Successful Aging Across Middle Versus High-Income Countries: An Analysis of the Role of eHealth Literacy Associated With Loneliness and Well-Being

Ivan, Loredana; Marston, Hannah R; Prabhu, Vishnunarayan Girishan; Großschädl, Franziska; Alexandra Silva, Paula; Buttigieg, Sandra C; Öztürk Çalıkoğlu, Halime; Bilir Koca, Burcu; Arslan, Hasan; Kanozia, Rubal; Browning, Matthew H E M; Freeman, Shannon and Earle, Sarah (2025). Successful Aging Across Middle Versus High-Income Countries: An Analysis of the Role of eHealth Literacy Associated With Loneliness and Well-Being. 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 wellbeing, emphasizing independence for overall satisfaction and quality of life. We investigate the impact of e-health literacy on reducing loneliness and sustaining wellbeing 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=2091) 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 wellbeing.
Results:
Respondents from high-income countries reported significantly higher wellbeing 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. Wellbeing 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 wellbeing. Gender differences are observed, with females and those with a partner reporting higher wellbeing. 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.

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