pew internet health online report

7/29/2019 Pew Internet Health Online Report

1/55

JANUARY15,2013

Health Online 2013

35% of U.S. adu lts have gone online to figure out a m edical condition; of

these, half follow ed up w ith a visit to a m edical professional

SusannahFoxAssociateDirector,PewInternetProject

MaeveDugganResearchAssistant,PewInternetProject

PewResearchCentersInternet&AmericanLifeProject1615LSt.,NWSuite700Washington,D.C.20036Phone:2024194500

http://pewinternet.org/Reports/2013/Healthonline.aspx


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Summary of Findings

One in three American adults have gone online to figure out a medical

condition

ThirtyfivepercentofU.S.adultssaythatatonetimeoranothertheyhavegoneonlinespecificallytotry

tofigureoutwhatmedicalconditiontheyorsomeoneelsemighthave.

ThesefindingscomefromanationalsurveybythePewResearchCentersInternet&AmericanLife

Project.Throughoutthisreport,wecallthosewhosearchedforanswersontheinternetonline

diagnosers.

Whenaskediftheinformationfoundonlineledthemtothinktheyneededtheattentionofamedical

professional,46%ofonlinediagnoserssaythatwasthecase.Thirtyeightpercentofonlinediagnosers

sayitwassomethingtheycouldtakecareofathomeand11%sayitwasbothorinbetween.

Whenweaskedrespondentsabouttheaccuracyoftheirinitialdiagnosis,theyreported:

41%ofonlinediagnoserssayamedicalprofessionalconfirmedtheirdiagnosis.Anadditional2%

sayamedicalprofessionalpartiallyconfirmedit.

35%saytheydidnotvisitacliniciantogetaprofessionalopinion.

18%saytheyconsultedamedicalprofessionalandtheclinicianeitherdidnotagreeoroffereda

differentopinionaboutthecondition.

1%saytheirconversationwithaclinicianwasinconclusive.

Womenaremorelikelythanmentogoonlinetofigureoutapossiblediagnosis.Othergroupsthathave

ahighlikelihoodofdoingsoincludeyoungerpeople,whiteadults,thosewholiveinhouseholdsearning

$75,000ormore,andthosewithacollegedegreeoradvanceddegrees.

Itisimportanttonotewhatthesefindingsmeanandwhattheydontmean.Historically,peoplehave

alwaystriedtoanswertheirhealthquestionsathomeandmadepersonalchoicesaboutwhetherand

whentoconsultaclinician.Manyhavenowaddedtheinternettotheirpersonalhealthtoolbox,helping

themselvesandtheirlovedonesbetterunderstandwhatmightbeailingthem.Thisstudywasnot

designedtodeterminewhethertheinternethashadagoodorbadinfluenceonhealthcare.Itmeasures

thescope,butnottheoutcome,ofthisactivity.

Clinicians are a central resource for information or support during serious

health episodes and the care and conversation take place mostly offline

Totrytocaptureafocusedpictureofpeopleshealthinformationsearchandinformationassessment

strategies,weaskedrespondentstothinkaboutthelasttimetheyhadaserioushealthissueandto

whomtheyturnedforhelp,eitheronlineoroffline:


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70%ofU.S.adultsgotinformation,care,orsupportfromadoctororotherhealthcare

professional.

60%ofadultsgotinformationorsupportfromfriendsandfamily.

24%ofadultsgotinformationorsupportfromotherswhohavethesamehealthcondition.

Thevastmajorityofthiscareandconversationtookplaceoffline,butasmallgroupofpeopledidcommunicatewitheachofthesesourcesonline.And,sinceamajorityofadultsconsulttheinternet

whentheyhavehealthquestions,thesecommunicationswithclinicians,family,andfellowpatients

joinedthestreamofinformationflowingin.

Eight in 10 online health inquiries start at a search engine

Lookingmorebroadlyattheonlinelandscape,72%ofinternetuserssaytheylookedonlineforhealth

informationofonekindoranotherwithinthepastyear. Thisincludessearchesrelatedtoserious

conditions,generalinformationsearches,andsearchesforminorhealthproblems.Forbrevityssake,

wewillrefertothisgroupasonlinehealthseekers.

Whenaskedtothinkaboutthelasttimetheyhuntedforhealthormedicalinformation,77%ofonline

healthseekerssaytheybeganatasearchenginesuchasGoogle,Bing,orYahoo.Another13%saythey

beganatasitethatspecializesinhealthinformation,likeWebMD.Just2%saytheystartedtheir

researchatamoregeneralsitelikeWikipediaandanadditional1%saytheystartedatasocialnetwork

sitelikeFacebook.

Half of health information searches are on behalf of someone else

Whenaskedtothinkaboutthelasttimetheywentonlineforhealthormedicalinformation,39%ofonlinehealthseekerssaytheylookedforinformationrelatedtotheirownsituation.Another39%say

theylookedforinformationrelatedtosomeoneelseshealthormedicalsituation.Anadditional15%of

theseinternetuserssaytheywerelookingbothontheirownandsomeoneelsesbehalf.

One in four people seeking health information online have hit a pay wall

Twentysixpercentofinternetuserswholookonlineforhealthinformationsaytheyhavebeenaskedto

payforaccesstosomethingtheywantedtoseeonline. Ofthosewhohavebeenaskedtopay,just2%

saytheydidso.Fully83%ofthosewhohitapaywallsaytheytriedtofindthesameinformation

somewhereelse.Thirteenpercentofthosewhohitapaywallsaytheyjustgaveup.

The social life of health information is a low-key but steady presence in

American life

Inpastsurveys,thePewInternetProjecthasnotdefinedatimeperiodforhealthactivitiesonline.This

time,thephraseinthepast12monthswasaddedtohelpfocusrespondentsonrecentepisodes.We


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4

findonceagainthatthereisasociallifeofhealthinformation,aswellaspeertopeersupport,as

peopleexchangestoriesabouttheirownhealthissuestohelpeachotherunderstandwhatmightlie

ahead:

26%saytheyreadorwatchedsomeoneelsesexperienceabouthealthormedicalissuesinthe

last12

months.

16%ofinternetuserssaytheywentonlineinthelastyeartofindotherswhomightsharethesamehealthconcerns.

Healthrelatedreviewsandrankingscontinuetobeusedbyonlyamodestgroupofconsumers.About

oneinfiveinternetusershaveconsultedonlinereviewsofparticulardrugsormedicaltreatments,

doctorsorotherproviders,andhospitalsormedicalfacilities.Andjust34%ofinternetusershave

postedonlinereviewsofhealthcareservicesorproviders.


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About this study

Theresultsreportedherecomefromanationwidesurveyof3,014adultslivingintheUnitedStates.

Telephoneinterviewswereconductedbylandline(1,808)andcellphone(1,206,including624withouta

landlinephone).ThesurveywasconductedbyPrincetonSurveyResearchAssociatesInternational.

InterviewsweredoneinEnglishandSpanishbyPrincetonDataSourcefromAugust7toSeptember6,

2012.Statisticalresultsareweightedtocorrectknowndemographicdiscrepancies.Themarginof

samplingerrorforthecompletesetofweighteddatais2.4percentagepoints.

ThePewInternet&AmericanLifeProjectisaninitiativeofthePewResearchCenter,anonprofitfacttankthatprovidesinformationontheissues,attitudesandtrendsshapingAmericaandtheworld.The

Projectisnonpartisanandtakesnopositiononpolicyissues.SupportfortheProjectisprovidedbythe

PewCharitableTrusts.

SupportforthisstudywasprovidedbytheCaliforniaHealthCareFoundation,anindependent

philanthropycommittedtoimprovingthewayhealthcareisdeliveredandfinancedinCalifornia.


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Part One: Information triage

For one-third of U.S. adults, the internet is a diagnostic tool

AsofSeptember2012,81%ofU.S.adultsusetheinternetand,ofthose,72%saytheyhavelookedonlineforhealthinformationinthepastyear.

Sinceonlinepersonaldiagnosisisascenariothathasintriguedobserversforyearsandcausedsome

anxietyaboutpeoplesabilitytonavigatetheonlineinformationlandscapethePewResearchCenters

Internet&AmericanLifeProjectexploreditinsomedepthinitsmostrecenthealthsurvey.Ofthose

whohavelookedonlineforhealthinformation,59%saytheyhaveevergoneonlinespecificallytotryto

figureoutwhatmedicalconditiontheyorsomeoneelsemighthave.Thattranslatesto35%ofU.S.

adults.

Womenaremorelikelythanmentogoonlinetofigureoutapossiblediagnosis.Othergroupsthathave

ahighlikelihoodofdoingsoincludeyoungerpeople,whiteadults,thoseinthehighestincomebracket,

andthosewithmoreeducation(seethetablebelowfordetails).

Thefollowinganalysisisbasedonquestionsaskedonlyofthat35%ofthepopulationwhoanswered

thattheyhavegoneonlinetofigureoutwhattheyorsomeoneelsemighthave.Wewillrefertothemas

onlinediagnosers.

First,onlinediagnoserswereaskediftheinformationtheyfoundonlineledthemtothinkthatthiswasa

conditionthatneededtheattentionofadoctororothermedicalprofessional,orthatitwasperhaps

somethingtheycouldtakecareofathome:

46%ofonlinediagnoserssaythattheconditionneededtheattentionofadoctor;

38%sayitcouldbetakencareofathome;and

11%saiditwaseitherbothorinbetween.

