Health-related Internet Use among Older People in Norway

Ali Acilar

Department of Information Systems, University of Agder, Universitetsveien 25, Kristiansand, Norway

Keywords: Health-related Internet Use, Health, Internet, Older People, Aging, Aging Population, Digital Divide, Digital

Inclusion, Norway.

Abstract: Like in many developed countries, the aging population presents a major challenge for Norway. Life

expectancy in the Norwegian population has increased, and the proportion of older people is expected to

increase. Since the use of internet-based technologies in healthcare is increasing, it is very important for older

adults to use the internet in order to benefit from these technologies. The main aim of this study is to explore

health-related internet use among older people in Norway by using national survey results of ICT usage in

households. Survey results show that general internet use and health-related internet use have been increased

among older Norwegian population. The most common purpose for health-related internet use among older

people was seeking health-related information and the least common purpose was other health services online.

Even though the rate of internet use among older people in Norway is higher than in many developed countries,

the results show that there exist age-based differences in health-related internet use.

1 INTRODUCTION

Today’s modern societies are facing a significant

transformation that is mainly characterized by two

developments: an aging population and technological

developments (Bujnowska-Fedak and Kurpas, 2015;

König et al., 2018). In 2020, there were estimated to

be 727 million people aged 65 and older worldwide

and it is projected that this number will more than

double by 2050, reaching over 1,5 billion people (UN,

2020). Populations around the world are steadily

aging. In recent decades, average life expectancy has

increased worldwide, and older adults have begun to

comprise a growing proportion of the population,

particularly in developed countries. According to the

World Health Organization (WHO), it is projected

that 22% of the world population will be over 60 years

in 2050 (It was 12% in 2015). In many developed

countries, an increasingly older population is more

prominent. For example, 30% of the population is

already over 60 years old in Japan (WHO, 2018). This

demographic change presents significant challenges

for governments and societies (Bloom et al., 2015;

Olphert and Damodaran, 2013).

In addition to worldwide aging populations, many

services started to be provided digitally, in parallel

https://orcid.org/0000-0003-1613-3521

with the developments in technology over the past

decades (Rønning and Sølvberg, 2017). Information

and communication technologies (ICTs), especially

the internet, have become an integral part of modern

life and present a significant impact on many aspects

of daily life. Today, the internet has become an

invaluable medium for the health sector in providing

health information and healthcare services.

Technological developments using the internet

promises to deliver healthcare services without time

and space restrictions (Merkel and Hess, 2020). These

developments in technology and population introduce

new challenges to societies, such as the digital divide;

some people risk being excluded from fully

participating in the digital society (Rønning and

Sølvberg, 2017). In many countries around the world,

certain groups in the population lag behind others in

terms of accessing and using ICT, such as older

adults, disabled people, and women. Older people are

the most challenging group in society in this context

because of their low adoption pace (Gerd and

Christian, 2005). As societies become digitalized,

older people are particularly vulnerable (Kania-

Lundholm and Torres, 2015).

Digital inclusion, enabling everyone to have

access and capability to use the internet and

196

Acilar, A.

Health-related Internet Use among Older People in Norway.

DOI: 10.5220/0010994800003188

In Proceedings of the 8th Inter national Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AWE 2022), pages 196-203

ISBN: 978-989-758-566-1; ISSN: 2184-4984

associated digital technologies, has wide-ranging

benefits to the individual, the economy, and society

(Olphert and Damodaran, 2013). Lower rates of

computer and internet use among older people have

critical social consequences (McDonough, 2016).

Being digitally disengaged has essential social,

health, and economic disadvantages (Siren and

Knudsen, 2017). As healthcare systems increasingly

depend on internet-based technologies to assist and

support healthcare delivery, it is very important to

engage older adults in using these technologies

(Nguyen et al., 2017). The main aim of this study is

to explore health-related internet use among older

people in Norway, one of the highly digitalized

European countries.

