In their recent article, Schweiberger et al. describe a retrospective assessment of scheduled and attended telemedicine visits over 1 year during the COVID-19 pandemic based on two academic pediatric primary care practices.1 Importantly, they found that several characteristics were associated with both scheduling and attending telehealth visits over their observed study period. In particular, they demonstrated that those patients who preferred a language other than English or Spanish had increased rates of scheduled telehealth visits over the study period, while individuals from neighborhoods with lower technology access had decreasing rates of scheduled telehealth visits during this period. In addition, they found that attendance at telehealth visits varied by language preference, with those preferring a language other than English or Spanish being more likely to attend a telehealth visit and those preferring the Spanish language having increased rates of attendance over the study period.

Disparities in telehealth access and utilization have been consistently reported across sociodemographic variables during the COVID-19 pandemic. Among commercially insured and Medicare Advantage adult patients, Patel et al. showed lower rates of telehealth use in communities with greater poverty.2 Rodriguez et al. found that, among primary and specialty care visits for adult patients, Black race, Hispanic ethnicity, being Spanish-speaking, and lacking access to broadband internet were associated with lower odds of using telehealth visits.3 Meanwhile, in a mixed cross-sectional analysis of pediatric general and specialty visits, Rosenthal et al. demonstrated that individuals who prefer to speak Spanish or another non-English language, as well as those who are publicly insured, have lower odds of the utilization of telehealth when compared to in-person healthcare visits.4 Khairat et al. investigated the association between geospatial social factors and utilization of telehealth, finding that among a cross-section of visits to a virtual pediatric urgent care facility, there were increased odds of utilization among areas of lower social vulnerability despite higher COVID-19 burden in areas of higher social vulnerability.5 While not exhaustive of the prior literature, combined, these studies uncovered that similar structural- and individual-level barriers to accessing healthcare exist for telehealth options as they do for in-person healthcare.

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