Fiftythreepercentofonlinediagnoserssaytheytalkedwithamedicalprofessionalaboutwhatthey

foundonline,46%didnot(seetablebelowfordetails).

Separately,weaskedifamedicalprofessionalconfirmedwhattheythoughttheconditionwasand

foundthat:

41%ofonlinediagnoserssayyes,amedicalprofessionalconfirmedtheirsuspicions.An

additional2%sayamedicalprofessionalpartiallyconfirmedthem.

35%saytheydidnotvisitacliniciantogetaprofessionalopinion.

18%sayamedicalprofessionaleitherdidnotagreeorofferedadifferentopinionaboutthe

condition.

1%saytheirconversationwithaclinicianwasinconclusivetheprofessionalwasunableto

diagnosewhattheyhad.


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Online diagnosis and professional follow-up%ofadultswholookedonlinetodiagnoseaconditionandthe%ofthoseonlinediagnoserswho

followedupwithamedicalprofessionalaboutwhattheyfound

Lookedonlinetodiagnose

acondition(Nforalladults=3,014)

Followedup

with

medical

professionalafteronline

diagnosis(Nforonlinediagnosers=1,003)

All 35% 53%

Men 30 50

Women 40* 55

Age

1829 47** 47

3049 43** 55

5064 29* 58

65+ 13 47

Race/ethnicity

White,NonHispanic 37** 52

Black,NonHispanic 30 59

Hispanic 25 58

Annualhouseholdincome

Lessthan$30,000/yr 25 44

$30,000

$49,999

37*

60*

$50,000$74,999 44* 62*

$75,000+ 51** 53

Educationlevel

Lessthanhighschooldiploma 9

Highschoolgrad 26* 51

SomeCollege 41** 55

College+ 49*** 51

Source:PewInternetHealthSurvey,August7September6,2012.N=3,014adultsages18+.InterviewswereconductedinEnglishandSpanishandonlandlineandcellphones. Marginoferroris+/ 2.4percentagepointsforalladultsand+/ 3.6percentagepointsforonlinediagnosers.

*Statisticallysignificantdifferencecomparedwithothersinthesamegrouping.Additionalasterisksindicateamoresignificantdifference.


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Thereisnostatisticallysignificantdifferencebetweenthosewhohavehealthinsuranceandthosewho

donotwhenitcomestousingtheinternettofigureoutanillness.

Itisimportanttonotewhatthesefindingsmeanandwhattheydontmean.Historically,peoplehave

alwaystriedtoanswertheirhealthquestionsathomeandmadepersonalchoicesaboutwhetherand

whentoconsultaclinician.Manyhavenowaddedtheinternettotheirpersonalhealthtoolbox,helpingthemselvesandtheirlovedonesbetterunderstandwhatmightbeailingthem.Thisstudywasnot

designedtodeterminewhethertheinternethashadagoodorbadinfluenceonhealthcare.Itmeasures

thescope,butnottheoutcome,ofthisactivity.

Eight in ten online health inquiries start at a search engine

Again,72%ofinternetuserssaytheylookedonlineforhealthinformationwithinthepastyear.For

brevityssake,wewillrefertothisgroupasonlinehealthseekers.

Whenaskedtothinkaboutthelasttimetheydidso,77%ofonlinehealthseekerssaytheybeganata

searchenginesuchasGoogle,Bing,orYahoo.Another13%saytheybeganatasitethatspecializesin

healthinformation,likeWebMD.Just2%saytheystartedtheirresearchatamoregeneralsitelike

Wikipediaandanadditional1%saytheystartedatasocialnetworksitelikeFacebook.

Usingasearchengineissomewhatassociatedwithbeingyounger.Forexample,82%ofonlinehealth

seekersage1829yearsoldsaytheyusedGoogle,Bing,Yahoo,oranothersearchengine,compared

with73%ofthoseages50andolder.

Overall,thispatternmatcheswhatwefoundinourveryfirsthealthsurvey,conductedin2000,when

justhalfofU.S.adultshadinternetaccess.Then,asnow,eightintenonlinehealthseekersstartedata

generalsearchenginewhenlookingonlineforhealthormedicalinformation.

Clinicians are a central resource for information or support during serious

health episodes and the care and conversation take place mostly offline

Totrytocaptureanaccuratepictureofpeopleshealthinformationseekingstrategies,weasked

respondentstothinkaboutthelasttimetheyhadaserioushealthissueandtowhomtheyturnedfor

help:

70%ofU.S.adultsgotinformation,care,orsupportfromadoctororotherhealthcare

professional.

60%ofadultsgotinformationorsupportfromfriendsandfamily.

24%ofadultsgotinformationorsupportfromotherswhohavethesamehealthcondition.

Thevastmajorityofthiscareandconversationtookplaceoffline(seetablebelow).


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Thelasttimeyouhadahealthissue,did

yougetinformation,care,orsupport

from

Totalyes

Yes,online

Yes,offline

Yes,both

Notasource

Adoctororotherhealthcareprofessional

70% 1% 61% 8% 28%

Friendsandfamily 60 1 39 20 39

Otherswhohavethesamehealthcondition

24 2 15 7 73

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adults.Marginoferrorforinternetusers(N=2,392)is+/ 2.6percentagepoints.

Certaingroupsaresignificantlymorelikelytoreportcallinguponaclinicianforhealthadvice:women,

adultsages50andolder,nonHispanicwhites,andadultswithatleastsomecollegeeducation.Fully

threequartersofpeoplewhohavehealthinsuranceconsultedadoctororotherhealthcare

professional,comparedwithhalf(49%)oftheuninsured.

Womenaremoreinclinedthanmentoseekinformation,care,orsupportfromfriendsandfamily: 68%

vs. 53%.NonHispanicwhites,adultswithhealthinsurance,andthosewithsomecollegeeducationare

alsomorelikelythanothergroupstoturntofriendsandfamily.Almosttwothirds(63%)ofthosewith

insuranceapproachedfriendsandfamily,whilehalf(48%)oftheuninsureddidso.

Differencesamongdemographicgroupsarelessapparentwhenlookingatpeerhealthsupport,buttwo

groupsstandout:womenandpeoplewithhealthinsurance.Twentyeightpercentofwomenhave

soughtadvicefromotherswhohavethesamehealthcondition,comparedwith21%ofmen.Onequarter(26%)oftheinsuredsoughtoutotherswiththesamehealthcondition,comparedto19%of

thosewithoutinsurance.

Thesefindingsreflectdifferenceswefirstobservedin2010,withlittlechangeoverthepasttwoyears.

Half of online health inquiries are on behalf of someone else

Whenaskedtothinkaboutthelasttimetheywentonlineforhealthormedicalinformation,39%of

internetuserswhohavedonethistypeofresearchsaytheylookedforinformationrelatedtotheirown

situation.Another39%saytheylookedforinformationrelatedtosomeoneelseshealthormedical

situation.And15%oftheseinternetuserssaytheywerelookingbothontheirownandsomeoneelsesbehalf.

Onlinehealthseekersage65andolderaremorelikelythanthoseinthemiddleagegroupstosaytheir

lastsearchwasontheirownbehalf:48%,comparedwith39%of5064yearolds,forexample.Parents

aremorelikelythannonparentstolookonbehalfofsomeoneelse:44%,comparedwith36%.


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Thistrendhasnotchangedsignificantlysincewefirstbegantrackingitin2000:morethanhalfofhealth

searchesareconductedonbehalfofsomeonenottouchingthekeyboard.

Specific diseases and treatments continue to dominate peoples online

queries

Inpastsurveys,thePewInternetProjecthasnotdefinedatimeperiodforhealthsearchesonline.This

time,thephraseinthepast12monthswasaddedtohelpfocusrespondentsonrecentsearches.

Asonewouldexpect,thepercentagesdippedforeachofthetopicsweincludeinthelist.Forexample,

55%ofinternetuserssaytheylookedonlineforinformationaboutaspecificdiseaseormedicalproblem

inthepastyear,comparedwith66%ofinternetuserswho,in2010,saidtheyhadeverdonesucha

search.

The%ofadultinternetuserswhohavelookedonlineinthelast12

monthsfor

information

about

55% Specificdiseaseormedicalproblem

43 Certainmedicaltreatmentorprocedure

27 Howtoloseweightorhowtocontrolyourweight

25 Healthinsurance,includingprivateinsurance,MedicareorMedicaid

19 Foodsafetyorrecalls

16 Drugsafetyorrecalls

16 Adrugyousawadvertised

15 Medicaltestresults

14 Caringforanagingrelativeorfriend12 Pregnancyandchildbirth

11 Howtoreduceyourhealthcarecosts

20 Anyotherhealthissue

72 atleastoneoftheabovetopics

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adults. Marginoferrorforinternetusers(N=2,392)is+/ 2.6percentagepoints.


