Digital Health Inequalities Among Immigrants in the United States: An Intersectional Analysis Using Nationally Representative Survey Data

The rapid expansion of digital health during COVID-19 transformed healthcare delivery, offering new opportunities for remote care. However, health access remains inequitable, with barriers such as technology access, language barriers, and financial constraints disproportionately affecting immigrants and marginalized populations. This study applied an intersectional approach to examine digital health utilization trends by immigration status and key sociodemographic factors. This study analyzed nationally representative data from the 2021-2023 National Health Interview Survey (NHIS) for adults (N = 83,116). Immigration status was cross-classified with race/ethnicity, gender, marital status, education, income, health insurance, chronic conditions, and rural residency. Weighted logistic regression models examined disparities and moderation effects. While digital health utilization generally declined post-pandemic with increased access to in-person care, disparities across populations persisted. While naturalized immigrants had similar odds of digital health use compared to U.S.-born individuals, noncitizen immigrants had significantly lower odds. The findings also reveal noncitizen immigrants, particularly those with lower income, no insurance, and living in rural areas, face significant barriers in accessing digital health services. These disparities highlight the need for targeted policies to ensure equitable access to digital health resources for immigrant populations.