2 RELATED LITERATURE

2.1 Characteristics of Aging and Older

People

Aging is a natural, inevitable, and normal process in

human lifespans. There is no consensus in the

definition of “old”, “old age” or “older adult” (Fox

and Connolly, 2018). While the United Nations (UN)

defines older people as those aged 60 years or more,

in most developed countries older people are

commonly defined as those aged 65 years or more

(Eurostat, 2020). Even though chronological age is

frequently used, the threshold where ‘old’ begins

varies contextually and culturally (Rockmann et al.,

2018).

Older age is an important level of life and can

affect the person and people around them in

significant ways. Older people may have

considerably different needs and wants because of the

life stage they have reached (Gregor et al., 2002).

Some of the common health conditions related to

aging include hearing loss, cataracts, and refractive

errors, back and neck pain and osteoarthritis, chronic

obstructive pulmonary disease, diabetes, depression,

and dementia (WHO, 2018). Chronological age and

perceived age have an important role in determining

one’s beliefs, attitudes, and behaviours (Lagacé et al.,

2016). Ageing is correlated with a decline in sensory,

perceptual, motor and cognitive abilities (Chen,

2013). Older people can suffer variety of impairments

such as reduced vision, hearing, memory, and

mobility, and these impairments can lead to difficulty

in learning and sometimes hinder the use of new

technologies (Chen, 2013).

The aging process can be different from person to

person. While some older people have physical and

mental capacities similar to younger people, some

people experience significant declines in physical and

mental capacities at much younger ages (WHO,

2018). Online older people are not a monolithic

group, and they have different health attitudes and

behaviours (McMillan and Macias, 2008). Today,

there are some radical changes that are influencing

the lives of older people in direct and indirect ways,

such as globalization, technological developments

(e.g., in transport and communication), urbanization,

migration, and changing gender norms (WHO, 2018).

2.2 Older People and Health-Related

Internet Use

The internet has become an important source of

health information and e-health channel (Bujnowska-

Fedak et al., 2019; Kummervold and Wynn, 2012).

The internet is an invaluable tool for enabling access

to health information, communication, attract the

attention of the public, and disseminating health

information (Paige et al., 2017). As an essential

source of health information, the internet provides

worldwide accessible resources on topics ranging

from specific diseases and treatment options to

healthcare providers and insurance plans, healthy

lifestyle choices and health products (Zulman et al.,

2011). Information seeking is the most common

activity in health-related internet use (Ghenai et al.,

2020; Hone et al., 2016; Wong et al., 2014). In 2019,

Google received more than one billion health-related

searches (About 70.000 searches every minute and 7

per cent of Google’s daily searches) worldwide in a

day (Murphy, 2019).

Today, physicians have less control over health-

related information that is transmitted to patients

(Tonsaker et al., 2014). People take a more active

approach to managing their health with digital access

to health information (Hall et al., 2015). Before the

internet, people relied on other health information

such as books, newspapers, magazines, and

information given by their doctors, family, and

friends (Kummervold and Wynn, 2012), but today the

internet has become the main source for health-

related information. The internet offers an enormous

quantity of online news and information on diseases,

treatment, and prevention in multiple formats ranging

from text articles to videos and podcasts (Crabb et al.,

2012). The internet provides an opportunity for

patients to explore sensitive conditions with privacy

and online support networks that patients can share

their personal health and illness experiences which

might not be provided by physicians (Hone et al.,

2016; Tonsaker et al., 2014). The internet offers

Health-related Internet Use among Older People in Norway

197

various ways to share and disseminate health-related

information, ranging from static websites to blogs,

social media sites, and video sharing sites.