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Womenaremorelikelythanmentoseekhealthinformationonline,asareinternetuserswithhigher

levelsofeducation:

Sex Educationlevel

HealthtopicAll

internetusers

Men WomenSomehigh

school

Highschool

grad

Somecollege

Collegegrad

N=2,392 N=1,084 N=1,308 N=107 N=574 N=656 N=1,046

Specificdiseaseormedicalproblem

55% 48% 62%* 34% 43% 58%** 67%***

Certainmedicaltreatmentorprocedure

43 37 49* 22 36* 45** 52***

Howtoloseweightorhowtocontrolyourweight

27 19 34* 23 20 29* 32*

Healthinsurance,includingprivateinsurance,MedicareorMedicaid

25 25 25 17 17 26* 32**

Foodsafetyorrecalls 19 19 19 16 16 19 23*

Drugsafetyorrecalls 16 14 18* 10 13 17 20**

Adrugyousawadvertised 16 15 16 9 13 18* 17*

Medicaltestresults 15 13 16 3 8 15** 23***

Caringforanagingrelativeorfriend

14 15 13 8 12 15 16**

Pregnancyandchildbirth 12 11 13 17 9 14* 12

Howtoreduceyourhealthcarecosts

11 11 11 11 8 11 13*

Anyotherhealthissue 20 16 25* 12 15 22** 25**

Atleastoneoftheabovetopics

72 65 79* 57 63 74** 81***

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adultsandthemarginoferroris+/ 2.6percentagepointsforinternetusers.Marginsoferrorforsubpopulationsarehigher.

*Statisticallysignificantdifferencecomparedwithothersinthesamegroup.Additionalasterisksindicateamoresignificantdifference.


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Thereareonlyfoursignificantdifferencesamongwhite,AfricanAmerican,andLatinointernetusers

whenitcomestohealthtopics:specificdiseases,weightcontrol,adrugseeninadvertising,and

pregnancy.Differencesamongagegroupsareamuchmoremixedbagoftopics.

Race/ethnicity

Age

HealthtopicAll

internetusers

White Black Latino 1829 3049 5064 65+

N=2,392 N=1,531 N=348 N=314 N=454 N=759 N=668 N=463

Specificdiseaseormedicalproblem

55% 58%** 47% 48% 53%* 59%* 59%* 43%

Certainmedicaltreatmentorprocedure

43 45 42 39 39 48** 44* 36

Howtoloseweightor

howtocontrolyourweight

27 23 34* 35* 32** 32** 21* 11

Healthinsurance,includingprivateinsurance,MedicareorMedicaid

25 24 23 26 26 28* 23 19

Foodsafetyorrecalls 19 18 18 20 18 24*** 17 12

Drugsafetyorrecalls 16 16 20 16 14* 20* 17* 8

Adrugyousawadvertised

16 15 22* 15 16 15 18* 11

Medicaltestresults 15 16 12 15 13 15 19** 10

Caringforanagingrelativeorfriend

14 14 15 15 13 16* 15* 8

Pregnancyandchildbirth 12 10 11 17* 25*** 13** 2

Howtoreduceyourhealthcarecosts

11 10 13 12 10* 13* 11* 5

Anyotherhealthissue 20 21 16 17 17 24** 22* 14

Atleastoneoftheabovetopics

72 73 69 66 76* 75* 71* 58

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adultsandthemarginoferroris+/ 2.6percentagepointsforinternetusers.Marginsoferrorforsubpopulationsarehigher.


Internetuserswithhealthinsurancearesignificantlymorelikelythanthosewithouthealthinsuranceto

researchcertaintopics,suchasaspecificdiseaseortreatment.Othertopics,suchasfoodanddrug

safety,aremoderatelymorepopularamonginternetuserswithhealthinsurance,comparedwiththose

whodonotreporthavinginsurancecoverage.


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Seeking health information online%ofinsuredvs.uninsuredinternetuserswhohavelookedforinformationonlineabout

Insured

(n=2,066)

Uninsured

(n=326)

Specificdiseaseormedicalproblem 60%* 35%

Certainmedicaltreatmentorprocedure 48* 24Howtoloseorcontrolweight 27 24

Healthinsurance 25 25

Foodsafetyorrecalls 20* 15

Drugsafetyorrecalls 17* 12

Medicaltestresults 17* 6

Advertiseddrug 16 12

Caringforanaginglovedone 15 11

Pregnancyandchildbirth 11 15

Reducepersonalhealthcarecosts 11 11

Otherhealthissue 22* 13

Anyof

the

above

75*

59

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adults. Marginoferrorforinternetusers(N=2,392)is+/ 2.6percentagepoints.

*Statisticallysignificantdifferencecomparedwithothersinthesamegroup.

Internet access drives information access

SinceoneinfiveU.S.adultsdonotgoonline,thepercentageofonlinehealthinformationseekersis

lowerwhencalculatedasapercentageofthetotalpopulation:59%ofalladultsintheU.S.saythey

lookedonlineforhealthinformationwithinthepastyear.

Therearetwoforcesatplay:accesstotheinternetandinterestinhealthinformation.Forexample,

womenandmenareequallylikelytohaveaccesstotheinternet,butwomenaremorelikelythanmen

toreportgatheringhealthinformationonline,whichexplainsthegendergapinthechartbelow.Forthe

othergroups,theiroveralllowerrateofinternetadoptioncombinedwithlowerlevelsofhealth

informationseekingonlinedrivestheirnumbersdownsignificantlywhencomparedwithotheradults.


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Looking online for health information:

demographics

%of

adults

whogoonline

%ofinternetusers

wholookonlineforhealthinformation

%ofalladults

who

look

online

forhealthinformation

Total 81% 72% 59%

Gender

Male 81 65 53

Female 81 79* 64*

Race

White 83** 73 60**

AfricanAmerican

74 69 51

Latino 73 66 48

Age

1829 95*** 76* 72**

3049 89** 75* 67**

5064 77* 71* 54*

65+ 52 58 30

Education

Somehighschool

47 57 27

Highschool 72* 63 45*

Somecollege 90** 74** 67**

Collegegraduate

96*** 81*** 78***

Householdincome


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Younger adults and minorities lead the way with mobile health information

search

Some85%ofU.S.adultsownacellphoneand,ofthose,31%saytheyhaveusedtheirphonetolookfor

healthormedicalinformationonline.Somegroupsaremorelikelythanotherstolookforhealth

informationontheirphones:Latinos,AfricanAmericans,thosebetweentheagesof18and49,and

thosewhohaveattendedatleastsomecollegeeducation.

Mobile health information: demographics%ofcellphoneownerswithineachgroupwhousetheirphonestolook

forhealthormedicalinformationonline

Allcellphoneowners(n=2,581) 31%

Men(n=1,163) 29

Women(n=1,418) 33

Age

1829(n=451) 42**

3049(n=770) 39**

5064(n=710) 19*

65+(n=599) 9

Race/ethnicity

White,NonHispanic(n=1,586) 27

Black,NonHispanic(n=434) 35*

Hispanic(n=351) 38*


Lessthan$30,000/yr(n=690) 28

$30,000$49,999(n=456) 30

$50,000$74,999(n=345) 37*

$75,000+(n=646) 37*

Educationlevel

Nohighschooldiploma(n=187) 17

Highschoolgrad(n=681) 26*

SomeCollege(n=679) 33**

College+(n=1020) 38**

Source:PewInternet/CHCFHealthSurvey,August7September6,2012.N=3,014adultsages18+.InterviewswereconductedinEnglishandSpanish,onlandlineandcellphones.Marginoferroris+/ 2.6percentagepointsforresultsbasedoncellphoneowners.



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Half of smartphone owners have used their phone to look up health

information

HalfofcellphoneownersintheU.S.(53%)saythattheyownasmartphone.Thistranslatesto45%ofall

Americanadults.Youngerpeoplearemorelikelythanolderadultstoownasmartphone,asarepeople

withhigherincomeandeducationlevels.

Who Owns Smartphones%ofU.S.adultswithineachgroupwhohaveasmartphone

Alladults(n=3,014) 45%

Men(n=1,337) 46

Women(n=1,677) 45

Age

1829(n=478) 66***

3049(n=833) 59**

5064(n=814) 34*

65+(n=830) 11

Race/ethnicity

White,NonHispanic(n=1,864) 42

Black,NonHispanic(n=497) 47

Hispanic(n=427) 49*


Lessthan$30,000/yr(n=876) 35

$30,000$49,999(n=523) 42*

$50,000$74,999(n=371) 56**

$75,000+(n=680) 68***

Educationlevel



SomeCollege(n=778) 50**

College+(n=1,115) 61***

Geographiclocation

Urban(n=1,095) 48*

Suburban(n=1,406) 49*

Rural(n=396) 29


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Source:PewInternet/CHCFHealthSurvey,August7September6,2012.N=3,014adultsages18+.InterviewswereconductedinEnglishandSpanish,onlandlineandcellphones. Marginoferroris+/ 2.4percentagepointsforresultsbasedonalladults.


Fiftytwopercentofsmartphoneownershavelookeduphealthinformationontheirphone,compared

withjust6%ofothercellphoneowners.

Apersonslikelihoodtousehisorhercellphonetolookforhealthinformationisamplifiedbyeachof

thecharacteristicsidentifiedinthetablesabove:relativeyouthfulness,havingahigherlevelof

education,livinginahigherincomehousehold,beingLatino,beingAfricanAmericanandowninga

smartphone.Eachoftheseobservationsholdstrueunderstatisticalanalysisisolatingeachfactor.In

otherwords,itisnotjustthatsmartphoneownersarelikelytobeyoungerthanotherAmericanadults

andbothgroupsarelikelytousetheirphonestolookuphealthinformation.Eachcharacteristichasan

independenteffectonmobilehealthinformationconsumption.

One in four people seeking health information online have hit a pay wall

Twentysixpercentofinternetuserswholookonlineforhealthinformationsaytheyhavebeenaskedto

payforaccesstosomethingtheywantedtoseeonline.Seventythreepercentsaytheyhavenotfaced

thischoicewhileseekinghealthormedicalinformationonline.

