Association between Health-Related Social Needs and Telehealth Use Among Adults with Type 2 Diabetes: The 2022 Health Information National Trends Survey

Background: Digital health can improve outcomes for adults with type 2 diabetes (T2D).Use of digital health tools, however, varies considerably across different patient populations. How health related social needs (HRSN) impact digital health use among adults with T2D is largely unknown. Methods: Data from the 2022 Health Information National Trends Survey were analyzed to investigate the association between HRSN and digital health use among American adults with T2D. HRSN variables of interest included self-reports of food insecurity, housing instability, and transportation challenges. Primary outcomes of digital health use included self-reported use of telehealth and patient portals during the previous year. Multivariate logistic regression analysis was used to estimate the association between HRSN and digital health use while controlling for age, sex, and race. Results: Among 1,304 adults with T2D (mean age 62.4 years, 56.4% women), 18.2% reported food insecurity, 12.6% housing instability, and 15.4% transportation challenges. In this study population, 47.8% reported telehealth use, and 56.1% reported portal use in the past year. Food insecurity was associated with increased telehealth use (OR 1.91, 95% CI 1.12–3.27) as were , individuals with housing and transportation challenges more likely to use telehealth. While individuals with T2D with all three HRSN were less likely to use the patient portal, none of these associations reached statistical significance after adjusting for age, sex, and race. Conclusion: In this study of U.S. adults with T2D, differential relationships between HRSN and digital health use were observed. The higher telehealth utilization among individuals with health-related social needs may suggest that it is more of an essential digital health tool than the patient portal is for persons who experience HRSN.