Rethinking the Digital Divide: Using an Internet Survey in a Flint Water Crisis Medicaid Population

J Health Care Poor Underserved. 2022;33(2):1054-1068. doi: 10.1353/hpu.2022.0080.

Abstract

This project examined the preferred mode of response (internet, phone, mail) to a health services survey. Data were collected via survey responses from a subsample of Flint Water Crisis Medicaid Expansion Waiver enrollees (N=2,584). Analyses were stratified by age, residency, race, and income. Chi-square tests were used to detect categorical differences. The majority of participants responded by internet (55.5%), followed by mail (39.4%), and phone (5.2%). Of those responding by internet, 75% used smartphones for connectivity. Black and White respondents used the internet at a greater rate than Hispanic respondents (p<.01). Respondents at 200% federal poverty level (FPL) or higher used the internet mode at greater rates than those below 200% FPL (p<.01). Our findings suggest greater internet use in a vulnerable population than expected, but the digital divide persists. In the advent of COVID-19, this finding can inform future health programming using digital communication and telehealth.

MeSH terms

  • COVID-19* / epidemiology
  • Digital Divide*
  • Humans
  • Internet
  • Medicaid
  • Surveys and Questionnaires
  • United States
  • Water

Substances

  • Water