Ofthosewhohavebeenaskedtopay,just2%saytheydidso.Fully83%ofthosewhohitapaywallsay

theytriedtofindthesameinformationsomewhereelse.Thirteenpercentofthosewhohitapaywall

saytheyjustgaveup.

Men,women,peopleofallagesandeducationlevelswereequallylikelytoreporthittingapaywall

whenlookingforhealthinformation.Respondentslivinginlowerincomehouseholdsweresignificantly

morelikelythantheirwealthiercounterpartstosaytheygaveupatthatpoint.Wealthierrespondents

werethelikeliestgrouptosaytheytriedtofindthesameinformationelsewhere.Noincomegroupwas

morelikelytosaytheypaidthefee.


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Part Two: Peer-to-peer Healthcare

Some seek counsel from fellow patients and caregivers

Wehavebeeninterestedinthesocialaspectofonlinehealthresourcessincetheverybeginningofourproject.In2000,weaskedpeopleiftheyhademailedadoctorandiftheyparticipatedinanonline

supportgroupforpeoplewhosharedthesamehealthissues.Associaltoolsproliferated,weadapted

oursurveyquestionstofitthecurrentreality.

Now,insteadofnamingcertainwebsitesorservices,wedescribeanactivityandtrackpeoplesuseof

theseresourcesovertime.Forexample,inthecurrentsurvey,wedidnotaskspecificallyabout

Facebook,insteadfocusingonmoregeneralsocialinteractionwhichmaytakeplaceonavarietyofsites.

Wetrustthatpeopleknowwhatwemeanwhenweaskiftheyhave,forexample,postedahealth

relatedquestiononlineandwedonotparticularlyneedtoknowhoworwheretheypostedit.

ThesociallifeofhealthinformationisasteadypresenceinAmericanlife.Aswenotedabove,onein

fouradults(24%)saysthattheyturnedtootherswhohavethesamehealthconditionduringtheirlast

boutwithillness,essentiallythesamefindingasinour2010survey.Oneinfourinternetusers(26%)

havereadorwatchedsomeoneelsesexperienceabouthealthormedicalissuesinthelast12months.

And16%ofinternetusershavegoneonlinetofindotherswhomightsharethesamehealthconcernsin

thelastyear.Weexploredthisphenomenoningreaterdepthinthe2011report,Peertopeer

Healthcare.1

Elevenpercentofinternetuserssaytheyhavesigneduptoreceiveemailupdatesoralertsabouthealth

ormedicalissuesinthepastyear.Twelvepercentofinternetusershavedownloadedformsonlineor

appliedforhealthinsuranceonlineinthepastyear,includingprivateinsurance,Medicare,orMedicaid.

Someofthemoststrikingdifferenceswerebetweenthosewhohavehealthinsuranceandthosewhodo

not(seetablebelow).

1http://www.pewinternet.org/Reports/2011/P2PHealthcare.aspx


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Online health activities, by insurance status%ofinsuredvs.uninsuredinternetuserswhohavegoneonlineinthepastyearto.

Insured

(n=2,601)

Uninsured

(n=413)Read/watchsomeoneelseshealthormedicalexperienceonline 22%* 17%

Findotherswhomighthavesimilarhealthconcerns 13 11

Downloadformsonlineorappliedforhealthinsuranceonline 10* 6

Receiveanyemailupdatesoralertsabouthealthormedicalissues 9* 6

Anyoftheabove 33* 26

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adultsandthemarginoferroris+/ 2.6percentagepointsforinternetusers.

*Statisticallysignificantdifferencebetweengroups.

Eightpercentofinternetuserssaytheyhave,inthepast12months,postedahealthrelatedquestion

onlineorsharedtheirownpersonalhealthexperienceonlineinanyway. Ofthose:

40%saytheypostedcommentsorstoriesaboutpersonalhealthexperiences

19%saytheypostedspecifichealthquestions

38%saytheypostedboth

Inaddition,78%ofthosewhopostedacomment,story,orquestionabouttheirhealthsaythattheydid

sotoreachageneralaudienceoffriendsorotherinternetusers.Elevenpercentsaytheyposted

somewherespecificallytogetfeedbackfromahealthprofessional.Fourpercentrepliedthatthey

postedforbothageneralandaprofessionalaudienceand5%saidneitherofthosechoicesfit.

Health care reviews have not caught on among general consumers

ThePewInternetProjecthastrackedtheuseofonlineconsumerreviewssince2000andithasalways

rankedamongthemostpopularactivitiesinthecommercialrealm:8in10internetuserssaytheyhave

researchedaproductorserviceonline.Bycontrast,onlyaboutoneinfiveinternetusershaveconsulted

onlinereviewsandrankingsofhealthcareserviceprovidersandtreatments.

Whenitcomestowritingreviewsofgeneralinterestitems,37%ofinternetuserssaytheyhaverateda

product,service,orpersononlineand32%havepostedacommentorreviewonlineaboutproducttheyboughtorservicetheyreceived.Peoplearemuchlesslikelytopostareviewofatreatment,hospital,or

clinicianbetween34%ofinternetusershavedoneso.

Theresultsforhealthrelatedreviewsarecomparabletothosewerecordedin2010. Consultingonline

reviewsofparticulardrugsormedicaltreatments,however,tookanoticeabledipinthelasttwoyears.

Some18%ofinternetusersdosotoday,comparedto24%in2010.


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Reviews and rankings online, 2010-2012%ofinternetuserswhoconsultedorpostedonlinereviewsorrankingsforthefollowinghealthrelatedsubjects

2010(n=2,065)

2012(n=2,392)

Consulted

online

reviews

of

particular

drugs

or

medical

treatments

24%*

18%

Consultedonlinerankingorreviewsofdoctorsorotherproviders 16 17

Consultedonlinerankingsorreviewsofhospitalsormedicalfacilities 15 14

Postedareviewonlineofadoctor 4 4

Postedareviewonlineofahospital 3 3

Postedyourexperienceswithaparticulardrugormedicaltreatmentonline 4 3

Source:PewResearchCentersInternet&AmericanLifeProject.Marginsoferrorare+/ 2.6percentagepointsforinternetusers.

*Statisticallysignificantdifferencebetweenyears.

Internetusersbetweentheagesof3064yearsoldarethemostlikelygrouptosaytheyhaveconsultedonlinereviewsandrankingsofhealthtreatmentsandservices. Suburbaninternetusersaremorelikely

thanruralinternetuserstoconsultonlinehealthcarereviews.

Consulting reviews and rankings online, by age%ofinternetuserswithineachagegroupwhoconsultedonlinereviewsorrankingsforthe

followinghealthrelatedsubjects


17

1413

19

21

16

21

17

14

1110

8

0

5

10

15

20

25

drugsormedical

treatments

doctorsorother

healthcareproviders

hospitalsorother

medicalfacilities

1829

3049

5064

65+


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Consulting reviews and rankings online, by urbanity%ofinternetuserswithineachgroupwhoconsultedonlinereviewsorrankingsforthe

followinghealthrelatedsubjects


Internetuserswithhigherlevelsofeducationweremorelikelytoconsultonlinereviewsandrankings

thantheirlesseducatedcounterparts.Thosewithanannualhouseholdincomebelow$30,000wereless

likelythanallotherincomebracketstoconsultorposthealthrelatedreviewsandrankingsonline.

1817

14

20 20

15

13

1110

0

5

10

15

20

25

drugsormedical

treatments

doctorsorother

healthcareproviders

hospitalsorother

medicalfacilities

Urban

Suburban

Rural


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Consulting reviews and rankings online, by education%ofinternetuserswithineachgroupwhoconsultedonlinereviewsorrankingsforthefollowing

healthrelatedsubjects


6

3

5

11

9 9

19

16

14

24

27

20

0

5

10

15

20

25

30

drugsormedical

treatments

doctorsorother

healthcareproviders

hospitalsorother

medicalfacilities

Nodiploma

Highschoolgrad

somecollege

collegegrad


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Consulting reviews and rankings online, by annual household income%ofinternetuserswithineachgroupwhoconsultedonlinereviewsorrankingsforthefollowinghealth

relatedsubjects

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.

N=3,014adultsandthemarginoferroris+/ 2.6percentagepointsforinternetusers.

Postingonlinehealthreviewsandrankingsiscomparativelyinfrequent. Just7%ofinternetusershave

everpostedreviewsorrankingsonanyofthethethreehealthtopicswesurveyed:drugsandmedical

treatments,doctors,andhospitals. Thistranslatesinto6%ofAmericanadults.

13

10

8

20

1415

2021

18

22

25

18

0

5

10

15

20

25

30

drugsormedical

treatments

doctorsorother

healthcareproviders

hospitalsorother

medicalfacilities


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Consulting vs. posting online health reviews and rankings%ofinternetuserswhoconsultedvs.postedonlinereviewsorrankingsforthefollowinghealth

relatedsubjects


Unlikeconsultingonlinehealthrankingsandreviews,therearenocleardemographictrendswhenit

comestoposting. (SeeAppendixfordetails.)

1817

14

34

3

0

2

4

6

8

10

12

14

16

18

20

drugsormedical

treatments

doctors hospitals

Consultedonline

reviews/rankings

Postedonline

reviews/rankings


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Appendix

Additionaldetailsaboutwhohassearchedforspecifichealthtopics.

