Successful Ageing across Middle vs High-Income Countries: An Analysis of the Role of E-Health Literacy Associated with Loneliness and Wellbeing

Ivan, Loredana; Marston, Hannah; Prabhu, Vishnunarayan; Großschädl, Franziska; Alexandra Silva, Paula; Buttigieg, Sandra; Ozturk, Halime; Bilir-Koca, Burcu; Arslan, Hasan; Kanozia, Rubal; Browning, Matthew; Freeman, Shannon and Earle, Sarah (2025). Successful Ageing across Middle vs High-Income Countries: An Analysis of the Role of E-Health Literacy Associated with Loneliness and Wellbeing. The Gerontologist, 65(1), article no. gnae170.

DOI: https://doi.org/10.1093/geront/gnae170

Abstract

Background and Objectives: “Successful aging” concerns the process of growing older while maintaining physical, cognitive, and social well-being, emphasizing independence for overall satisfaction and quality of life. We investigate the impact of eHealth literacy on reducing loneliness and sustaining well-being during the pandemic, comparing middle- and high-income countries.
Research Design and Methods: Online surveys were conducted between April 4, 2020, and September 30, 2021, collecting responses (N = 2,091) from medium- and high-income countries in Europe, Asia, and North America. T-tests and ANOVAs were used to test how sociodemographic predictors were associated with differences in e-Health literacy, loneliness, and well-being.
Results: Respondents from high-income countries reported significantly higher well-being scores than those from middle-income countries and respondents from high-income countries had significantly higher e-HEALS (e-Health literacy) scores compared to middle-income countries.
No significant difference was observed in loneliness scores between high-income and middle-income country respondents. Well-being is associated with age, with younger adults (18–29 years) and those aged 40+ reporting higher levels. Higher education and income are linked to greater well-being. Gender differences are observed, with females and those with a partner reporting higher well-being. In middle-income countries, higher education levels are more linked to loneliness, while in higher-income countries, loneliness is observed across education levels.
Discussion and Implications: Future interventions by governments and policymakers should consider intersectionality in e-Health planning and offer digital literacy and digital skills training to those with lower education levels.