Abstract Body (Do not enter title and authors here): Background
Wearable devices that track health indicators are increasingly recognized as valuable tools in preventing cardiovascular diseases by facilitating self-monitoring and engagement in heart-healthy behaviors. However, disparities in utilization persist, raising concerns about equitable adoption.
Objective
To investigate sociodemographic disparities in wearable device use, focusing on independent and interactive effects of race/ethnicity, income and education.
Methods
We conducted a cross-sectional analysis of the 2022 Health Information National Trends Survey. The primary outcome was self-reported use of wearable devices in the past months to track physical activity or health-related metrics. Key exposures included race/ethnicity, income and education. We used multivariable survey-weighted logistic regression models to estimate adjusted odds ratios (AORS) with 95% confidence intervals (CIs), with education as a covariate. The Rao-Scott adjusted likelihood ratio test evaluated the interaction between race/ethnicity and income. Statistical analyses were conducted in R (version 4.5.0), employing the "svyglm" function with a quasibinomial family specification.
Results
Among 5,486 U.S adults surveyed, 29.7% reported using a wearable device in the past 12 months to track physical activity or health indicators. After adjusting for education and covariates, Non-Hispanic Black adults had significantly lower odds of wearable device use compared to Non-Hispanic Whites (AOR 0.74; 95% CI, 0.63 -0.88), as did Hispanic adults (AOR 0.85; 95% CI, 0.72-0.99). Individuals with incomes >400% of the federal poverty level were more than twice as likely to use wearables than those below 100% FPL (AOR 2.33; 95% CI, 1.89 – 2.86). College graduates had higher odds of wearable use than those with less than a high school education (AOR 2.46; 95% CI, 1.89 – 3.19). A significant interaction was observed between race/ethnicity and income (Rao-Scott likelihood ratio test, p = 0.041). Stratified contrasts suggested that income-related increases in use were more substantial among non-Hispanic White adults than non-Hispanic Black or Hispanic individuals, suggesting a compounded disparity by race and socioeconomic status.
Conclusion
Despite the promise of wearable devices, findings point to persistent and intertwined racial and socioeconomic gaps in use. These disparities are not merely statistical; they represent missed opportunities for early intervention in vulnerable populations.