%ofalladultswhohaveeverlookedonlineforinformationaboutvarioushealthtopics,byage

AllAdultsN=3,014

Age

1829N=478

3049N=833

5064N=814

65+N=830

Specificdiseaseormedicalproblem 45 50* 52** 45 23

Certainmedicaltreatmentorprocedure 35 38* 43** 34* 19

Healthinsurance,includingprivateinsurance,

MedicareorMedicaid20 24** 25** 18* 10

Pregnancyandchildbirth 10 24*** 12** 1 0

Foodsafetyorrecalls 16 17* 22** 14* 7

Drugsafetyorrecalls 13 14* 17* 13* 4

Medicaltestresults 12 12* 14* 14* 5

Howtoloseweightorcontrolyourweight 22 31** 28** 16* 6

Howtoreducehealthcarecosts 9 10* 12* 9* 3

Caringforanagingrelativeorfriend 12 12* 15* 11* 4

Drugyousawadvertised 13 15* 14* 14* 6

Anyotherhealthissue 17 17* 21* 17* 8

Source:PewInternetHealthSurvey,August7September6,2012.N=3,014adultsages18+.InterviewswereconductedinEnglishandSpanishandonlandlineandcellphones. Marginoferroris+/ 2.4percentagepointsforalladults.

*Statisticallysignificantdifferencecomparedwithothersinthesamegrouping.Additionalasterisksindicatea

moresignificantdifference.


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%ofalladultswhohaveeverlookedonlineforinformationaboutvarioushealthtopics,byeducationlevel

AllAdults

N=3,014

Education

LTHS

N=269

HS

N=830

Some

Coll.N=778

Coll+

N=1,115

Specificdiseaseormedicalproblem 45 16 31* 52** 64***

Certainmedicaltreatmentorprocedure 35 10 26* 40** 50***

Healthinsurance,includingprivateinsurance,

MedicareorMedicaid20 8 12 24** 30***

Pregnancyandchildbirth 10 8 6 12** 11*

Foodsafetyorrecalls 16 8 11 18** 22**

Drugsafetyorrecalls 13 5 9* 15** 19**

Medicaltestresults 12 2 6* 13** 22***

Howtoloseweightorcontrolyourweight 22 11 14 26** 30**

How

to

reduce

health

care

costs

9

5

6

10**

13**

Caringforanagingrelativeorfriend 12 4 8* 13** 16**

Drugyousawadvertised 13 4 9* 16** 17**

Anyotherhealthissue 17 6 11* 20** 24**

Source:PewInternetHealthSurvey,August7September6,2012.N=3,014adultsages18+.InterviewswereconductedinEnglishandSpanishandonlandlineandcellphones. Marginoferroris+/ 2.4percentagepointsforalladults.

*Statisticallysignificantdifferencecomparedwithothersinthesamegrouping.Additionalasterisksindicatea

moresignificantdifference.

Additionaldetails

about

the

health

insurance

landscape

in

the

U.S.

Health Insurance Coverage, by Type of Insurance%ofAmericanswhoreporthavingthefollowingtypesofhealthinsurance

Alladults

(n=3,014)

Privatehealthinsuranceofferedthroughan

employerorunion51%

Medicare 21

Medicaidorsomeothertypeofstatemedical

assistanceforlowincomepeople14

Privatehealthinsurancepaidbytheindividual 17

Healthinsurancethroughanyothersource,

includingmilitaryorveteranscoverage12

Totalinsured 82

Notinsured 18

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adultsandthemarginoferroris+/ 2.4percentagepointsforthefullsample.


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Womenaremorelikelytohavehealthinsurancethanmen,alongwithwhitesandAfricanAmericans

comparedtoHispanics. Thosewithahigherincomeandlevelofeducationarealsomorelikelytohave

healthinsurance. Verynearlyalladultsover65havehealthinsurance(99%),mostlyduetoMedicare.

Health insurance coverage, by demographic group%ofadultswithineachgroupwhohavehealthinsurance

Alladults(n=3,014) 82%

Men(n=1,337) 79

Women(n=1,677) 86*

Age

1829(n=478) 64

3049(n=833) 83*

5064(n=814) 86*

65+(n=830) 99***

Race/ethnicity

White,NonHispanic(n=1,864) 87**

Black,NonHispanic(n=497) 81*

Hispanic(n=427) 63


Lessthan$30,000/yr(n=876) 67

$30,000$49,999(n=523) 84*

$50,000$74,999(n=371) 95**

$75,000+(n=680) 96**

Educationlevel



SomeCollege(n=778) 82*

College+(n=1,115) 94***

Source:PewResearchCentersInternet&AmericanLifeProject,August7September6,2012Survey.N=3,014adultsandthemarginoferroris+/ 2.4percentagepointsforthefullsample.Marginsoferrorforsubpopulationsare

higher.



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Additionaldetailsaboutthosewhopostreviewsonline.


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Survey questions

Healt h Tracking Survey 2012 Revised Topline 11/27/2012

DataforAugust7September6,2012

Princeton Survey Research Associates International forthe Pew Research Centers Internet & American Life Project

Sample: n=3,014 national adults, age 18 and older, including 1,206 cell phone interviewsInterviewing dates: 08.07.2012 09.06.2012

Margin of error is plus or minus 2.4 percentage points for results based on total [n=3,014]

Margin of error is plus or minus 2.6 percentage points for results based on internet users [n=2,392]Margin of error is plus or minus 2.6 percentage points for results based on cell phone owners [n=2,581]

Margin of error is plus or minus 3.1 percentage points for results based on online health seekers [n=1,741]Margin of error is plus or minus 3.8 percentage points for results based on caregivers [n=1,171]

Q1 Overall,howwouldyouratethequalityoflifeforyouandyourfamilytoday?Wouldyousayitis

excellent,verygood,good,fairorpoor?

EXCELLENT VERY GOOD GOOD FAIR POOR DON'T KNOW2

REFUSED

Current 17 26 32 19 5 * *

2 For this question and many others throughout the topline, results for Dont know often reflect combined Dont knowand Refused percentages. DK and REF are reported separately where available.


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I NTUSE Do you use the internet, at least occasionally?

EMLOCCDo you send or receive email, at least occasionally?

I NTMOBDo you access the internet on a cell phone, tablet or other mobile handheld device, atleast occasionally?3

USES INTERNETDOES NOT USE

INTERNET

Current 81 19

QL1 Do you have a cell phone... or a Blackberry or iPhone or other device that is also a cellphone?4

YES NO DONT KNOW REFUSED

Current

85 15 * 0

SMPH Some cell phones are called smartphones because of certain features they have. Isyour cell phone a smartphone, such as an iPhone, Android, Blackberry or Windowsphone, or are you not sure?5

Based on cell phone owners

CURRENT

% 53 Yes, smartphone

40 No, not a smartphone

6 Not sure/Dont know

* Refused

[n=2,581]

3 The definition of an internet user varies from survey to survey. From January 2005 thru February 2012, an internet user issomeone who uses the internet at least occasionally or sends/receives email at least occasionally (two-part definition withquestion wording Do you use the internet, at least occasionally? OR Do you send or receive email, at leastoccasionally?). Prior to January 2005, an internet user is someone who goes online to access the internet or to send andreceive email (question wording Do you ever go online to access the Internet or World Wide Web or to send and receive

email?).4 Question was asked of landline sample only. Results shown here have been recalculated to include cell phone sample inthe "Yes" percentage. In past polls, question was sometimes asked as an independent question and sometimes as an itemin a series. In January 2010, question wording was Do you have...a cell phone or a Blackberry or iPhone or other handhelddevice that is also a cell phone. In Dec 2008, Nov 2008, May 2008, January 2005 and Nov 23-30 2004, question wordingwas "Do you happen to have a cell phone?" In August 2008, July 2008 and January 2008, question wording was "Do youhave a cell phone, or a Blackberry or other device that is also a cell phone?" In April 2008, Dec 2007, Sept 2007 and April2006, question wording was Do you have a cell phone? Beginning December 2007, question/item was not asked of thecell phone sample, but results shown here reflect Total combined Landline and cell phone sample.5 Prior to the current survey, question wording was slightly different: Some cell phones are called smartphones because ofcertain features they have. Is your cell phone a smartphone or not, or are you not sure?


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CELL1 Please tell me if you ever use your cell phone to do any of the following things. Do youever use your cell phone to [INSERT ITEMS; ALWAYS ASK a-b FIRST in order;RANDOMIZE c-f]?6



a. Sendorreceiveemail

Current[N=2,581]50 50 * 0

b. Sendorreceivetextmessages

Current80 20 * 0

c. Takeapicture

Current82 18 * *

d. Accesstheinternet7

Current56 44 0 0

e. Lookforhealthormedical

informationonline8

Current31 69 * *

f. Checkyourbankaccountbalanceor

doanyonlinebanking9

Current29 70 * *

6 In May 2011, the question was asked of all Form B cell phone owners and Form A cell phone owners who said in CELL7that they do more than make calls on their phone. The percentages shown here are based on all cell phone users, countingas no Form A cell phone owners who said in CELL7 they use their phones only for making calls. Prior to May 2011,question was asked of all cell phone owners. Prior to January 2010, question wording was Please tell me if you ever useyour cell phone or Blackberry or other device to do any of the following things. Do you ever use it to [INSERT ITEM]? In

January 2010, question wording was Please tell me if you ever use your cell phone or Blackberry or other handheld deviceto do any of the following things. Do you ever use it to [INSERT ITEMS]? For January 2010, December 2009, andSeptember 2009, an answer category Cell phone cant do this was available as a volunteered option; No percentages forthose trends reflect combined No and Cell phone cant do this results.7 In December 2007, item wording was Access the internet for news, weather, sports, or other information8 In April 2012, question was asked of cell phone owners who use the internet or email on their cell phone or downloadapps to their cell phone [N=953]; results are re-percentaged on all cell phone owners. In September 2010, question was astandalone question with the following question wording: Do you ever use your cell phone to look up health or medicalinformation?9 In April 2012, question was asked of Form A cell phone owners who use the internet or email on their cell phone ordownload apps to their cell phone [N=953]; results are re-percentaged on all Form A cell phone owners.


