AUTHOR=Zhang Chi , Hou Jiayu , Zhang Hengyuan 

TITLE=Bridging the silver–digital divide: how digital literacy shapes diverse healthcare utilisation among China’s older adults—a cross-sectional study in seven Chinese cities

JOURNAL=Frontiers in Public Health

VOLUME=Volume 13 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2025.1577231

DOI=10.3389/fpubh.2025.1577231

ISSN=2296-2565

ABSTRACT=BackgroundAs of December 2023, China’s population aged 60 and above reached 296.97 million, accounting for 21.1% of the total population. The convergence of an aging society and a digital society presents significant challenges for older adults, particularly in terms of digital inclusion and access to healthcare. This study investigates the impact of digital literacy on the consumption of healthcare services among older adults in China and explores the underlying mechanisms involving social support and technology acceptance.MethodsData from 1,107 valid questionnaires from adults aged 60 and above were analyzed. Digital literacy was assessed using a unidimensional 10-item scale developed for this study. Healthcare service consumption was measured using a validated 8-item scale covering two dimensions: therapeutic and preventive services. Data analysis employed OLS regression, mediation, and moderation models. This study adopted a cross-sectional design with two independent waves of surveys (2019 and 2022) to avoid repeated sampling of the same individuals.ResultsDigital literacy demonstrated a significant positive effect on the consumption of healthcare services among older adults (p < 0.01), encompassing both therapeutic and preventive services. Age, urban residence, and education level were also significant positive predictors. Both formal and informal social support were identified as significant mediators in this relationship, with informal support exhibiting a stronger mediating effect. Specifically, digital literacy was positively associated with overall healthcare utilisation (β = 0.218, 95% CI: 0.182–0.254, p < 0.01), therapeutic services (β = 0.182, 95% CI: 0.145–0.219, p < 0.01), and preventive services (β = 0.265, 95% CI: 0.223–0.307, p < 0.01).ConclusionEnhancing digital literacy is a crucial strategy for promoting healthcare service utilisation among older adults in an increasingly digitalized society. Policymakers should prioritize improving digital literacy and integrating digital technology into social support systems. Fostering technology acceptance can further amplify these positive effects. This study provides empirical evidence for understanding the role of digital literacy in healthcare consumption and offers valuable insights for policy development. Limitations include the small sample size relative to China’s total older population (n = 1,107) and limited geographical coverage (only seven cities), which may restrict the generalisability of findings to remote rural or megacity areas.