Characteristics associated with use of public and private web sites as sources of health care information: Results from a national survey

OBJECTIVE: We sought to determine the frequency with which Americans access health information from governmental (public sector) and nongovernmental (private sector) web sites and to identify similarities and differences in the characteristics associated with use of each type. METHODS: Data derive from 928 individuals who responded to a November 2005 national survey. In addition to forms of health communication, we asked about age, gender, race, income, education, insurance, lifestyle, residence, satisfaction, literacy, and health. We report the extent of web site use stratified by sponsorship type-public and private. We also use χ² tests to examine bivariate associations. Logistic regression and multiple imputation of missing data were used to examine the correlates of use in a multivariate context. RESULTS: More than twice as many respondents visited private web sites (29.6%) than public web sites (13.2%). However, just 23.6% and 18.9% of private and public web site visitors, respectively, reported doing so once a month or more. Both public and private web site visitors were more likely to be better-educated respondents (odds ratio [OR] = 0.83, OR = 1.57) reporting greater concerns about health care access (OR = 1.28, OR = 1.20) than nonvisitors. Younger individuals (OR = 0.83) living in urban areas (OR = 1.59) with stronger health literacy (OR = 1.24) and reporting greater concerns about health care affordability (OR = 1.59) were more likely to visit privately sponsored web sites but nonpublicly sponsored ones. CONCLUSION: Relatively low utilization levels necessitate a concerted effort to improve the quality, accessibility, and relevance of Internet health information. Efforts to close the digital divide must recognize differences in user characteristics across governmental and nongovernmental web site providers.