November 26, 2013

The Diagnosis Difference

Forty-five percent of U.S. adults report that they live with one or more chronic conditions, such as high blood pressure, lung conditions, diabetes, heart disease, or cancer. They are more likely than other adults to be older, to have faced a medical emergency in the past year, and, as other studies have shown, to contribute to the explosion of health care costs in the U.S.1

In this study, the Pew Research Center explores how adults with chronic conditions gather, share, and create health information, both online and offline.

We provide evidence that many people with serious health concerns take their health decisions seriously—and are seriously social about gathering and sharing information, both online and offline.

72% of U.S. adults living with chronic conditions use the internet

People living with chronic conditions are significantly less likely than other adults to have internet access: 72%, compared with 89% of adults who report no chronic conditions.

This is partly tied to the fact that as a group they are older than the general population and have less education – both of which are associated with being offline. Still, the Pew Research Center has identified what we call a “diagnosis difference.” Holding other variables constant (including age, income, education, ethnicity, and overall health status), living with a chronic disease has an independent, negative effect on someone’s likelihood to use the internet.

Living with a chronic condition is independently associated with key health-related activities

If someone living with a chronic condition has access to the internet, however, the diagnosis difference is tied to certain online behaviors. When controlling for age, income, education, ethnicity, and overall health status, internet users living with one or more conditions are more likely than other online adults to:

  • Gather information online about medical problems, treatments, and drugs.
  • Consult online reviews about drugs and other treatments.
  • Read or watch something online about someone else’s personal health experience.

People living with chronic conditions are more likely than others to fact check with a medical professional what they find online

Thirty-one percent of U.S. adults living with chronic conditions say they have gone online specifically to try to figure out what medical condition they or someone else might have. They are more likely than other “online diagnosers” to talk with a clinician about what they find:

  • 60% of online diagnosers living with chronic conditions say they talked with a medical professional about the information they found online, compared with 48% of online diagnosers who report no conditions.
  • About half of online diagnosers living with chronic conditions say that a clinician confirmed their suspicions, either completely or in part. About one in five say that a clinician offered a different opinion.

Many of those tracking health indicators report it can have a significant impact

People living with chronic conditions are significantly more likely than other adults to track weight, diet, exercise, or health indicators like blood pressure, blood sugar, sleep patterns, or headaches. Eighty percent of adults living with two or more conditions do so, compared with 70% of those living with one condition and 61% of those who report no chronic conditions.

Trackers living with chronic conditions are also more likely than others to take formal notes, to track on a regular basis, and to share their notes with other people, particularly clinicians. Fully 72% of trackers living with chronic conditions say that keeping notes of any kind has had an impact on their health routine or the way they care for someone else, compared with 55% of trackers who report no conditions.

About this study

The results reported here come from a nationwide survey of 3,014 adults living in the United States. Telephone interviews were conducted by landline (1,808) and cell phone (1,206, including 624 without a landline phone). The survey was conducted by Princeton Survey Research Associates International. Interviews were done in English and Spanish by Princeton Data Source from August 7 to September 6, 2012. Statistical results are weighted to correct known demographic discrepancies. The margin of sampling error for the complete set of weighted data is ±2.4 percentage points. In this survey there are 1,498 respondents who are living with one or more chronic health conditions. Margin of error for results based on that group is ±3 percentage points.

The Pew Research Center is a nonprofit “fact tank” that provides information on the issues, attitudes and trends shaping America and the world. The Center is nonpartisan and takes no position on policy issues. Support for the Center is provided by the Pew Charitable Trusts.

Support for this study was provided by the California HealthCare Foundation, an independent philanthropy committed to improving the way health care is delivered and financed in California.

Additional analysis and editorial guidance was provided by Kristen Purcell and Lee Rainie.

An extensive appendix contains stand-alone analysis of each group included in the survey: the general population, adults living with high blood pressure, adults living with lung conditions, adults living with diabetes, adults living with heart conditions, adults living with cancer, and adults living with other chronic health conditions. Since one in five U.S. adults is living with two or more conditions, we cannot compare the groups.

  1. Hamilton Moses III, MD, et al. “The Anatomy of Health Care in the United States.” (Journal of the American Medical Association: November 13, 2013) Available at: http://jama.jamanetwork.com/article.aspx?articleid=1769890