Studies show that age, gender, education level,

income and health condition are the most important

common predictors of health-related internet use

(Alvarez-Galvez et al., 2020; Calixte et al., 2020;

Merkel and Hess, 2020; Nguyen et al., 2017). Older

individuals are less likely to use the internet for

health-related purposes (Calixte et al., 2020; Merkel

and Hess, 2020; Nguyen et al., 2017). Females are

more likely than males to use the internet for health-

related reasons (Alvarez-Galvez et al., 2020;

Escoffery, 2018). Education levels are positively

associated with health-related internet use (Alvarez-

Galvez et al., 2020; Calixte et al., 2020; Merkel and

Hess, 2020; Nguyen et al., 2017). People with low

socioeconomic status are less likely to use the internet

for health-related reasons (Calixte et al., 2020;

Merkel and Hess, 2020). People who live in rural

areas are less likely to have access to and use the

internet for health-related use (Bujnowska-Fedak et

al., 2019; Merkel and Hess, 2020; Nguyen et al.,

2017). Individuals with chronic health conditions

(diseases) or a significant number of health problems

are more likely to use the internet for health-related

reasons (Alvarez-Galvez et al., 2020). There are some

studies that also reported racial/ethnic disparities in

health-related internet use (Calixte et al., 2020;

Gordon and Hornbrook, 2018; Nguyen et al., 2017).

In addition to having an information source about

health, the internet can be used for an alternative

medium to face-to-face healthcare services for older

adults (Berner et al., 2015). The internet not only

provides users with a platform for information

exchange but also helps promote healthcare, such as

service delivery, in-home monitoring, interactive

communication, and support (Wong et al., 2014).

Computers and the internet can become powerful

assistive technologies for older people, helping them

to maintain and enhance their level of independence,

maintain their psychological well-being, social

connectedness, and sense of worth in the face of

declining health or limited capabilities, as well as also

offering new opportunities to improve their quality of

life (Lee et al., 2014; Olphert and Damodaran, 2013).

The internet and e-health services have significant

potential to support efficient and effective care for

older people (Bujnowska-Fedak and Mastalerz-

Migas, 2015). Accessing health information and

health-management tools by using the internet can

have a positive impact on the many dimensions of

healthy aging (Cresci et al., 2012). Also, living in

remote areas or far from a hospital, healthcare

centers, and towns can become less of a problem for

older internet users (Berner et al., 2015). Since

healthcare systems increasingly rely on internet-

based technologies, it is crucial to engage older

individuals in using the internet and these

technologies (Nguyen et al., 2017).

Since it is possible to carry out an increasingly

diverse array of tasks online, older adults who have

health problems and feel socially isolated are

especially likely to benefit from using internet

technology, especially when they lack family, friends,

and health and social service providers who can help

with these tasks (Choi and DiNitto, 2013).

As the internet is a main source for health-related

information, healthcare providers, governments and

other healthcare-related parties are concerned that it

is important to be accessed by everyone. In particular,

older people with less internet experience face the

risk of being excluded as healthcare becomes more

dependent on the internet (Merkel and Hess, 2020).

Even though the internet has an important potential in

supporting their health with providing information,

communication, assistance, and services, studies

show that older adults are less likely to use the

internet, both overall and for health-related purposes

(Calixte et al., 2020; Choi and DiNitto, 2013; Gordon

and Hornbrook, 2018; Merkel and Hess, 2020; Miller

and Bell, 2012; Zulman et al., 2011). Studies show

that age is an important factor for technology

adoption and health-related internet use. Age is one

of the important demographic variables in digital

divide research and has been included in many studies

about digital inequalities (Acilar, 2021).

There are various reasons why older people have

less health-related internet use compared to the

younger generations, such as inexperience with

technology or physical limitations, preferring

traditional sources of health information, and distrust

of the internet as a source of health information

(Zulman et al., 2011). (Bujnowska-Fedak and

Mastalerz-Migas, 2015) found that the factors

influencing the use of the internet among older people

for health purposes included age, higher education,

living with family, and mobile phone use. (Sheng and

Simpson, 2015) explored internet use among seniors

for health purposes and found that demographics,

trust in health information websites, perceived

usefulness of the internet, and internal locus of

control each significantly impact seniors’ use of the

internet to seek health information. Besides, (Merkel

and Hess, 2020) found that young age, high

education, high social class, and living in an urban

area were positively associated with a high

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

198

probability of using internet-based health and social

services.

