Page 124 - IJPS-10-4

International Journal of
Population Studies Gender disparities in pandemic telehealth use

logistic regression models were employed to examine the 3.2. Gender differences in communication methods
gender differences in each communication method both with health-care providers
before and during COVID-19. The study also examined Table 2 presents the gender differences in the utilization
the mediating role of health variables in the relationship of various communication methods with health-
between gender and telehealth usage during the pandemic. care providers, accounting for covariates. Before the
In addition, logistic regression was utilized to calculate pandemic, the in-person visits for females were slightly
odds ratios (OR) to assess the association of various less than for males (OR = 0.93; 95% confidence interval
health, sociodemographic, and technology use factors [CI]: 0.58 – 1.47), but this difference was not statistically
with telehealth utilization within male and female groups. significant. While during COVID-19, the odds decreased
Statistical significance was set at a threshold of two-tailed, further (OR = 0.77; 95% CI: 0.60 – 1.00), reaching
with p < 0.05. All statistical analyses were conducted using statistical significance (p < 0.05). Moreover, slightly lower
the STATA software. odds of females had phone communication with the
3. Results providers (Before: OR = 0.95; 95% CI: 0.74 – 1.22, During:
OR = 0.88; 95% CI: 0.67 – 1.15), and slightly higher odds
3.1. Descriptive characteristics using social media or text compared to males in both
In Table 1, out of the total 3,257 participants, 1,370 (42.06%) periods (Before: OR = 1.12; 95% CI: 0.79 – 1.57, During:
were male and 1,887 (57.94%) were female. The median OR = 1.05; 95% CI: 0.77 – 1.44), but these differences were
age of the sample was 81.18 years, with an interquartile not statistically significant. In terms of telehealth use, the
range of 6.82. Among male participants, the majority odds of females were lower compared to males (OR = 0.87;
were White (78.39%), married/partnered (68.54%), had 95% CI: 0.49 – 1.55), with no significant outcomes before
completed college or above education (47.32%), reported COVID-19. However, there was a significant shift toward
a high income (25.91%), and experienced multimorbidity greater use of telehealth by females during the pandemic
(75.55%). In addition, 88.02% owned a cell phone, 75.24% (OR = 1.40; 95% CI: 1.02 – 1.91; p < 0.05).
owned a computer, and 47.81% owned a tablet. During the 3.3. The mediating effect of health characteristics
COVID-19 pandemic, 23.28% of male participants learned between gender and telehealth use
to use new technology.
Given the pivotal role of health in our study, we examined
For female participants, the majority were White whether health characteristics among older adults mediate
(74.09%), widowed (49.18%), had completed high school the relationship between gender and telehealth use during
(28.56%), reported the lowest income level (22.58%), and COVID-19. We first analyzed the mediating effect of
experienced multimorbidity (87.49%). In comparison multimorbidity while controlling for other covariates. The
to males, 84.57% of females owned a cell phone, 63.79% direct effect of female gender on telehealth use was non-
owned a computer, and 45.68% owned a tablet. In significant (β = 0.27; standard error [SE] = 0.17; p = 0.11).
addition, 26.71% of female participants learned to use Subsequently, the effect of gender on multimorbidity (β = 1.08;
new technology during COVID-19. Comparing the two SE = 0.17; p < 0.001) and the effect of multimorbidity on
genders, a significantly higher proportion of males owned telehealth use (β = 0.69; SE = 0.25; p = 0.005), were analyzed.
a working cell phone (p < 0.01) and a computer (p < 0.001). The Sobel test was conducted to assess the significance of the
Our study revealed that before COVID-19, the mediating effect. The test statistic was calculated to be 2.55,
primary methods of communication with health-care indicating a significant mediating effect of multimorbidity
providers among male older adults were in-person in the relationship between the female gender and the use
medical visits, followed by telephone calls. Only 23.68% of telehealth services (p < 0.05). The study also tested self-
used emails/texting/portal messages/social media, and rated health as a potential mediator but found no significant
the lowest proportion of the participants, 6.15%, used mediating effect.
video calls/telehealth. For female older adults, similar
to males, a small proportion, specifically 5.20%, utilized 3.4. Factors associations with telehealth use during
video calls/telehealth before the pandemic. During the COVID-19 pandemic by gender
the COVID-19 outbreak, in-person visits decreased Table 3 presents the associations between telehealth
by nearly 24% for males and 30% for females, while use during the COVID-19 pandemic and a range of
telephone calls, emails, texting, and portal messaging sociodemographic, health, and technology-related factors.
saw significant increases. Telehealth usage during the For males, those with multimorbidity (OR = 2.03; 95%
outbreak increased significantly to 23.45% for males and CI: 1.07 – 3.84), ownership of a tablet before COVID-19
24.57% for females. (OR = 1.89; 95% CI: 1.13 – 3.14), and those who learned

Volume 10 Issue 4 (2024) 118 https://doi.org/10.36922/ijps.1817