Online health information -seeking, health locus of control and health literacy among low -income Internet users in East Baltimore

Millions of Americans search for health information online every day. Although the majority of low-income individuals do not have Internet access, this population segment has been making great strides in crossing the Digital Divide in recent years. Little is known about the online health information-seeking (OHIS) behaviors of low-income Internet users. Results from the East Baltimore Internet Health Survey (EBIHS) and comparisons to the Pew Internet and American Life Project's Internet health survey are presented. Ninety-two percent of respondents were African American/Black. The median annual family income was ;Methods. The EBIHS is a community based participatory research interview study of 520 participants within the East Baltimore Empowerment Zone (EB-EZ), a majority low-income inner-city community. The street-intercept survey method and simple random cluster sampling were used. A survey team of trained community residents conducted the PalmRTM-based survey.;Results. One out of four participants reported using the Internet, while 71% of these Internet users reported seeking health information online. Several significant differences in the types of health information sought by low-income Internet users were identified. Discriminant analysis revealed that personal computer (PC) users were more likely to have higher levels of self-efficacy and education, be employed and have visited a doctor in the last 3 months. Internet users were more likely to report a higher level of education and self-efficacy, and lower values of chance health locus of control and perceived health competence. Online health information seekers were more likely to be female and to have greater levels of religiosity and perceived health competence.;Conclusions. Low-income people who use the Internet in the EB-EZ are not excluded from the large group in the United States who are using online health information to make decisions that influence their health. They often use the Internet in more intensive ways to meet their health needs (more online support groups, more online physician communication, and more follow-up discussion with a doctor or nurse). For the majority of low-income people in the EB-EZ with Internet access and the corresponding skills, the Internet plays a role in serving their healthcare information needs.