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Q2 Switching topics... In general, how would you rate your own health excellent, good,only fair, or poor?

CURRENT

% 28 Excellent

52 Good

16 Only fair

4 Poor

* Dont know

* Refused


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Q3 Are you now living with any of the following health problems or conditions? First,[INSERT ITEM; RANDOMIZE a-e; ITEM f ALWAYS LAST]? And what about... [INSERTITEM]? [IF NECESSARY: Are you now living with [INSERT ITEM]?]

YES NO DON T KN OW REFU SED

a. Diabetesorsugardiabetes

Current11 88 * *

b. Highbloodpressure

Current25 74 1 *

c. Asthma,bronchitis,emphysema,orother

lungconditions

Current13 86 * *

d. Heartdisease,heartfailureorheartattack

Current7 92 * *

e. Cancer

Current3 96 * *

f. Anyotherchronichealthproblemor

conditionIhaventalreadymentioned

Current16 83 * *

Q4 In the last 12 months, have you personally...[INSERT ITEMS IN ORDER]?

YES NO DON T KN OW REFU SED

a. Facedaseriousmedicalemergencyor

crisis10

Current11 89 * *

b. Gonetotheemergencyroomorbeen

hospitalizedunexpectedly

Current17 83 * *

10 In September 2010, question was asked as a standalone question. For December 2008 and earlier, trend questionwording was: And in the last 12 months, have you or has someone close to you faced a serious medical emergency orcrisis?


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c. Experiencedanysignificantchangeinyour

physicalhealth,suchasgainingorlosinga

lotofweight,becomingpregnant,or

quittingsmoking11

Current18 81 * *

Q5 Thinking about the LAST time you had a serious health issue or experienced any

significant change in your physical health... Did you get information, care or supportfrom... [INSERT ITEM; RANDOMIZE]? [IF YES AND INTERNET USER: Did you interactwith them ONLINE through the internet or email, OFFLINE by visiting them in person ortalking on the phone, or BOTH online and offline?]12

YES,ONLINE

YES,OFFLINE YES, BOTH

NO, NOT ASOURCE

DONTKNOW REFUSED

a. Adoctororotherhealthcareprofessional

Current1 61 8 28 1 1

b. Friendsandfamily

Current1 39 20 39 * 1

c. Otherswhohavethesamehealth

condition

Current2 15 7 73 1 1

11 In September 2010, question was asked as a standalone question with the following question wording: And in the last 12months, have you experienced any other significant change in your physical health, such as gaining or losing a lot of weight,becoming pregnant, or quitting smoking?12 September 2010 question wording was slightly different: Thinking about the LAST time you had a health issue, did youget information, care or support from [INSERT; RANDOMIZE]? [IF YES AND INTERNET USER: Did you interact with themONLINE through the internet or email, OFFLINE by visiting them in person or talking on the phone, or BOTH online andoffline?]


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[READ TO ALL:] On another topic...

CARE2 In the past 12 months, have you provided UNPAID care to an adult relative or friend 18years or older to help them take care of themselves? Unpaid care may include help withpersonal needs or household chores. It might be managing a persons finances,arranging for outside services, or visiting regularly to see how they are doing. Thisperson need not live with you.

[IF R ASKS IF GIVING MONEY COUNTS, ASK:] Aside from giving money, do you provideany other type of unpaid care to help them take care of themselves, such as help withpersonal needs, household chores, arranging for outside services, or other things?

CURRENT

% 36 Yes

64 No

* Dont know

* Refused

CARE3 Do you provide this type of care to just one adult, or do you care for more than oneadult?

Based on those who provide unpaid care to adults

CURRENT

% 66 One adult only

34 Provide care to multiple adults

* Dont know

* Refused

[n=1,085]


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CARE4 [ASK IF PROVIDE UNPAID CARE TO ONE ADULT:] Is this person your parent or yourmother-in-law or father-in-law, or not?13

CARE5 [ASK IF PROVIDE UNPAID CARE TO MULTIPLE ADULTS, DONT KNOW OR REFUSED:]Are any of the adults you care for your parent or your mother-in-law or father-in-law, ornot?14

Based on those who provide unpaid care to adults

CURRENT

% 47 Yes, parent or mother-in-law/father-in-law

53 No, not a parent or mother-in-law/father-in-law

* Dont know

* Refused

[n=1,085]

CARE6 In the past 12 months, have you provided UNPAID care to any CHILD under the age of18 because of a medical, behavioral, or other condition or disability? This could includecare for ongoing medical conditions or serious short-term conditions, emotional orbehavioral problems, or developmental problems, including mental retardation.

CURRENT

% 8 Yes

92 No

* Dont know

* Refused

13 September 2010 question wording was slightly different: Is this person a parent of yours, or not?14 September 2010 question wording was slightly different: Are any of the adults you care for a parent of yours, or not?


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Q6 Now, wed like to know if youve looked for information ONLINE about certain health ormedical issues, either for yourself or someone else. Specifically, in the last 12 months,have you looked online for information about... [INSERT FIRST ITEM; ASK a-b FIRST INORDER THEN RANDOMIZE c-k; ITEM L ALWAYS LAST]? In the last 12 months, have youlooked online for information about... [INSERT NEXT ITEM]?15

Based on all internet users [N=2,392]

YES, HAVEDONE THIS

NO, HAVE NOTDONE THIS DONT KNOW REFUSED

a. Aspecificdiseaseormedicalproblem

Current55 44 * *

b. Acertainmedicaltreatmentorprocedure

Current43 56 * *

c. Healthinsurance,includingprivate

insurance,MedicareorMedicaid

Current25 75 * *

d. Pregnancyandchildbirth

Current12 88 0 *

e. Foodsafetyorrecalls

Current19 80 * *

f. Drugsafetyorrecalls

Current16 84 * *

g. Medicaltestresults

Current15 85 * *

h. Howtoloseweightorhowtocontrolyour

weight

Current27 73 * *

i. Howtoreduceyourhealthcarecosts

Current 11 89 * *

15 Prior to the current survey, question wording was: Now, wed like to ask if youve looked for information ONLINE aboutcertain health or medical issues. Specifically, have you ever looked online for [INSERT ITEM]? List of items may varyfrom survey to survey. The phrase in the last 12 months was added in the 2012 survey.


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YES, HAVEDONE THIS

NO, HAVE NOTDONE THIS DONT KNOW REFUSED

j. Caringforanagingrelativeorfriend

Current14 86 * *

k. Adrugyousawadvertised

Current16 84 * *

l. Anyotherhealthissue

Current20 79 * *

Totalyestoanyitemabove72

Totalnotoallitems

28

Q7 Thinking about the LAST time you went online for health or medical information... Didyou go online to look for information related to YOUR OWN health or medical situationor SOMEONE ELSES health or medical situation?

Based on online health seekers

CURRENT

% 39 Own

39 Someone elses

15 Both (VOL.)

3 Dont know

3 Refused

[n=1,741]


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Q8 Still thinking about the LAST time you went online to look for health information... Howdid you begin looking? Did you start... [READ 1-4 IN ORDER]

Based on online health seekers [N=1,741]

CURRENT

% 77 At a search engine such as Google, Bing or Yahoo

13 At a site that specializes in health information, like WebMD

2 At a more general site like Wikipedia, that contains information on all kinds of

topics, OR

1 At a social network site like Facebook?

3 (VOL.) Other (SPECIFY)

2 (VOL.) Dont know

2 (VOL.) Refused

There is no Question Q9.


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Q10 When looking for health information online, have you ever been asked to PAY for accessto something you wanted to see on the internet?


CURRENT

% 26 Yes

73 No

1 Dont know

* Refused

Q11 The last time you were asked to PAY to access health content online, what did you do?Did you... [READ 1-3; READ CATEGORIES IN REVERSE ORDER FOR HALF THE SAMPLE]

Based on online health seekers who have been asked to pay for health content online [N=456]

CURRENT

% 2 Pay for access

83 Try to find the same information somewhere else

13 Give up

1 (VOL.) Other

* (VOL.) Dont know

* (VOL.) Refused

Q12 Have you ever gone online specifically to try to figure out what medical condition you orsomeone else might have?


CURRENT

% 59 Yes

40 No

* Dont know

* Refused


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Q13 Did the information you found online lead you to think that this was a condition thatneeded the attention of a doctor or other medical professional, or that it was somethingyou could take care of at home?

Based on online health seekers who have gone online to figure out what medical condition they or someoneelse might have [N=1,003]

CURRENT

% 46 Needed attention of doctor

38 Could take care of at home

11 Both/in-between (VOL.)

4 Dont know

1 Refused

Q14 Did you happen to talk with a medical professional about what you found online?


CURRENT

% 53 Yes

46 No

1 Dont know

1 Refused

Q15 Did a medical professional confirm what you thought the condition was with a medicaldiagnosis, did they offer a different medical opinion or diagnosis, or did you not visit adoctor or other medical professional for a diagnosis?


