) Have you ever gone online to look for information about this? Yes Not online DK/Ref Total:... n=129 How much has the information you have found on the Internet helped you take care of your health? Has it helped… (READ) Based on those who go online for health information A lot Somewhat Only a little Not at all DK/Ref Total: 16 40 23 20 1 n=628 50-64: 18 42 22 18 * n=464 9 35 28 25 2 n=129 65 & older: 29 Thinking about all the times you’ve gone on the Internet to look for health or medical information, ... longer-term, Internet- based outreach effor ts m ay p rove to be more effec tive as baby boomers age onto M e d i c a re If we are to take advantage of the potential t h e I nte r n e t offers as a useful tool for seniors, then healt h p rov i d e r s, advocates and the entire public health comm u n i t y w i l l need to reach out to seniors and work with th e m to ensure that the information and tools they... in Question 2 and 3 15 e -health_ and the elderly_toplines 4 Now, I’d like to ask you about some specific sources you might use to get information about health problems or issues that are important to you Please tell me how much information about these kinds of issues you generally get from each of the following sources First, what about… (INSERT – READ AND RANDOMIZE)? (READ FOR FIRST ITEM THEN AS NECESSARY)... member about health information you found online Changed your own behavior because of health information you saw online Made a decision about how to treat an illness or condition because of information you found online Visited a doctor or other health care provider because of information you found online 29 e -health_ and the elderly_toplines Question 29 continued Yes 46 53 * 50 50 * 65 & older: 34 65... for health information Online health seeker Not online health seeker Among Total Sample: 40 60 50-64: 53 47 65 & older: 21 79 Among Those Who Have Ever Gone Online: 75 25 50-64: 77 23 65 & older: 69 31 kaiser family foundation_january 2005 28 27 You mentioned having used the Internet to look for information about health- related issues How often do you use the Internet to look for any kind of health or... 6 65 & older: 11 89 0 n=190 Health insurance policies, such as Medigap or long term care insurance Now, please tell me if you have ever used the Internet to look for information about any of the following specific health problems or medical conditions (First/Next,) what about… (INSERT; READ AND RANDOMIZE)? READ AS NECESSARY: Have you ever used the Internet to look for information about this? Yes a . 2 00 5 e -Health and the Elderly: How Seniors Use the Internet for Health Information A C K N O W L E D G E M E N T S Res earch direc ted by and repor. t provides the first close look at how seniors use the Internet for he alth information – and how that may c hange in the years ahead as the baby boom