Digital Health and Rural Aging in Korea

Authored by: Chloe Lee

Art by: Ava Shi

South Korea is often celebrated as a global leader in digital health innovation, integrating telemedicine, wearable monitoring, and AI-driven diagnostics to transform patient care. Yet beneath this story of success lies a growing inequality: elderly patients in rural regions remain largely excluded from these advancements. The country’s rapid technological transformation has inadvertently widened the healthcare gap between urban and rural populations, highlighting how technological innovation does not guarantee accessibility and equity [1].

In rural provinces such as Gyeongsangbuk-do, physician shortages have long strained local healthcare systems. To compensate, community health centers implemented video consultations for elderly patients managing chronic illnesses such as hypertension and diabetes. In theory, these virtual check-ins promised convenience and continuity of care. However, in practice, many older adults were unable to navigate the required smartphone applications to access services. Some were unable to log in or install the necessary apps without assistance, while others struggled with unstable internet connections or outdated devices [6]. As a result, many patients missed their scheduled follow-ups or failed to transmit vital health data, undermining the fundamental purpose of telemedicine. Rather than bridging the care gap, these systems often reinforced it [6].

Digital literacy is a core reason for the growing divide. Although smartphone ownership among older Koreans has grown rapidly, proficiency remains low. A 2024 national survey found that over 60 percent of adults aged sixty-five and older could not independently install or delete applications, with greater than half saying they relied on younger family members to help them use health apps [5]. Limited education, economic constraints, and physical impairments such as poor eyesight further worsen usability. This phenomenon, known as the “third-level digital divide,” reflects inequalities in access to technology and the ability to effectively use it [5]. In rural areas, where social isolation and limited infrastructure significantly burden older adults, the divide becomes even more pronounced [4].

Cultural attitudes contribute to the implementation of new technology. Many older Koreans express hesitation or distrust towards telemedicine, viewing in-person visits as more reliable and personal. For chronic conditions requiring regular monitoring, patients often fear that remote consultations will miss important symptoms [1]. Some prefer to travel long distances to local clinics rather than rely on unfamiliar digital systems. Psychological factors, such as fear of making mistakes, embarrassment over lack of skill, or anxiety about privacy, further discourage participation [1,6]. In interviews conducted by rural health initiatives, older adults often described feeling that “telemedicine is not for people like me,” reflecting both generational and cultural divides [4].

Even for those willing to adopt telehealth, infrastructural challenges persist. Rural broadband is less reliable, and many older users depend on outdated smartphones or shared family tablets to access the internet [4]. These technical limitations often result in dropped video calls or incomplete uploads of biometric data, forcing patients and physicians to revert to traditional phone calls [6]. Local governments have launched creative initiatives to address these challenges. In Gyeongsangbuk-do, “digital literacy academies” now offer basic technology classes for older residents, while tablet-lending programs provide access to simplified devices with preinstalled health apps [4]. While these programs show promise, they remain unevenly distributed and limited in scale, often relying on short-term funding or volunteer staff to function [4].

The consequences of these digital inequities are far-reaching. When elderly patients cannot engage with telehealth services, follow-up appointments are missed, medication adherence declines, and chronic conditions worsen between in-person visits [3]. This not only endangers individual health outcomes but also increases strain on local healthcare systems that must absorb preventable complications [1]. Moreover, digital exclusion reinforces social isolation. As healthcare education, community updates, and even social interactions increasingly shift online, those unable to access these spaces are further marginalized [2]. A study conducted in 2025 found that digital literacy among older Koreans correlated positively with life satisfaction and mental health, largely through increased social capital and connection [2]. Exclusion from digital healthcare, therefore, is not merely a technical issue; rather, it is a social determinant of health [2,4].

Closing this gap requires going beyond distributing devices or software, requiring the prioritization of human-centered design. Health apps targeted at older users should feature simplified layouts, large fonts, and voice guidance in regional dialects [6]. Governments and local clinics could deploy “digital navigators,” where trained community health workers or volunteers visit patient homes and provide hands-on assistance with devices and consultations [6]. Crucially, hybrid care models that blend telehealth with in-person visits can preserve patient trust while easing the logistical burdens of travel [1]. Lastly, investment in rural infrastructure to expand high-speed broadband and reliable power supply is essential to ensure continuity of care [4].

References

1. Jeon, H., Lee, S., Kim, J., & Park, E. (2025). Willingness to use and pay for telemedicine in Korea: A cross-sectional study. Journal of Medical Internet Research, 27(1), e65304. https://doi.org/10.2196/65304

2. Jung, H., Kim, S., & Choi, Y. (2025). Mediating effect of social capital on the association between digital literacy and life satisfaction in older Koreans. Frontiers in Public Health, 13, 1457623. https://doi.org/10.3389/fpubh.2025.1457623

3. Lee, H., Park, Y., & Cho, J. (2024). Digital health technology use among older adults in Korea: Influence of frailty and satisfaction with wearable devices. Journal of Korean Medical Science, 39(e7). https://doi.org/10.3346/jkms.2024.39.e7

4. Pan, T. H., Seo, S., & Kwon, H. (2024). Digital inclusion among community older adults in the Republic of Korea. International Journal of Environmental Research and Public Health, 21(8), 154. https://doi.org/10.3390/ijerph21080154

5. Park, S., Kim, D., & Lee, J. (2024). Third-level digital divide among older adults in Korea: A comparative analysis of digital literacy and outcomes. Technological Forecasting and Social Change, 203, 123812. https://doi.org/10.1016/j.techfore.2024.123812

6. Ju, H. R., Lee, J. Y., & Nam, G. (2024). Content analysis of telemedicine applications in South Korea: Implications for user accessibility and design. Health Informatics Journal, 30(1), 112–128. https://doi.org/10.1177/14604582241260644