Journal of Community Medicine & Public Health Care Category: Medical Type: Case Report
Online Health Information and Health Changes: A Gender Approach to Technology and Health Empowerment among Jewish Women in Israel
*Corresponding Author:Rita S Mano
Department Of Human Services, University Of Haifa, Haifa, Israel
Received Date: Aug 17, 2016 Accepted Date: Oct 21, 2016 Published Date: Nov 04, 2016
More and more people are seeking information about health issues on the internet, thus underscoring the importance of technology-embedded information regarding health concerns. In this study, we examine how gender affects the search for health information online and influences changes in health behavior. A total of 2008 individuals who returned questionnaires constituted an initial representative sample. Of these, 1406 (67.6%) were identified as internet users from the Jewish population (46.5% men and 53.5% women). Using a logistic regression analysis, we show that being a Jewish woman in Israel has (a) a significant impact on use of online health information and (b) a limited effect on health behavior. More specifically, we show that online health information induces positive changes regarding smoking and starting a diet among women. We conclude that gender is a motivating factor in the use of online health information but not necessarily in the initiation of health changes. The theoretical implication of the study is that the conceptual integration of a “gendered” perspective regarding online health information use with health empowerment offers a promising framework for testing the link between online health information and health behavior. The study’s practical applications for health management are highlighted as well, since women’s role as caregivers serves as a cornerstone for increased health promotion.
Internet use is constantly rising, and access to online health information is seen as an advantage in achieving health literacy and increasing health empowerment . Among internet users, women are reported as highly attracted to Online Health Information (hereafter OHI). In the US, nearly 56% of women used the internet for various purposes and 22.8% sought out health information, whereas only 17.4% of men visited health sites [2,3]. For women who do have technology skills, the Internet triggers a learning process and provides basic and often necessary information about health products and services thus increasing health empowerment. The current study focuses on the effect of gender variations in Online Health Information (hereafter OHI) and health changes among Israel’s Jewish population.In Israel, 75% of the Jewish population has access to the internet, and 62% of the population reported conducting internet health searches [4,5]. According to OECD reports , between 2000 and 2012 access to the Internet in Israel increased considerably, from 19.7% to 70.2%. This increase is higher than the increase in other industrial countries during the same period. In Canada, for example, the rate increased from 42.8% to 80.3%. In EU countries such as Germany and France, internet use increased from 18.4% in 2000 to 83.5% in 2012, while internet use in 2012 in Ireland reached 94.6% and in Sweden 91.69%. In general terms, Israel’s overall rate of internet access is lower than the median of 76.13% reported for the EU zone (28 countries). Since these differences may indicate variations between groups it is interesting to consider the extent to which health empowerment is a gender-specific process that affects OHI and health changes.The internet offers a wide range of options for men and women alike by providing immediate results for individuals seeking OHI. The technological and functional features of the internet enable individuals to find health information quickly and efficiently. Yet at the same time, a substantial number of studies have raised concerns that the “technology embedded” internet may affect women and additional social groups who may lack the necessary technical skills or just dislike using Computer-Mediated Communication (CMC) to seek information . Addressing the link between gender OHI and health changes is especially important because a large segment of Jewish women in Israel seeks to combine work responsibilities and career with the role of family caregiver [7-9]. At the same time, women have been shown to be quite selective in the scope of their internet use. They are likely to search diverse sites  and to use information in different ways  and for the benefit of various persons, including family and community members [12-14].In communication and sociological studies the concept of digital divide provides ample evidence for the existence of differences in access and use of internet sources. The “first level” of the digital divide, is caused by low technological skills [15,16] that stem from socioeconomic variations-gender, education, income, occupation and ethnicity. The “second level” digital divide effect  occurs when individuals from “weak” social groups fail to benefit from OHI information to improve their health literacy and this may affect their healthcare status [18,19] and health behaviors . In regard to women the “second level” digital divide is closely related to the “gendered” approach of technology [21,22] suggesting that the “masculinity” of technology on platforms generates “gendered” variations in internet access and use . Thus, women may be less willing to embrace health behaviors advocated by various health platforms and/or provided by health care providers .A “gendered” approach to women’s access to OHI may have important implications for the wellbeing of family and community members [14,25-27] who often rely on women’s roles as caretakers to take concrete steps towards better health routines, new health habits and health changes [28,29] increasing the level of Health Empowerment (hereafter HE). HE has many manifestations, including alleviating fears, tracing bothersome symptoms and increasing willingness to adopt new health habits [27,30,31] that can help generate health changes  and increase overall wellbeing among community members .The present study examines the link between OHI and women’s health empowerment. We draw upon a theoretical link between (a) health empowerment models [28,32] (b) the internet  and (c) gender studies [34,35]. We contend that variations in the OHI-HE relationship reflect the strain between basic assumptions of Health Empowerment (hereafter HE) theory and the “techno-feminism” approach [36,37]. HE theory suggests that women’s caregiving roles will be a strong motivator for using OHI and for incorporating health changes, whereas the techno-feminism approach suggests the emergence of gendered outcomes.