Older people are more likely to develop one or

more physical disabilities that could affect their use

of computers and the internet, such as visual

problems, motor problems, or musculoskeletal

problems (Olphert and Damodaran, 2013). Factors

related to the aging process can be important barriers

to older adults using the internet for health-related

activities (Choi, 2011). For seniors, internet search

and understanding health information can be difficult

and demanding (Miller and Bell, 2012) with the

declining cognitive ability that comes with age. Age-

related changes in visual, perceptual, motor and

cognitive abilities make it more difficult for older

adults to learn and use new technologies (Xie, 2003).

Chung et al., (2011) found that too much information

was the prime barrier to using online health

information by older adult internet users. Too much

health information on the internet can be confusing

for older people.

Trust is an important predictor of health-related

internet use among older adults. Zulman et al. (2011),

Miller and Bell (2012), and Marinescu (2017)

reported that older individuals are less trusting the

internet as a health resource, and that older adults’

distrust can hinder their optimal usage of the internet

for their health. Instead of the internet, traditional

sources of health information, such as physicians and

pharmacists, may be preferred by older people (Miller

and Bell, 2012).

Even though older people in particular could

benefit from eHealth, they often show resistance and

anxiety towards new technologies (Rockmann and

Gewald, 2015). Choi and DiNitto (2013) found that

symptoms of anxiety and depression were negatively

associated with internet use among older adults, and

having a diagnosis of dementia or Alzheimer’s

disease significantly lowered the odds of internet use.

“Feeling too old” is also recognized as a barrier to

using the internet as people become older (Morris,

2007).

3 METHODOLOGY

This research was based on two data sources: the

Norwegian Statistics Bureau, Statistics Norway

(SSB) and European Statistical Office (Eurostat). The

statistics were drawn from Statistics Norway ICT

Usage in Households database and Eurostat ICT

Usage in Households and Individuals database. In

addition, Statistics Norway population projections

were used. In this study, descriptive methodology and

simple statistical analysis were used to explore

health-related internet use among older people in

Norway. Health-related internet use among older

people in Norway was explored among different age

groups and between genders. In addition, Norway and

EU statistics were presented in comparison.

3.1 The Aging Population in Norway

As in other developed countries, Norway has an aging

population, and the increase in life expectancy of

Norwegian people is projected to continue. Life

expectancy at birth is expected to rise from around

81,2 years for men and 84,7 years for women in 2020,

to 89 and 91 years in 2060, according to Statistics

Norway. The Norwegian population was 5.391.369 in

2021 (January) and projected to be 6.001.759 in 2050.

67,4% population growth is expected between 2020

and 2060 in the over 60 age group, an increase from

about 1,25 million (23,3%) to 2,09 million people

(34,4%). In the same period, a decrease is projected

for the under 30 age group, from 1,96 million (36,5%)

in 2020 to 1,86 million (30,6%) in 2060. The age

structure of the Norwegian population is changing

with the aging population. The proportion of older

people in the general Norwegian population is

increasing. This aging trend in the population

underlines the need to focus on older people’s

inclusion in the information society.

In 2021, there were 965.742 people (17,9%) aged

65 and over in Norway. According to Norway’s

population projections by Statistics Norway, there

will be more older people (65+ years) than children

and teenagers (0-19 years) living in Norway in

approximately ten years. In 2050, it is projected that

there will be about 1,5 million people (26,2%) aged

65 years and over.

