Unequal Access, Uneven Progress: Socioeconomic and Demographic Divides in Healthcare Digitalization
Date of Award
Fall 2025
Document Type
Dissertation
Degree Name
Doctor of Healthcare Administration (DHA)
Committee Chair
Alyncia Bowen
Committee Member
Ronald Bucci
Committee Member
Larry Hughes
Abstract
Digital health technologies hold substantial promise to transform care, enhance patient engagement, and reduce health disparities. Yet, unequal access threatens to deepen existing inequities. Guided by the Digital Divide framework and the Unified Theory of Acceptance and Use of Technology (UTAUT) model, this dissertation investigates how socioeconomic and demographic factors influence health information technology (HIT) engagement across three stages: desire to use, actual access, and intention for sustained adoption. A cross-sectional survey of 389 adult patients from a large urban primary care clinic assessed demographics, technology attitudes, and HIT engagement behaviors using an 18-item instrument survey administered in both electronic and paper formats.
Data were analyzed using Pearson’s ¿² tests, bivariate correlations, ANOVA, and multivariate techniques. Traditional demographic factors – gender, age, education, and employment – showed no significant association with HIT access or adoption intent. Satisfaction with income modestly predicted adoption intent, while social influence from close ties and lower technology anxiety were positively linked to desire and access. Employment status marginally influenced expectations for HIT use.
Findings indicate that socioeconomic context, supportive social networks, and emotional readiness, rather than traditional demographic factors, play pivotal roles in shaping HIT engagement. Interventions that enhance financial stability, leverage social encouragement, and reduce technology anxiety may enhance both initial uptake and sustained use of digital health tools, promoting equitable participation in the evolving digital health landscape.
Recommended Citation
Jackson, Latoya Marteisha, "Unequal Access, Uneven Progress: Socioeconomic and Demographic Divides in Healthcare Digitalization" (2025). All Doctoral Student Dissertations. 240.
https://fuse.franklin.edu/docpub/240