Gender and health changes
|No access to internet||Access to internet|
|Marital status (1=Married)||0.73||0.70|
|Number of children||3.65||2.80|
|Chronic illness (1=Yes)||0.34||0.68|
|The physician explained using language I could understand||3.94||4.11|
|The physician showed empathy for my complaints||4.24||4.35|
|The physician paid attention to my condition||4.19||4.26|
|The physician shared decisions about my condition with me||3.89||3.96|
|Satisfaction with health provider||0.12||0.03||0.01**|
|Adjusted R square||0.27|
|Change health routine||Start diet||Start physical activity||Stop smoking||Change physician||Ceased prescribed medication||Coping with chronic disease|
|Satisfaction with health provider||1||1||1||1.24||0.63||0.7||0.85|
Table 3: Logistic regression coefficients predicting health changes following OHI.
Individuals are using online health communication more and more but little research attention has been devoted to gender differences in the use of online health information and health behaviors. In this study we considered the extent to which gender affects the likelihood of health changes following access to online health information. We considered this possibility because women are often more involved in the health of their partners, children, larger family unit and community. We obtained our hypotheses from two opposing theories-health empowerment and a gendered approach to technology-in order to formulate the relationship between online health information and health changes among Jewish women in Israel. We assumed that women would be highly motivated to use online health information but that the technological difficulties inherent in the use of online devices might counterbalance the expected positive effect of health empowerment motivations. The results provide indeed evidence of a twofold effect.According to the health empowerment approach, being a woman should increase access to online health information  and hence positively affect health changes consequent to this information. These expectations were partially corroborated. The results support assumptions regarding the significance of health information to women, possibly because women seek to attend to parental, spousal, individual and community health concerns and hence are affected byte motivational aspects of health empowerment . Moreover, assessing the positive impact of being a woman on accessing online health information indicates that Jewish women in Israel have overcome the gendered technology barriers and achieved high levels of technology skills that enable them to access the internet and use OHI. We can thus conclude that gender in Israel is not a source of either first or second level digital divide effects in health  for the Jewish population.A less definitive picture emerges regarding health changes that are the behavioral outcome of health empowerment. The results indicate that people use online health information to implement health changes only to a certain extent. Being a female user of online health information positively affects only some health changes, i.e., diet and health habits, but not health changes related to health care, i.e., those involving changing medication and physicians. It is possible that while women are eager to learn more about health concerns via internet platforms, they may still feel reluctant to consider the use of the internet as an efficient means for activating health changes. The results indicate therefore that a gendered approach and the digital divide hypotheses is still a possibility for women’s health behaviors despite access to online health information and thus provide only a partial support of the health empowerment hypothesis .The contrasting findings support the notion that the internet is a valid arena for searching for health-related information and constitutes a major source of health empowerment for women in contributing to their own wellbeing and that of their family and community [6,29], though only to a certain extent [22,37]. The gendered approach may possibly explain why women who do search for health information online perceive of the internet as a “masculine” technology that precludes extensive use and prevents the behavioral translation of such information into comprehensive health-empowered behavior confirming recent studies  especially regarding the use of health services .Summarizing the study’s findings, we conclude that women’s ability to conduct such searches increases their knowledge and promotes their understanding of health-related details relevant to diagnoses and health habits. Yet, it does not provide sufficient motivation to initiate health-related changes, partly because additional socioeconomic factors as well as individual health conditions may act as blocking influences. Moreover, online health information cannot replace face-to-face consultations. Nonetheless, the internet can provide women with valuable health information and increase health literacy. In turn, health literacy can have a significant effect on health empowerment, which can then be applied in relevant situations among family and community members under women’s care. We accordingly propose that the link between gender and health behavior should address the discrepancy between a health empowerment approach and a gendered approach. An integrative approach considering the contextual variations presented in the Social Diversification Hypothesis [16,20] increases our theoretical and empirical potential to examine health-related behaviors within a broader social, demographic and possibly ethnicity-dependent environment because it enables to account for variations in the level of resources available to social groups and individuals.
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|General population||Internet users||Internet users for health|
|Income up to 4000 NIS||14.40%||13.90%||13.20%|
|Education high school (part)||15.50%||6.80%||5.60%|
|High school (full)||31.50%||33.10%||32.50%|
|Chronic condition (1=yes)||52.30%||46.10%||46.20%|
Appendix 1: Demographic profile of Internet users and Internet users for health purposes.
|Internet use||No internet use||Internet use||No internet use|
|Online health services for appointments||Online health services for updates|
Appendix 2: Distribution differences between Internet users and non-users of online health information and online services used for (a) making appointments and (b) updates.
Citation:Mano RS (2016) Online Health Information and Health Changes: A Gender Approach to Technology and Health Empowerment among Jewish Women in Israel. J Community Med Public Health Care 3: 023.
Copyright: © 2016 Rita S Mano, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.