3.2 Internet Use among Older People

in Norway

Norway is among the most digitalized countries in

Europe, according to the Digital Economy and

Society Index (DESI) reports in 2021. In 2020,

Norway was ranked as 13rd in the United Nation’s E-

Government Development Index and 18th in E-

Participation Index out of 193 countries. The rate of

Internet users in Norway rose from 79% in 2006 to

99% in 2021 among those aged 16-79 years in the

population (Statistics Norway). The majority of the

Norwegian population is well equipped with today’s

technologies such as smartphones, computers and

tablets to use digital platforms (Rønning and

Sølvberg, 2017).

Health-related Internet Use among Older People in Norway

199

The rate of internet use among older people in

Norway is much higher than in other European

countries. According to the results of 2021 ICT usage

in households survey in Norway, the rate of internet

use (in the last 3 months) is 97% among 65-74 years

old and 92% among 75-79 years old, while 99% of

those aged 55-64 and 100% of those aged 16-54 years

are internet users. The rate of internet use has

increased from 28% among 65-74 years old and 16%

among 75-79 years old in 2006 to 97% and 92%

respectively in 2021. Eurostat estimated the rate of

internet use (in the last 3 months) in 2021 among 65-

74 years old as 64% in the EU.

Older Norwegians actively use the internet for

various purposes. According to results of 2021 ICT

usage in households survey in Norway, older adults

(aged 65-74 and 75-79) reported that they used the

internet for e-mail (92% and 84%), finding

information about goods and services (82% and

72%), banking (91% and 82%), making calls or

videocalls (58% and 44%) and participation in social

networks (69% and 53%).

3.3 Health-related Internet Use among

Older People in Norway

The survey on ICT usage in households by Statistics

Norway includes four variables about health-related

internet use: “seeking health-related information”,

“making an appointment with a medical doctor”,

“getting access to personal health record” and “other

health services online”. Norwegian national statistics

are available for “seeking health-related information”

from 2005 (except for 2012 and 2014), for “making

an appointment with a medical doctor” for 2016, 2018

and 2020. Internet use statistics for variables “getting

access to personal health record” and “other health

services online” are collected from 2020.

Internet use for seeking health-related information

among older people in Norway has increased

significantly, from 6 percent in 2005 to 52% in 2020

among 65-74 years old and 38% among 75-79 years

old and increased even more in 2021. Internet use for

seeking health-related information was reported as

62% among 65-74 years old and 55% among 75-79

years old in 2021.

Health-related internet use in the Norwegian

population is higher than in the European Union for

all age groups (Table 1). In general, the rate of

internet use for health purposes in Norway is less

among the youngest (16-24 years) and the oldest

people (75-79 years) compared to middle age groups.

In 2020, 65-74 years old people reported using the

internet for seeking health-related information (52%),

getting access to their personal health record (36%),

making an appointment with a medical doctor (33%)

and using other health services online (23%). These

rates are even lower for those aged 75-79, seeking

health-related information (38%), getting access to

personal health record (23%), making an appointment

with a medical doctor (25%) and using other health

services online (16%) (Statistics Norway).

Table 2 and Figure 1 presents health-related

internet use by age. As shown in the table, for all age

groups and genders, the most common purpose for

health-related internet use was seeking health-related

information, and the least common purpose was other

health services online. Among 65-74 years old, the

rates of internet use among females were higher than

males for seeking health-related information and

other health services online. Health-related internet

use among the 75-79 years old was less than those

aged 65-74. Among the 75-79 years old, the rates of

health-related internet use for men were higher than

for women for seeking health-related information,

getting access to personal health record and other

health services online.

Table 1: Health-related internet use in Norway and the EU, 2020, by age (%)

16-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65-74 years

75-79 years

NOR

Used the internet to seek for health-

related information

Used the internet to get access to

personal health record

Used the internet to make an

appointment with a medical doctor

Used the internet to use other health

services online

Data source: Statistics Norway and Eurostat

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

200

Table 2: Health-related internet use in Norway, 2020, by age and gender (%).

