Examining Relationship between Discriminated Medical Care and Telehealth Use in The United States

Introduction: Discrimination in healthcare can lead to reduced trust in the system and reluctance to seek care. Telehealth and other digital health technologies may have the potential to reduce inequality and bias within the healthcare system since the virtual space may minimize the implicit social and cultural biases that can influence face-to-face interactions in the traditional in-person healthcare delivery settings. However, amidst a growing body of literature on how different racial and ethnic groups use telehealth services, the extent to which discrimination in medical care drives the use of telehealth in the United States has remained largely uncharacterized. We aimed to address this gap by examining the relationship between past experiences of racial or ethnic discrimination in healthcare and telehealth use in the United States. Methods and Findings: This study used the Health Information National Trend Survey (HINTS) cycle six as its primary data source. HINTS is a nationally representative survey conducted between March and November 2022. The analytic sample included 5437 participants 18 years of age and older. A logistic regression was used to examine the relationship between medical care discrimination and telehealth utilization among different racial/ethnic groups, controlling several potential confounders. The findings show that individuals who experienced racial or ethnic discrimination during medical care were more likely to report higher odds of telehealth use (odds ratio [OR]= 1.45, 95% CI= 1.03-2.05). Factors such as gender, education, health status, and age were also found to be associated with telemedicine utilization.                  Conclusions: The findings highlight the potential of telehealth in addressing racial discrimination in healthcare by offering an alternative to in-person care. However, given the potential for disparities in digital literacy and technology access to limit its impact, especially for socioeconomically disadvantaged groups, there is a need for targeted interventions to enhance digital literacy and expand healthcare access.