Digital divides in telehealth accessibility for cancer care in the United States
Abstract Telehealth has been promoted as a solution to spatial healthcare access barriers, yet its role in addressing cancer care disparities remains uncertain, particularly in the context of digital divides in broadband availability and affordability. This study assessed spatial and telehealth acce...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-08-01
|
| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-025-01931-5 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849225923422846976 |
|---|---|
| author | Lingbo Liu Tracy Onega Erika L. Moen Anna N. A. Tosteson Rebecca E. Smith Qianfei Wang Lauren Cowan Fahui Wang |
| author_facet | Lingbo Liu Tracy Onega Erika L. Moen Anna N. A. Tosteson Rebecca E. Smith Qianfei Wang Lauren Cowan Fahui Wang |
| author_sort | Lingbo Liu |
| collection | DOAJ |
| description | Abstract Telehealth has been promoted as a solution to spatial healthcare access barriers, yet its role in addressing cancer care disparities remains uncertain, particularly in the context of digital divides in broadband availability and affordability. This study assessed spatial and telehealth accessibility to cancer care across 33,499 ZIP Code Tabulation Areas (ZCTA) in the United States using the two-step floating catchment area (2SFCA) and two-step virtual catchment area (2SVCA) methods, respectively. Incorporating physician locations, cancer incidence, travel time based on transportation networks, and broadband coverage and subscription rates, we found that accessibility declined from urban to rural areas and was lower in ZCTA with greater socioeconomic deprivation. Areas with higher proportions of Black and Hispanic populations showed modestly higher access scores, yet a three-way interaction among rurality, deprivation, and racial ethnic composition revealed compounded disadvantages. Telehealth reduced but did not eliminate these gaps, highlighting how its reliance on digital infrastructure may both alleviate and intensify disparities in cancer care access. |
| format | Article |
| id | doaj-art-883173cff64b4db58da363002e78f6f6 |
| institution | Kabale University |
| issn | 2398-6352 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj-art-883173cff64b4db58da363002e78f6f62025-08-24T11:51:59ZengNature Portfolionpj Digital Medicine2398-63522025-08-018111110.1038/s41746-025-01931-5Digital divides in telehealth accessibility for cancer care in the United StatesLingbo Liu0Tracy Onega1Erika L. Moen2Anna N. A. Tosteson3Rebecca E. Smith4Qianfei Wang5Lauren Cowan6Fahui Wang7Center for Geographic Analysis, Harvard UniversityHuntsman Cancer Institute, University of UtahDepartment of Biomedical Data Science, Geisel School of Medicine at DartmouthThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at DartmouthThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at DartmouthThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at DartmouthHuntsman Cancer Institute, University of UtahDepartment of Geography and Anthropology, Louisiana State UniversityAbstract Telehealth has been promoted as a solution to spatial healthcare access barriers, yet its role in addressing cancer care disparities remains uncertain, particularly in the context of digital divides in broadband availability and affordability. This study assessed spatial and telehealth accessibility to cancer care across 33,499 ZIP Code Tabulation Areas (ZCTA) in the United States using the two-step floating catchment area (2SFCA) and two-step virtual catchment area (2SVCA) methods, respectively. Incorporating physician locations, cancer incidence, travel time based on transportation networks, and broadband coverage and subscription rates, we found that accessibility declined from urban to rural areas and was lower in ZCTA with greater socioeconomic deprivation. Areas with higher proportions of Black and Hispanic populations showed modestly higher access scores, yet a three-way interaction among rurality, deprivation, and racial ethnic composition revealed compounded disadvantages. Telehealth reduced but did not eliminate these gaps, highlighting how its reliance on digital infrastructure may both alleviate and intensify disparities in cancer care access.https://doi.org/10.1038/s41746-025-01931-5 |
| spellingShingle | Lingbo Liu Tracy Onega Erika L. Moen Anna N. A. Tosteson Rebecca E. Smith Qianfei Wang Lauren Cowan Fahui Wang Digital divides in telehealth accessibility for cancer care in the United States npj Digital Medicine |
| title | Digital divides in telehealth accessibility for cancer care in the United States |
| title_full | Digital divides in telehealth accessibility for cancer care in the United States |
| title_fullStr | Digital divides in telehealth accessibility for cancer care in the United States |
| title_full_unstemmed | Digital divides in telehealth accessibility for cancer care in the United States |
| title_short | Digital divides in telehealth accessibility for cancer care in the United States |
| title_sort | digital divides in telehealth accessibility for cancer care in the united states |
| url | https://doi.org/10.1038/s41746-025-01931-5 |
| work_keys_str_mv | AT lingboliu digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT tracyonega digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT erikalmoen digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT annanatosteson digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT rebeccaesmith digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT qianfeiwang digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT laurencowan digitaldividesintelehealthaccessibilityforcancercareintheunitedstates AT fahuiwang digitaldividesintelehealthaccessibilityforcancercareintheunitedstates |