16-24 years

25-34 years

35-44 years

45-54 years

55-64 years

65-74 years

75-79 years

Used the internet to seek for

health-related information

Used the internet to get access to

personal health record

Used the internet to make an

appointment with a medical doctor

Used the internet to use other

health services online

Data source: Statistics Norway

Figure 1: Health-related internet use by age (%), 2020. Data

source: Statistics Norway

4 CONCLUSIONS

Like in other developed countries, Norway has an

aging population, and life expectancy is projected to

increase further in the coming decades. The aging

trend in the Norwegian population is an important

threat to achieving a completely inclusive digital

society, as an increasing number of public and private

services are being provided digitally.

This study has attempted to explore health-related

internet use among older people in Norway using

national ICT usage in households survey results.

Survey results indicate an increased internet use

among older adults in Norway. Even though the rates

of internet use and health-related internet use among

older Norwegians are higher than in many developed

countries, the age-based divide is still apparent.

Internet use among older people (65+) is less than

younger generations.

The most common purpose for health-related

internet use was seeking health-related information,

and the least common purpose was other health

services online. There are also some differences

observed between genders in terms of health-related

internet use.

This study highlights the digital gap in health-

related internet use among older people in Norway,

an increasingly digitalized and aging country. The

digital divide is not just a problem for developing

countries but also for developed nations. In order not

to be excluded from increasingly digital health

services, necessary measures should be taken into

consideration to bridge the digital gap among older

people.

The Covid-19 pandemic has significantly affected

our lives all over the world, and older people are

among the most dramatically affected by the

coronavirus. The pandemic has highlighted the

importance of information technologies in our lives,

especially during lockdowns. There is a need to

research how the Covid-19 pandemic has affected

older people in terms of using the internet for general

purposes and health-related use. Future research

should continue to explore affecting factors in health-

related internet use among older people and how to

increase it. Comparative studies between different

countries can also be considered in future research.

REFERENCES

Acilar, A. (2021). Age and Digital Divide: The Case of a

Developing Country, Turkey, International Journal of

Innovation in the Digital Economy, 12(3), 17-29.

Alvarez-Galvez, J., Salinas-Perez, J.A., Montagni, I. &

Salvador-Carulla, L. (2020). The persistence of digital

divides in the use of health information: a comparative

study in 28 European countries, International Journal

of Public Health, 65(3), 325-333.

Berner, J., Rennemark, M., Jogréus, C., Anderberg, P.,

Sköldunger, A., Wahlberg, M., . . . Berglund, J. (2015).

Factors influencing Internet usage in older adults (65

years and above) living in rural and urban Sweden,

Health Informatics Journal, 21(3), 237-249.

Health-related Internet Use among Older People in Norway

201

Bloom, D.E., Canning, D. & Lubet, A. (2015). Global

population aging: Facts, challenges, solutions &

perspectives, Daedalus, 144(2), 80-92.

Bujnowska-Fedak, M.M. & Kurpas, D. (2015). The

influence of online health information on the attitude

and behavior of people aged 50+, In M. Pokorski (Ed.),

Respiratory Health (pp. 1-17), Cham: Springer

International Publishing.

Bujnowska-Fedak, M.M. & Mastalerz-Migas, A. (2015).

Usage of medical internet and e-health services by the

elderly, In M. Pokorski (Ed.), Environment Exposure to

Pollutants (pp. 75-80), Cham: Springer International

Publishing.

Bujnowska-Fedak, M.M., Waligóra, J. & Mastalerz-Migas,

A. (2019). The internet as a source of health

information and services, In Advancements and

Innovations in Health Sciences (pp. 1-16): Springer.

Calixte, R., Rivera, A., Oridota, O., Beauchamp, W. &

Camacho-Rivera, M. (2020). Social and demographic

patterns of health-related internet use among adults in

the United States: A secondary data analysis of the

health information national trends survey, International

Journal of Environmental Research and Public Health,

17(18), 6856.

Chen W. (2013) Gesture-Based Applications for Elderly

People. In: Kurosu M. (eds) Human-Computer

Interaction. Interaction Modalities and Techniques.

