A new study from researchers at the University of Iowa reveals significant disparities in telehealth use for mental health and substance use disorder (SUD) treatment, particularly among vulnerable populations. While telehealth became a crucial tool during the COVID-19 pandemic, providing continued access to care amid widespread disruptions, not all communities benefited equally due to barriers such as limited technology and poor internet access.

The systematic review, which analyzed 25 of 2,740 eligible studies, found that rural residents, older adults, and Black/African American communities had notably lower rates of telehealth utilization during the pandemic. Most of the studies focused on mental health conditions, with some also addressed opioid use disorders.

The study’s key findings suggest that while many studies examined telehealth utilization and demographic factors, more research is needed to understand how these disparities impact health outcomes. The researchers emphasize that addressing these inequities is critical to improving access to care for underserved populations.

Lead author Priyanka Vakkalanka, assistant professor of emergency medicine and epidemiology at the University of Iowa, stresses the importance of studying telehealth inequities. “Barriers like limited technology and poor internet access disproportionately affect low-income and rural communities, leading to unequal access to care and poorer health outcomes,” Vakkalanka says.

By identifying and addressing these challenges, the researchers believe telehealth services can be improved to ensure they are more accessible, equitable, and effective for all populations, ultimately contributing to better health outcomes and a more inclusive healthcare system.

Other contributors to the study include Khyathi Gadag, Lauren Lavin, Sara Ternes, Heather S. Healy, Kimberly A.S. Merchant, Marcia M. Ward, and Nicholas M. Mohr from the University of Iowa, along with Wakina Scott and Whitney Wiggins from the Office for the Advancement of Telehealth, Health Resources and Services Administration, U.S. Department of Health and Human Services.