Tallinn University study reveals digital health divide among Estonians over 50

A doctoral thesis defended at Tallinn University shows that Estonians aged 50 and over face starkly unequal ability to find, assess, and use online health information. The study found that 16% of respondents have never used a computer, while nearly half rely solely on the first Google search result. Researcher Marianne Paimre argues that Estonia's biggest digital challenge is not internet access itself, but the skills needed to benefit from it.

A new doctoral thesis defended at Tallinn University has shed light on a growing divide in how older Estonians engage with digital health information, one that the researcher warns is fundamentally a question of social inequality.

Marianne Paimre, who received her doctorate in information society technologies from Tallinn University on 10 June 2026, surveyed nearly 500 people aged 50 and over and conducted in-depth interviews to map how older Estonians search for health information online.

A divided picture

The findings paint a strikingly uneven picture. While some respondents searched for health information daily, the majority did so only occasionally or sporadically. Twelve percent said they had never sought health information online at all, and 16% said they had never used a computer.

«Health information-seeking, evaluation, and utilisation capacity is unevenly distributed across society. That is why digital health is also a question of social inequality,» Paimre said.

Education emerged as a key dividing factor. Those with higher education searched for online health information significantly more than those with lower levels of schooling. Paimre had initially expected age to be the primary variable, but the role of education turned out to be equally important.

Trusting the first result

Even among those who do search online, the ability to critically assess the information found was alarmingly low. Nearly half, 47%, said they rely primarily on the first Google search result, and 68% reported difficulty in judging whether the information they found was relevant or trustworthy for their particular health concern.

«It was somewhat surprising that although people searched quite a lot, they were not particularly good at evaluating what they found,» Paimre noted.

Despite widespread concerns about technology replacing doctors, Paimre's findings offered a different picture. Healthcare professionals remained the most trusted source of health information across all age groups. «The media-driven fear that Google or artificial intelligence is the new doctor displacing medical workers did not emerge from my study,» she said.

Men more drawn to health apps

The study also revealed a notable gender difference. Men showed considerably greater interest in health apps and digital services than women. «We tend to think that men don't look after their health and are indifferent to it. Yet my study showed that when health information comes through digital technology, men's interest is high,» Paimre observed, suggesting that the digital sphere could be a key avenue for reaching men on health topics.

In terms of vaccination willingness, the study was conducted at the start of the COVID-19 pandemic, those who searched more actively and used higher-quality sources such as news outlets and health portals were significantly more willing to get vaccinated. This link did not appear for other health behaviours such as physical activity or dietary choices.

Beyond access, the real divide

Paimre argues that Estonia's primary digital challenge is no longer the so-called first-level divide, whether people have internet access at all. The more serious problem lies at the second and third levels: whether people can find the information they need, evaluate its quality, and translate it into meaningful improvements in their health and wellbeing.

«The third level means the ability to actually benefit from it all, whether people can do something sensible with the information they find online to improve their health,» she explained.

Her recommendations include tailored support for different skill levels among older adults. She highlighted that a one-off training session is insufficient for those with no prior digital experience. «They need a place and a person who introduces them to smart devices consistently and does not get annoyed by questions,» she said. While libraries currently fill this role to some extent, Paimre suggested that neighbourhood social centres and community groups could provide more sustainable, ongoing digital skills support for older Estonians.

The thesis, titled Patterns of Online Health Information-Seeking Behaviour and Related Factors Among Estonian Older Adults, was supervised by distinguished professor Sirje Virkus of Tallinn University. The opponents were emeritus professor Ágústa Pálsdóttir from the University of Iceland and associate professor Nafiz Zaman Shuva from the City University of New York.