Objectives: Little is known about the use of electronic health (eHealth) services supported by information technology in the United States among immigrants, a group that faces barriers in accessing care and, consequently, disparities in health outcomes. We examined differences in the use of eHealth services in the United States by immigration status in a nationally representative sample. Methods: We used data from the 2011-2015 National Health Interview Survey to assess use of eHealth services among US natives, naturalized citizens, and noncitizens. Our outcome variable of interest was respondent-reported use of eHealth services, defined as making medical appointments online, refilling prescriptions online, or communicating with health care professionals through email, during the past 12 months. We analyzed use of eHealth services, demographic characteristics, socioeconomic status, and health status among all 3 groups. We used multivariate logistic regression models to examine the association between immigration status and the likelihood of using eHealth services, adjusting for individual demographic, socioeconomic, and health characteristics. Results: Among 126 893 US natives, 18 763 (16.1%) reported using any eHealth services in the past 12 months, compared with 1738 of 15 102 (13.0%) naturalized citizens and 1020 of 14 340 (7.8%) noncitizens. Adjusting for socioeconomic factors reduced initial gaps: naturalized citizens (adjusted odds ratio [aOR] 1/4 0.81; 95% confidence interval [CI], 0.75-0.87) and noncitizens (aOR 1/4 0.81; 95% CI, 0.72-0.90) had approximately 20% lower odds of using eHealth services than did US natives. However, the differences varied by type of eHealth service. Immigrants with higher English-language proficiency were more likely to use eHealth services than were immigrants with lower English-language proficiency. Conclusions: Targeted interventions that reduce socioeconomic barriers in accessing technology and promote multilingual electronic portals could help mitigate disparities in use of eHealth services. © 2018, Association of Schools and Programs of Public Health All rights reserved.

minority health Immigrant language barriers disparities Ehealth services

immigrant minority health telehealth English (language) indigenous people e-mail human immigration middle aged statistics and numerical data controlled study health status Aged Logistic Models Health Surveys interview prescription United States Young Adult social status migrant Humans Adolescent male Emigrants and Immigrants female Socioeconomic Factors socioeconomics Article adult human experiment outcome variable statistical model Facilities and Services Utilization Telemedicine Health Services Accessibility public health health care delivery health survey