The social distribution of digital health literacy in UK adults

Abstract Aim Digital health literacy (DHL) is increasingly central to accessing care in health systems undergoing rapid digital transformation. While socio-demographic gradients in DHL have been widely reported, nationally weighted modelling within specific health system contexts remains limited. This study examined the social distribution of DHL and identified population subgroups at increased risk of digital exclusion among UK adults. Methods Secondary analysis was conducted using data from a nationally weighted cross-sectional online survey of 973 UK adults aged 16–75 years (IPSOS omnibus panel, March 2023). DHL was measured using an adapted eHealth Literacy Scale. Descriptive and univariable analyses were performed. Generalised linear modelling (GLM) estimated independent socio-demographic associations with DHL scores. Classification and regression tree (CART) analysis identified intersectional clusters of vulnerability. Results Although most participants reported confidence in using online health resources, 31% reported difficulty distinguishing reliable from unreliable information. Adjusted analyses demonstrated clear socio-demographic gradients. Working-age adults had higher DHL scores than pension-age adults (B = 0.93, 95% CI: 0.26–1.60), and males had lower scores than females (B = − 0.68, 95% CI: − 1.20 to − 0.16). Higher DHL was also associated with upper social grade and mid-level household income. CART analysis identified older adults with lower education and lower social grade as the most vulnerable subgroup. Conclusions Digital health literacy in the UK is socially patterned and reflects broader structural inequalities. As health systems embed digital pathways into routine care, population-level monitoring and targeted equity-oriented strategies are required to prevent digital transformation from exacerbating existing health disparities.