Work

“Willing but unable”: the generative logic and bridging pathways of the digital health divide among rural older adults in China

Year: 2026

Type: article

Abstract: Objectives: Widespread digital transformation in healthcare has led to serious digital exclusion among rural older adults. This study aims to explore the formation mechanisms of the rural digital health divide in China and propose targeted solutions to address this issue. Methods: This research adopted reflexive thematic analysis. We conducted in-depth interviews and participant observation with 105 older adults and 20 reference participants (15 adult children/relatives and 5 community workers) recruited from 12 administrative villages in Hubei Province to collect first-hand empirical data. Results: A typical paradox was identified: rural older adults demonstrate strong willingness and practical needs to use digital health tools, yet remain unable to access the full range of digital health services. The digital health divide is jointly shaped by three interrelated factors: individual physical and cognitive limitations, structural exclusion caused by inadequate digital health infrastructure, and intergenerational disconnection. Conclusion: Beyond simple individual and infrastructure logic, the rural digital health divide is a complex problem shaped by individual, structural and intergenerational contexts. Informed by spatial justice theory, this study puts forward a systematic optimization framework across physical, social and symbolic spatial dimensions, covering infrastructure upgrading, community capacity building and cultural adaptation. The research findings help eliminate access barriers to digital health services, build an inclusive digital health ecosystem, and promote health equity for rural older populations.

Source: Frontiers in Public Health

DOI: 10.3389/fpubh.2026.1907383

Authors: Yang Wang, Junli Liang, Zhendong Wu

Institutions: Hubei University of Technology, Wuhan University of Technology

Language: English

Topic: Technology Use by Older Adults

Subfield: Geriatrics and Gerontology

Field: Medicine

Domain: Health Sciences

SDGs: Reduced inequalities, Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801