Broadband quality associated with mental health and digital-health equity in elderly people

As digital infrastructure becomes a more crucial part of the contemporary environment, research is looking at how this may correlate with the mental health of older people.

Over recent decades the rapid expansion of broadband coverage and broader internet access has transformed how we function in daily life, including how we access health information, health services, and other medical resources. However, the speed at which digital infrastructure has developed has not been even across the country, with some areas progressing faster than others - whether this is due to geographic region or socio-economic groups. For instance, 12% of rural households do not have access to basic broadband, whereas the number is only 2% in urban areas.

The older population (those aged 65 or over) is increasing across the United Kingdom, but is more concentrated in coastal and rural areas, the areas which tend to have lower levels of broadband coverage and poorer access to the internet. Therefore, this insufficient digital infrastructure could limit access to online health information, telehealth services, video communications and other digital support, all of which are becoming increasingly commonplace options. Alongside this, mental health challenges associated with the United Kingdom's ageing population shows that depression in those over 65 years is rising. By looking at data around antidepressant prescription use, mapped onto the United Kingdom, we can see that higher prescription rates are observed in the Northeast, the Midlands, parts of the Southwest and several coastal areas.

Using official Ofcom data our findings indicate that reliance on lower-quality broadband connectivity is associated with higher depression-related burden in older adults. Broadband quality may affect older adults not only through technical access, but also through pathways related to health-information seeking, telehealth access, online service use, video communication, and digitally mediated social support.

One of the core conceptual contributions of our study is the digital quality gradient framework. This framework moves beyond the binary distinction between being connected and unconnected by considering broadband quality as an ordered spectrum from low-speed (< 30 Mbps) to medium-speed (30-300 Mbps), high-speed (≥ 300 Mbps), gigabit availability, and observed download and upload performance.

Low-speed connections below 30 Mbps worsens depression-related burden for older adults, whereas higher-quality broadband connectivity aids their mental health through protective-direction associations. This pattern suggests that the quality and performance of the internet infrastructure may be more informative than access alone for older adults in low-social-status areas.

The study suggests digital-health equity should consider broadband quality, not simply access, and encourages digital infrastructure to be planned together with the conventional built-environment and service-access, as broadband quality can improve access to support and information.

"Digital Quality Gradient and the Burden of Elderly Depression: A Spatial Multi kernel SVR Analysis of Socio economically Vulnerable Groups in England ", by Rui, Li, Menendez and Pinto da Costa, was published in Digital Health.