CURRENT

% 41 Yes, confirmed

18 No, did not confirm/offered different diagnosis

35 Did not visit a doctor or medical professional for a diagnosis

2 Confirmed part but not all of Rs diagnosis (VOL.)

1 Medical professional was unable to diagnose (VOL.)

1 Dont know

1 Refused


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Q16 Apart from looking for information online, there are many different activities related tohealth and medical issues a person might do on the internet. Im going to read a list ofonline health-related activities you may or may not have done in the last 12 months.Just tell me if you happened to do each one, or not. (First,) in the last 12 months, haveyou... [INSERT ITEM; RANDOMIZE]? In the last 12 months, have you...[INSERT ITEM]?


a. Signeduptoreceiveemailupdatesoralerts

abouthealthormedicalissues

Currentinternetusers[N=2,392]11 89 * *

b. Readorwatchedsomeoneelse'scommentary

orpersonalexperienceabouthealthormedical

issuesonline

Currentinternetusers

26 74 * *

c. Goneonlinetofindotherswhomighthave

healthconcernssimilartoyours

Currentinternetusers16 84 * *

d. Downloadedformsonlineorappliedforhealth

insuranceonline,includingprivateinsurance,

Medicare,orMedicaid

Currentinternetusers12 88 * 0

Q17 Still thinking just about the last 12 months, have you posted a health-related questiononline or shared your own personal health experience online in any way?

Based on all internet users [N=2,392]

CURRENT

% 8 Yes

92 No

* Dont know

0 Refused


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Q18 And what was it that you posted or shared online? Was it a specific QUESTION aboutyour health, a COMMENT or STORY about your personal health experience, or BOTH aquestion and a comment?

Based on internet users who have posted about a health topic or shared a health experience online [N=173]

CURRENT

% 19 Specific health question

40 Comments/Stories about personal health experiences

38 Both

2 Neither/Something else (VOL.)

1 Dont know

0 Refused

Q19 And the LAST time you posted or shared health material online, did you post it

somewhere specifically to get feedback from a health professional, or did you post itsomewhere it would be read by a more general audience of friends or other internetusers?

Based on internet users who have posted about a health topic or shared a health experience online [N=173]

CURRENT

% 11 Health professional

78 More general audience

4 Both (VOL.)

5 Neither/Something else (VOL.)

1 Dont know

0 Refused


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Q20 Thinking again about health-related activities you may or may not do online, have you...[INSERT ITEM; RANDOMIZE]?(Next,) have you...[INSERT ITEM]?16


a. Consultedonlinerankingsorreviewsofdoctors

orotherproviders17

Currentinternetusers[N=2,392]17 83 * *

b. Consultedonlinerankingsorreviewsof

hospitalsorothermedicalfacilities18


c. Consultedonlinereviewsofparticulardrugsor

medicaltreatments

Currentinternetusers18 82 1 *

d. Postedareviewonlineofadoctor

Currentinternetusers4 96 0 0

e. Postedareviewonlineofahospital

Currentinternetusers3 97 * *

f. Postedyourexperienceswithaparticulardrug

ormedicaltreatmentonline


16 Current question was asked of all internet users. September 2010 trend question was also asked of all internet users,with items asked in rotated order. December 2008 trend question was asked of online health seekers, with thefollowing question wording: There are many different activities related to health and medical issues a person might doon the internet. Im going to read a list of things you may or may not have ever done online related to health andmedical issues. Just tell me if you happened to do each one, or not. Have you [INSERT ITEM; ROTATE]?17 December 2008 trend item wording was Consulted rankings or reviews online of doctors or other providers18 December 2008 trend item wording was Consulted rankings or reviews online of hospitals or other medical facilities


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[READ TO CELL PHONE OWNERS:] Now thinking about how you might use your cell phone tohelp manage your health...

Q21 Do you receive any TEXT updates or alerts about health or medical issues, such as fromyour doctors or pharmacists?

Based on cell phone owners who text message [N=1,896]

CURRENT

% 9 Yes

91 No

* Dont know

* Refused

Q22 On your cell phone, do you happen to have any software applications or apps thathelp you track or manage your health, or not?


CURRENT

% 11 Yes

88 No

1 Dont know

* Refused

[n=2,581]


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Q23 What kind of health apps do you currently have on your phone? [IF NECESSARY,CLARIFY: What health issue or topic do your apps deal with?] [DO NOT READ;PRECODED OPEN-END]

Based on those who have health apps on their cell phone [N=254]

CURRENT

% 38 Exercise, fitness, pedometer or heart rate monitoring (includes specific types of

exercise like running, ab workouts, yoga, etc.)

31 Diet, food, calorie counter

12 Weight

7 Period or menstrual cycle

5 Blood pressure

4 WebMD

3 Pregnancy

2 Blood sugar or diabetes

2 Medication management (tracking, alerts, etc.)

* Mood

* Sleep

14 Other (SPECIFY)

6 Dont know

* Refused

Note: Total may exceed 100% due to multiple responses.


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[READ TO ALL:] A few last questions for statistical purposes only...

I NS1 Now I would like to ask you about any health insurance you CURRENTLY have that helpspay for the cost of health care. Im going to read a list of a few types of healthinsurance, and Id like you to tell me which of these you have, if any. (First,) are younow PERSONALLY covered by [INSERT ITEMS IN ORDER]?

[IF RESPONDENT NOT SURE WHICH INSURANCE IS INCLUDED: Please think aboutinsurance plans that cover the costs of doctor and hospital bills IN GENERAL, and NOTthose that cover ONLY dental or eye care or the costs of caring for specific diseases.]

[IF RESPONDENTS TRY TO TELL TYPE THEY HAVE INSTEAD OF GOING THROUGH THELIST: Im sorry but I have to ask about each type of insurance for the survey. Just tellme no if you dont have this type.]

YES NO DON T KN OW REFUSED

a. Privatehealthinsuranceofferedthroughan

employerorunion[IFNO:Thiscouldbe

insurancethroughacurrentjob,aformerjob,

yourjoborsomeoneelsesjob.]51 47 1 1

b. Aprivatehealthinsuranceplanthatyoubought

yourself17 82 1 1

c. Medicaid,[IFSTATECALIFORNIA:MediCal],or

someothertypeofstatemedicalassistancefor

lowincomepeople14 85 1 *

d. Medicare,thegovernmentprogramthatpays

healthcarebillsforpeopleoverage65andfor

somedisabledpeople21 78 1 *

ItemE:

Based

on

those

who

are

not

insured

through

privatehealthinsurance,Medicaid,orMedicare

[N=526]

e. HealthinsurancethroughANYothersource,

includingmilitaryorveteranscoverage12 87 * 1

I NS2 Medicare is health insurance coverage most people receive when they turn 65 and areeligible for Social Security. This includes different kinds of health plans offeredTHROUGH the Medicare program like the plans called H-M-Os. Are you now coveredby Medicare or by ANY Medicare plan?

Based on those age 65 and older who are not covered by Medicare [N=82]

CURRENT

% 38 Yes, covered

56 No, not covered

3 Dont know

3 Refused


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I NS3 Does this mean you personally have NO health insurance now that would cover yourdoctor or hospital bills?

Based on those who are not covered by any health insurance or are undesignated [N=450]

CURRENT

% 91 I do NOT have health insurance

7 I HAVE some kind of health insurance

1 Dont know

2 Refused

SUMMARY OF INSURANCE STATUS (BASED ON I NS1, I NS2, I NS3)

CURRENT

% 82 Insured

18 Not insured

The remaining demographic questions are not reported in this topline.


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Methodology

Summary

The2012HealthSurvey,sponsoredbythePewResearchCentersInternet&AmericanLifeProjectand

theCaliforniaHealthCareFoundation,obtainedtelephoneinterviewswithanationallyrepresentative

sampleof3,014adultslivingintheUnitedStates.Telephoneinterviewswereconductedbylandline

(1,808)andcellphone(1,206,including624withoutalandlinephone).Thesurveywasconductedby

PrincetonSurveyResearchAssociatesInternational.InterviewsweredoneinEnglishandSpanishby

PrincetonDataSourcefromAugust7toSeptember6,2012.Statisticalresultsareweightedtocorrect

knowndemographicdiscrepancies.Themarginofsamplingerrorforthecompletesetofweighteddata

is2.4percentagepoints.

DESIGNANDDATACOLLECTIONPROCEDURES

SampleDesign

Acombinationoflandlineandcellrandomdigitdial(RDD)sampleswasusedtoreacharepresentative

sampleofalladultstheUnitedStateswhohaveaccesstoeitheralandlineorcellulartelephone.Both

samplesweredisproportionatelystratifiedtoincreasetheincidenceofAfricanAmericanandHispanic

respondents.Withinstrata,phonenumbersweredrawnwithequalprobabilities.Thelandlinesamples

werelistassistedanddrawnfromactiveblockscontainingthreeormoreresidentiallistingwhilethecell

sampleswerenotlistassisted,butweredrawnthroughasystematicsamplingfromdedicatedwireless

100blocksandsharedservice100blockswithnodirectorylistedlandlinenumbers.

ContactProcedures

InterviewswereconductedfromAugust7toSeptember6,2012.Asmanyas7attemptsweremadeto

contacteverysampledtelephonenumber.Samplewasreleasedforinterviewinginreplicates,whichare

representativesubsamplesofthelargersample.Usingreplicatestocontrolthereleaseofsample

ensuresthatcompletecallproceduresarefollowedfortheentiresample.Callswerestaggeredover

timesofdayanddaysoftheweektomaximizethechanceofmakingcontactwithpotential

respondents.Eachphonenumberreceivedatleastonedaytimecall.