HCI 2013. Lecture Notes in Computer Science, vol

8007. Springer, Berlin, Heidelberg.

Choi, N. (2011). Relationship between health service use

and health information technology use among older

adults: Analysis of the US national health interview

survey, Journal of Medical Internet Research, 13(2),

e33.

Choi, N.G. & DiNitto, D.M. (2013). Internet use among

older adults: Association with health needs,

psychological capital, and social capital, Journal of

Medical Internet Research, 15(5), e97.

Chung, J., Gassert, C.A. & Kim, H.S. (2011). Online health

information use by participants in selected senior

centres in Korea: Current status of internet access and

health information use by Korean older adults,

International Journal of Older People Nursing, 6(4),

261-271.

Crabb, R.M., Rafie, S. & Weingardt, K.R. (2012). Health-

related internet use in older primary care patients,

Gerontology, 58(2), 164-170.

Cresci, M.K., Jarosz, P.A. & Templin, T.N. (2012). Are

health answers online for older adults?, Educational

Gerontology, 38(1), 10-19.

Escoffery, C. (2018). Gender similarities and differences

for e-health behaviors among US adults, Telemedicine

and e-Health, 24(5), 335-343.

Fox, G. & Connolly, R. (2018). Mobile health technology

adoption across generations: Narrowing the digital

divide, Information Systems Journal, 28(6), 995-1019.

Gerd, P. & Christian, S. (2005). Is the digital divide

between young and elderly people increasing?, First

Monday, 10(10),

Ghenai, A., Smucker, M.D. & Clarke, C.L. (2020). A think-

aloud study to understand factors affecting online

health search, The 2020 Conference on Human

Information Interaction and Retrieval, Vancouver,

Canada, 273-282.

Gordon, N.P. & Hornbrook, M.C. (2018). Older adults’

readiness to engage with eHealth patient education and

self-care resources: a cross-sectional survey, BMC

Health Services Research, 18(1), 220.

Gregor, P., Newell, A.F. & Zajicek, M. (2002). Designing

for dynamic diversity: interfaces for older people, The

Fifth International ACM Conference on Assistive

Technologies, Edinburgh, Scotland.

Hall, A.K., Bernhardt, J.M. & Dodd, V. (2015). Older

adults’ use of online and offline sources of health

information and constructs of reliance and self-efficacy

for medical decision making, Journal of Health

Communication, 20(7), 751-758.

Hone, T., Palladino, R. & Filippidis, F.T. (2016).

Association of searching for health-related information

online with self-rated health in the European Union,

The European Journal of Public Health, 26(5), 748-

753.

Kania-Lundholm, M. & Torres, S. (2015). The divide

within: Older active ICT users position themselves

against different ‘Others’, Journal of Aging Studies, 35,

26-36.

König, R., Seifert, A. & Doh, M. (2018). Internet use

among older Europeans: an analysis based on SHARE

data, Universal Access in the Information Society,

17(3), 621-633.

Kummervold, P.E. & Wynn, R. (2012). Health information

accessed on the internet: The development in 5

European countries, International Journal of

Telemedicine and Applications, 2012, 297416.

Lagacé, M., Charmarkeh, H., Zaky, R. & Firzly, N. (2016).

From psychological to digital disengagement:

exploring the link between ageism and the ‘grey digital

divide’, Romanian Journal of Communication and

Public Relations, 18(1), 65-75.

Lee, E., Han, S. & Chung, Y. (2014). Internet use of

consumers aged 40 and over: Factors that influence full

adoption, Social Behavior and Personality: An

International Journal, 42(9), 1563-1574.

Marinescu, V. (2017). Romanian seniors, internet and

health, Romanian Journal of Sociological Studies, 2,

135-143.

