Renahy Emilie, Parizot Isabelle, Chauvin Pierre
INSERM, U707, Research Team on the Social Determinants of Health and Healthcare, Paris, F-75012, France.
BMC Public Health. 2008 Feb 21;8:69. doi: 10.1186/1471-2458-8-69.
The Internet is a major source of information for professionals and the general public, especially in the field of health. However, despite ever-increasing connection rates, a digital divide persists in the industrialised countries. The objective of this study was to assess the determinants involved in: 1) having or not having Internet access; and 2) using or not using the Internet to obtain health information.
A cross-sectional survey of a representative random sample was conducted in the Paris metropolitan area, France, in the fall of 2005 (n = 3023).
Close to 70% of the adult population had Internet access, and 49% of Internet users had previously searched for medical information. Economic and social disparities observed in online health information seeking are reinforced by the economic and social disparities in Internet access, hence a double divide. While individuals who reported having a recent health problem were less likely to have Internet access (odds ratio (OR): 0.72, 95% confidence interval (CI): 0.53-0.98), it is they who, when they have Internet access, are the most likely to search for health information (OR = 1.44, 95% CI = 1.11-1.87).
In the French context of universal health insurance, access to the Internet varies according to social and socioeconomic status and health status, and its use for health information seeking varies also with health beliefs, but not to health insurance coverage or health-care utilisation. Certain economic and social inequalities seem to impact cumulatively on Internet access and on the use of the Internet for health information seeking. It is not obvious that the Internet is a special information tool for primary prevention in people who are the furthest removed from health concerns. However, the Internet appears to be a useful complement for secondary prevention, especially for better understanding health problems or enhancing therapeutic compliance.
互联网是专业人士和普通大众获取信息的主要来源,尤其是在健康领域。然而,尽管网络连接率不断提高,但工业化国家中数字鸿沟依然存在。本研究的目的是评估以下方面的决定因素:1)是否能够接入互联网;2)是否使用互联网获取健康信息。
2005年秋季在法国巴黎大区对具有代表性的随机样本进行了横断面调查(n = 3023)。
近70%的成年人口能够接入互联网,49%的互联网用户曾搜索过医疗信息。在获取在线健康信息方面观察到的经济和社会差异,因互联网接入方面的经济和社会差异而加剧,因此形成了双重鸿沟。虽然报告近期有健康问题的个体接入互联网的可能性较小(优势比(OR):0.72,95%置信区间(CI):0.53 - 0.98),但在接入互联网的情况下,他们最有可能搜索健康信息(OR = 1.44,95% CI = 1.11 - 1.87)。
在法国全民医疗保险的背景下,互联网接入情况因社会、社会经济地位和健康状况而异,其用于获取健康信息的情况也因健康观念而有所不同,但与医疗保险覆盖范围或医疗保健利用情况无关。某些经济和社会不平等似乎对互联网接入以及利用互联网获取健康信息产生累积影响。对于那些最不关注健康问题的人来说,互联网是否是初级预防的特殊信息工具并不明确。然而,互联网似乎是二级预防的有用补充,特别是对于更好地理解健康问题或提高治疗依从性。