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Online older adults do a better job of managing their health

How did we get people to quit smoking? Do you remember the early days when 'Smoking is bad for your health' ads (based on published research) emerged? In the 1960s, 44% of adults smoked. I thought of the research-based ads this week when Pew Research released an enormous report (94 pages) called The Diagnosis Difference, funded by the California Healthcare Foundation. In its many pages, the report makes two key points: 1) People with chronic diseases are less likely to have Internet access than those without chronic diseases --72% versus 89%, thus described as the "17-point difference." 2) Those with chronic diseases who are online use the Internet to find information as well as other people who share their chronic disease(s).  And – one more thing – 43% of the 65+ surveyed had two or more chronic conditions. Now you know, but what should you do?

If these points seem familiar, it is because they are familiar.  Recent other Pew points include the fact that 53% of the 65+ are online. So let’s just remember that, per Pew, 47% of the 65+ are NOT online. Therefore they would not likely be searching for health-related data or perusing sites like PatientsLikeMe. In previous health-related reports – including their January, 2013 Health Online research -- Pew revealed that online information seekers were likelier to be younger, whiter, wealthier, and better educated. And the previous Pew report, nearly 12 months old, had a disclaimer: "This study was not designed to determine whether the internet has had a good or bad influence on health care." The new report,  with its 17-point difference, draws the connection, but does not assert causality.

Must we infer what is actionable? Get everyone online. Poorer, older and less educated adults are more likely to have chronic diseases. And they are less likely to be online. What if those who are offline went online – to help them get facts about their condition, prepare them to discuss that data with their doctor, and last but not least, look for others who share their chronic disease(s)? This has been said so many times, many ways. Despite the connection, it’s nobody’s national task to get older adults online to better manage their health -- especially if the aged 65+ population that suffers from two or more chronic diseases is secretly 75+. We know and bemoan the cost of getting online. We know and lament the learning curve. We are aware of available training sources. Life’s good -- but it is best for those who can afford devices, spend on associated access costs and receive appropriate training -- both initially and ongoing.

Back to smoking – guess what, it’s down.  Forty-four percent of adults in the 1960's smoked. Now it’s closer to 20%. That change seems a direct result of banning smoking in public places, advertising adverse effects, educating the young, boosting cigarette taxes, and broadcasting repeated anti-smoking campaigns. Back to the Pew report.  If there is a connection -- those online will better manage chronic diseases -- won't they also have lower health care costs? Let's see a national "Online for Health" campaign that factors in the health-related benefits. Leverage the younger to train the older, slash the cost of high bandwidth connection, and run advocacy campaigns until the desired result is obtained. Social media use has tripled among the 65+. Now is the time for the campaign -- Online for Health. In 2015, it will be a decade since the last White House Conference on Aging. As the oldest baby boomers approach 70 -- getting all online by 2015 is well-timed. 


On the issue of chronic disease and aging...I see people in the clinic with 30 SEPARATE co-morbidies--none cured, only managed over long periods of time at great expense. People now know what they will die of 20 years in advance...

Being online and having access to health information--at any age, is only part of the answer. We have so much health related information (we are awash in it) and yet our chronic disease states like obesity continue to plague us as a society. The real key to all this is self-efficacy and locus of control; without these in place older adults will not seek Internet access--and dare I say, not seek health either. So are we extending health? or are we extending life? They are not the same. This all begins in the mind--then follows in the physical...and when I say mind, I mean self-efficacy/locus of control. Do seniors have a self-efficacy/locus of control that facilitates healthy behavior, which includes learning how to use technology and searching information online?