McDonough, C. (2016). The effect of ageism on the digital

divide among older adults, Journal of Gerontology &

Geriatric Medicine, 2(8),

McMillan, S.J. & Macias, W. (2008). Strengthening the

safety net for online seniors: Factors influencing

differences in health information seeking among older

internet users, Journal of Health Communication,

13(8), 778-792.

Merkel, S. & Hess, M. (2020). The use of internet-based

health and care services by elderly people in Europe and

the importance of the country context: Multilevel study,

JMIR Aging, 3(1), e15491.

ICT4AWE 2022 - 8th International Conference on Information and Communication Technologies for Ageing Well and e-Health

202

Miller, L.M.S. & Bell, R.A. (2012). Online health

information seeking: the influence of age, information

trustworthiness, and search challenges, Journal of

Aging and Health, 24(3), 525-541.

Morris, A. (2007). E-literacy and the grey digital divide: a

review with recommendations, Journal of Information

Literacy, 1(3), 13-28.

Murphy, M. (2019). Dr Google will see you now: Search

giant wants to cash in on your medical queries,

Retrieved from https://www.telegraph.co.uk/

technology/2019/03/10/google-sifting-one-billion-

health-questions-day/

Nguyen, A., Mosadeghi, S. & Almario, C.V. (2017).

Persistent digital divide in access to and use of the

Internet as a resource for health information: Results

from a California population-based study, International

Journal of Medical Informatics, 103, 49-54.

Olphert, W. & Damodaran, L. (2013). Older people and

digital disengagement: A fourth digital divide?,

Gerontology, 59(6), 564-570.

Paige, S.R., Krieger, J.L. & Stellefson, M.L. (2017). The

influence of ehealth literacy on perceived trust in online

health communication channels and sources, Journal of

Health Communication, 22(1), 53-65.

Rockmann, R. & Gewald, H. (2015). Elderly people in

ehealth: Who are they?, Procedia Computer Science,

63, 505-510.

Rockmann, R., Gewald, H. & Haug, M. (2018). Equal

access for everyone? A digital divide cascade for retired

senior citizens, ECIS 2018, Portsmouth, UK

Rønning, W.M. & Sølvberg, A.M. (2017). Older adults’

coping with the digital everyday life, Seminar.net -

International Journal of Media, Technology and

Lifelong Learning, 13(2), 55-71.

Sheng, X. & Simpson, P.M. (2015). Health care

information seeking and seniors: determinants of

Internet use, Health Marketing Quarterly, 32(1), 96-

112.

Siren, A. & Knudsen, S.G. (2017). Older adults and

emerging digital service delivery: A mixed methods

study on information and communications technology

use, skills, and attitudes, Journal of Aging & Social

Policy, 29(1), 35-50.

Statistics Norway. https://www.ssb.no/

Tonsaker, T., Bartlett, G. & Trpkov, C. (2014). Health

information on the Internet: Gold mine or minefield?,

Canadian Family Physician, 60(5), 407-408.

UN (2020). World Population Ageing 2020 Highlights.

Retrieved from https://www.un.org/development/desa/

pd/sites/www.un.org.development.desa.pd/files/files/d

ocuments/2020/Sep/un_pop_2020_pf_ageing_10_key

_messages.pdf

WHO (2018). Ageing and Health. Retrieved from

https://www.who.int/news-room/fact-sheets/detail/

ageing-and-health

Wong, C.K., Yeung, D.Y., Ho, H.C., Tse, K.P. & Lam,

C.Y. (2014). Chinese older adults’ Internet use for

health information, Journal of Applied Gerontology,

33(3), 316-335.

Xie, B. (2003). Older adults, computers, and the Internet:

Future directions, Gerontechnology, 2(4), 289-305.

Zulman, D.M., Kirch, M., Zheng, K. & An, L.C. (2011).

Trust in the internet as a health resource among older

adults: Analysis of data from a nationally representative

survey, Journal of Medical Internet Research, 13(1),

e19.

Health-related Internet Use among Older People in Norway

203