Smartphone Access and Health-Related Mobile Phone Use in a Low-Income Urban Community in Delhi, India: A Cross-Sectional Study

Background Smartphone penetration in India has grown rapidly, expanding the potential reach of mobile health (mHealth). However, device access does not by itself ensure meaningful health-related use, and this gap is often greater in low-income urban communities where literacy, language, and usability barriers persist. We assessed health-related mobile phone use and its determinants among adults in a low-income urban resettlement community of North-East Delhi. Methods A community-based cross-sectional study was conducted between November and December 2025 among adults aged ≥18 years residing in a low-income resettlement colony in North-East Delhi. Households were selected through simple random sampling from a verified line list, and one eligible adult per household was enrolled using the Kish grid method. Data were collected through interviewer-administered questionnaires (English and Hindi) at the participants’ homes. The primary outcome was any self-reported health-related mobile phone use in the preceding six months. Bivariate and multivariable binary logistic regression were used to identify independent predictors. Results Of 320 participants, 99.1% had access to a mobile phone and 95.6% of those with access used a smartphone. Health-related mobile phone use in the preceding six months was reported by 39.1% (95% CI: 33.7–44.7) of participants with access. Activity was concentrated in information seeking (30.6%); use of structured digital health functions, including teleconsultation (8.2%), appointment booking (10.1%), and health applications (7.9%) was substantially lower, and no participant reported using electronic medical records, government mHealth applications, or symptom-tracking tools. In the adjusted model, higher educational attainment (graduate or above vs. primary or less: aOR 6.12, 95% CI: 1.59–23.6; p = 0.008) and comfort reading English (aOR 4.89, 95% CI: 2.51–9.53; p < 0.001) were independently associated with health-related mobile phone use. Conclusions In this low-income urban setting, smartphone access was near-universal but health-related use was modest and largely confined to information seeking. Education and English-reading comfort were the principal independent determinants, indicating that the contemporary barrier to digital health adoption is skills, language, and usability rather than device availability. Findings rely on self-reported use and should be interpreted accordingly. Digital health programmes should prioritise vernacular-first design, simplified workflows, and assisted-use models to deliver equitable benefit.