Abstract 4363388: Digital Divide: Who Tracks Their Steps or Heart Rate?

Abstract

Background: Wearable devices that track health indicators are increasingly recognized as valuable tools in preventing cardiovascular diseases by facilitating self-monitoring and engagement in heart-healthy behaviors. However, disparities in utilization persist, raising concerns about equitable adoption. Objective: To investigate sociodemographic disparities in wearable device use, focusing on independent and interactive effects of race/ethnicity, income and education. Methods: We conducted a cross-sectional analysis of the 2022 Health Information National Trends Survey. The primary outcome was self-reported use of wearable devices in the past months to track physical activity or health-related metrics. Key exposures included race/ethnicity, income and education. We used multivariable survey-weighted logistic regression models to estimate adjusted odds ratios (AORS) with 95% confidence intervals (CIs), with education as a covariate. The Rao-Scott adjusted likelihood ratio test evaluated the interaction between race/ethnicity and income. Statistical analyses were conducted in R (version 4.5.0), employing the "svyglm" function with a quasibinomial family specification. Results: Among 5,486 U.S adults surveyed, 29.7% reported using a wearable device in the past 12 months to track physical activity or health indicators. After adjusting for education and covariates, Non-Hispanic Black adults had significantly lower odds of wearable device use compared to Non-Hispanic Whites (AOR 0.74; 95% CI, 0.63 -0.88), as did Hispanic adults (AOR 0.85; 95% CI, 0.72-0.99). Individuals with incomes >400% of the federal poverty level were more than twice as likely to use wearables than those below 100% FPL (AOR 2.33; 95% CI, 1.89 – 2.86). College graduates had higher odds of wearable use than those with less than a high school education (AOR 2.46; 95% CI, 1.89 – 3.19). A significant interaction was observed between race/ethnicity and income (Rao-Scott likelihood ratio test, p = 0.041). Stratified contrasts suggested that income-related increases in use were more substantial among non-Hispanic White adults than non-Hispanic Black or Hispanic individuals, suggesting a compounded disparity by race and socioeconomic status. Conclusion: Despite the promise of wearable devices, findings point to persistent and intertwined racial and socioeconomic gaps in use. These disparities are not merely statistical; they represent missed opportunities for early intervention in vulnerable populations.