Sociodemographic determinants of digital health literacy: A systematic review and meta-analysis
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INTRODUCTION: Differences in digital health literacy levels are associated with a lack of access to digital tools, usage patterns, and the ability to effectively use digital technologies. Although some studies have investigated the impact of sociodemographic factors on digital health literacy, a comprehensive evaluation of these factors has not been conducted. Therefore, this study sought to examine the sociodemographic determinants of digital health literacy by conducting a systematic review of the existing literature. METHODS: A search of four databases was conducted. Data extraction included information on study characteristics, sociodemographic factors, and the digital health literacy scales used. Meta-analyses for age and sex were conducted using RStudio software with the metaphor package. RESULTS: A total of 3922 articles were retrieved, of which 36 were included in this systematic review. Age had a negative effect on digital health literacy (B = -0.05, 95%CI [-0.06; -0.04]), particularly among older adults, whereas sex appeared to have no statistically significant influence among the included studies (B = - 0.17, 95%CI [-0.64; 0.30]). Educational level, higher income, and social support also appeared to have a positive influence on digital health literacy. DISCUSSION: This review highlighted the importance of addressing the digital health literacy needs of underprivileged populations, including immigrants and individuals with low socioeconomic status. It also emphasizes the need for more research to better understand the influence of sociodemographic, economic, and cultural differences on digital health literacy. CONCLUSIONS: Overall, this review suggests digital health literacy is dependent on sociodemographic, economic, and cultural factors, which may require tailored interventions that consider these nuances.
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Individual resources for the use of digital tools, such as digital health literacy, are unequally distributed along socioeconomic factors.
“At the same time, individual resources for the use of digital tools, such as digital health literacy, are unequally distributed along socioeconomic factors (Estrela et al., 2023), which may further exacerbate social differences in relation to health and healthcare.”
From Sociodemographics and Digital Health Literacy in Using Wearables for Health Promotion and Disease Prevention: Cross-Sectional Nationwide Survey in Germany (2025) · cites this paper as Estrela et al., 2023
A recent systematic review highlighted individual and social differences in digital health literacy: higher education, income, and social support are associated with higher digital health literacy, whereas older age is associated with lower levels of digital health literacy.
“However, a recent systematic review has highlighted individual and social differences in digital health literacy: Higher education, income, and social support are associated with higher digital health literacy, whereas older age is associated with lower levels of digital health literacy (Estrela et al., 2023).”
From Sociodemographics and Digital Health Literacy in Using Wearables for Health Promotion and Disease Prevention: Cross-Sectional Nationwide Survey in Germany (2025) · cites this paper as Estrela et al., 2023
Previous research has demonstrated associations between socioeconomic status and digital health literacy.
“Subjective social status was positively associated with DHLI scores, which was consistent with previous research that has demonstrated associations between general health literacy and socioeconomic status (Duong et al., 2017; Ishikawa et al., 2023; Sorensen et al., 2015), as well as between socioeconomic status and digital health literacy (Estrela et al., 2023; Jiang et al., 2025).”
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Estrela et al., 2023
Previous studies have reported mixed findings regarding the association between gender and digital health literacy.
“While previous studies have reported mixed findings regarding the association between gender and digital health literacy (Estrela et al., 2023; Jiang et al., 2025), male students exhibited higher DHLI scores in our total sample.”
From Digital health literacy and trust in health information sources: A comparative study of university students in Japan, the United States, and India (2025) · cites this paper as Estrela et al., 2023
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“Digital health literacy, or the individual’s ability to find, understand, appraise, and apply health information from electronic sources [68] is an emerging priority as people regularly interface with digital technology for health information.”
- Authors
- Estrela, M., Semedo, G., Roque, F., Ferreira, P. L., & Herdeiro, M. T.
- Affiliations
- University of Beira Interior (PT)
- University of Coimbra (PT)
- Corresponding author
- Estrela, Marta
- Venue
- International Journal of Medical Informatics
- Publisher
- Elsevier BV
- Published
- 2023-09
- Volume
- 177
- Pages
- 105124
- ISSN
- 1386-5056 (ISSN-L)
- OpenAlex
- W4380204422
- Cited by
- 414
- References
- 70
- Citations by year
- 2026: 178 · 2025: 164 · 2024: 64 · 2023: 8
- FWCI
- 21.30
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- International Journal of Medical Informatics (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by-nc-nd)
- Funders
- Fundação para a Ciência e a Tecnologia
- FCT NOVA
- Institute of Biomedicine, University of Aveiro
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Social Sciences › Demography › Technology Use by Older Adults
- Physical Sciences › Computer Science › Information Systems › Digital literacy in education
- Keywords
- digital health literacy, sociodemographic factors, age differences, sex differences, educational attainment, income, social support, older adults, socioeconomic status, immigrants, digital divide
- MeSH terms
- Aged, Health Status, Humans, Health Literacy
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