Forthelandlinesample,interviewersaskedtospeakwitheithertheyoungestmaleoryoungestfemale

currentlyathomebasedonarandomrotation.Ifnomale/femalewasavailableatthetimeofthecall,

interviewersaskedtospeakwiththeyoungestadultoftheoppositesex.Thissystematicrespondent

selectiontechniquehasbeenshowntoproducesamplesthatcloselymirrorthepopulationintermsof

ageandgenderwhencombinedwithcellsample.

Forthecellsample,interviewswereattemptedwiththepersonwhoansweredthephone.Interviewers

firstverifiedthatthepersonwasandadultandinasafeplacebeforecontinuingwiththeinterview.

WEIGHTINGANDANALYSIS

Weightingisgenerallyusedinsurveyanalysistoadjustforeffectsofthesampledesignandto

compensateforpatternsofnonresponsethatmightbiasresults.Theweightingwasaccomplishedin


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multiplestagestoaccountforthedisproportionatelystratifiedsample,theoverlappinglandlineandcell

sampleframesanddifferentialnonresponseassociatedwithsampledemographics.

Thefirststageofweightingcompensatedforthedisproportionatesampledesign.Thisadjustment

(calledSAMPWTinthedataset)wascomputedbydividingtheproportionofthepopulationfromeach

stratumbytheproportionofsampledrawnfromthestratum.Thelandlineandcellsamplesweredrawn

usingthesamerelativesamplingfractionswithinstratasothe.Table1showstheSAMPWTvaluesby

strata.

Table1.SAMPWTbyStratum

Strata

Population

Dist'n

Sample

Dist'n SAMPWT

1 10.8% 4.1% 2.63

2 9.0% 3.4% 2.63

3 9.8% 3.7% 2.63

4 9.5% 3.6% 2.63

5 10.6% 8.1% 1.31

6 9.0% 10.2% 0.88

7 9.7% 11.1% 0.88

8 11.4% 17.4% 0.66

9 9.3% 17.8% 0.53

10 10.7% 20.5% 0.53

Thesecondstageofweightingcorrectedfordifferentprobabilitiesofselectionbasedonthe

numberofadultsineachhouseholdandeachrespondentstelephoneuse(i.e.,whethertherespondent

hasaccesstoalandline,toacellphoneortobothtypesofphone).

Thesecondstageweightcanbeexpressedas:

1

1

LLi =1ifrespondenthasalandlinephoneand=0ifrespondenthasnolandlinephone

CP =1ifrespondenthasacellphoneand=0ifrespondenthasnocellphone

SLL thesizeofthelandlinesample

SCP thesizeofthecellsample

R theestimatedratioofthesizeofthelandlinesampleframetothesizeofthecell


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sampleframe.ForthissurveyR=0.55.

Bothadjustmentswereincorporatedintoafirststageweightthatwasusedasaninputweightforpost

stratification.Thedatawasrakedtomatchsampledistributionstopopulationparameters.TheAfrican

AmericanandWhite/Othersampleswererakedtomatchparametersforsexbyage,sexbyeducation,agebyeducationandregion.Hispanicswererakedtomatchpopulationparametersforsexbyage,sex

byeducation,agebyeducationandregion.Inaddition,theHispanicgroupwasrakedtoanativity

parameter.

Thecombineddatawasthenrakedtomatchpopulationparametersforsexbyage,sexbyeducation,

agebyeducation,region,householdphoneuseandpopulationdensity.Thewhite,nonHispanic

subgroupwasalsobalancedbyage,educationandregion.Thetelephoneusageparameterwasderived

fromananalysisofrecentlyavailableNationalHealthInterviewSurveydata19.Thepopulationdensity

parameteriscountybasedandwasderivedfromCensus2000data.Allotherweightingparameters

werederivedfromtheCensusBureaus2011AnnualSocialandEconomicSupplement(ASEC).

Thisstageofweighting,whichincorporatedeachrespondent'sfirststageweight,wasaccomplished

usingSampleBalancing,aspecialiterativesampleweightingprogramthatsimultaneouslybalancesthe

distributionsofallvariablesusingastatisticaltechniquecalledtheDemingAlgorithm.Theraking

correctsfordifferentialnonresponsethatisrelatedtoparticulardemographiccharacteristicsofthe

sample.Thisweightensuresthatthedemographiccharacteristicsofthesamplecloselyapproximatethe

demographiccharacteristicsofthepopulation.Table2comparesfullsampleweightedandunweighted

sampledemographicstopopulationparameters.

19 Blumberg SJ, Luke JV. Wireless substitution: Early release of estimates from the National Health Interview Survey,July-December, 2011. National Center for Health Statistics. June 2012.


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Table2.SampleDemographics

Parameter Unweighted Weighted

Gender

Male 48.6 44.4 48.9

Female 51.4 55.6 51.1

Age

18-24 12.8 10.0 12.8

25-34 18.0 12.4 17.5

35-44 17.2 13.2 17.3

45-54 19.0 17.8 19.2

55-64 16.0 18.5 16.0

65+ 17.0 28.1 17.3

Education (changed)

Less than HS Graduate 13.3 9.0 11.7HS Graduate 30.4 27.7 30.6

Some College/AssocDegree 28.5 26.0 28.8

College Graduate 27.8 37.3 28.9

Race/Ethnicity

White/not Hispanic 67.8 63.0 68.1

Black/not Hispanic 11.5 16.8 11.8

Hisp - US born 6.6 7.6 6.6

Hisp - born outside 7.4 6.8 7.0

Other/not Hispanic 6.7 5.7 6.5

Region

Northeast 18.3 16.4 19.2

Midwest 21.7 19.0 22.1

South 36.8 41.5 36.1

West 23.2 23.0 22.6

(continued)

Table2.SampleDemographics(continued)

County Pop. Density

1 - Lowest 20.1 18.8 20.4

2 20.0 18.0 20.1

3 20.1 18.9 20.2

4 20.2 20.0 19.9

5 - Highest 19.6 24.4 19.3


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Household Phone Use

LLO 7.0 7.9 7.2

Dual - few,some cell 39.0 54.4 40.3

Dual - most cell 18.8 16.9 18.9

CPO 35.2 20.8 33.6

EffectsofSampleDesignonStatisticalInference

Postdatacollectionstatisticaladjustmentsrequireanalysisproceduresthatreflectdeparturesfrom

simplerandomsampling.PSRAIcalculatestheeffectsofthesedesignfeaturessothatanappropriate

adjustmentcanbeincorporatedintotestsofstatisticalsignificancewhenusingthesedata.Thesocalled

"designeffect"ordeffrepresentsthelossinstatisticalefficiencythatresultsfromadisproportionate

sampledesignandsystematicnonresponse.Thetotalsampledesigneffectforthissurveyis1.75.

PSRAIcalculatesthecompositedesigneffectforasampleofsizen,witheachcasehavingaweight,wi

as:

2

1

1

2

n

i

i

n

i

i

w

wn

deff formula1


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Inawiderangeofsituations,theadjustedstandarderrorofastatisticshouldbecalculatedby

multiplyingtheusualformulabythesquarerootofthedesigneffect(deff).Thus,theformulafor

computingthe95%confidenceintervalaroundapercentageis:

where p isthesampleestimateandnistheunweightednumberofsamplecasesinthegroupbeing

considered.

Thesurveysmarginoferroristhelargest95%confidenceintervalforanyestimatedproportionbased

onthetotalsampletheonearound50%.Forexample,themarginoferrorfortheentiresampleis

2.4percentagepoints.Thismeansthatin95outofevery100samplesdrawnusingthesame

methodology,estimatedproportionsbasedontheentiresamplewillbenomorethan2.4percentage

pointsawayfromtheirtruevaluesinthepopulation.Itisimportanttorememberthatsampling

fluctuationsareonlyonepossiblesourceoferrorinasurveyestimate.Othersources,suchas

respondentselectionbias,questionwordingandreportinginaccuracymaycontributeadditionalerrorof

greaterorlessermagnitude.Table3showsdesigneffectsandmarginsoferrorforkeysubgroups.

Table3.DesignEffectsandMarginsofSamplingError

Sample

Size

Design

Effect MarginofError

TotalSample 3,014 1.75 2.4percentagepoints

White,notHispanic 1,864 1.75 3.0percentagepoints

AfricanAmerican,notHispanic 497 1.62 5.6percentagepointsHispanic 427 1.56 5.9percentagepoints

n

ppdeffp

)1(96.1 formula2


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RESPONSERATE

Table4reportsthedispositionofallsampledtelephonenumberseverdialedfromtheoriginal

telephonenumbersamples.Theresponserateestimatesthefractionofalleligiblesamplethatwas

ultimatelyinterviewed.20

Table 4. Sample Disposition

Landline Cell

1807 1205 I=Completes

8660 10980 R=Refusal and breakoff

3941 5570 NC=Non contact

164 87 O=Other

40051 13668 OF=Business/computer/not working/child's cell phone

4225 619 UH/UO=Unknown household/Unknown other

0.27 0.57 AAPOR's e=(I+R+NC+O)/(I+R+NC+O+OF)

11.5% 6.6% AAPOR RR3=I/[I+R+NC+O+(e*UH/UO)]

pew internet health online report

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