Telehealth is used by roughly 30% of U.S. adults in any given year, but certain groups rely on it far more than others. The typical telehealth user skews older, female, and is seeking mental health care or managing a chronic condition. Where you live, your education level, and the type of care you need all shape how likely you are to have a virtual visit.
Age and Gender Patterns
Telehealth use actually increases with age, which surprises many people who assume younger, tech-savvy adults would dominate. CDC data from 2021 showed that 43.3% of adults 65 and older had used telemedicine in the past year, compared to just 29.4% of adults aged 18 to 29. Older adults visit doctors more often in general, and telehealth removes the burden of transportation, mobility challenges, and long waits in clinic lobbies. For seniors managing multiple conditions, a quick video or phone check-in with a specialist can replace what used to be a half-day outing.
Women consistently use telehealth at higher rates than men, a pattern that mirrors in-person healthcare. Women are more likely to seek mental health services, manage chronic conditions, and coordinate care for family members, all of which translate into more virtual visits.
Race and Ethnicity Differences
The picture here depends on which population you’re looking at. Among the general adult population in 2021, non-Hispanic White adults (39.2%) were more likely than Hispanic (32.8%), Black (33.1%), or Asian (33.0%) adults to have used telehealth. Non-Hispanic American Indian or Alaska Native adults had the highest rate at 40.6%.
But among Medicare beneficiaries, the pattern flips. A study published in JAMA Health Forum found that during the second pandemic year, Black, Hispanic, and other racial minority groups all had higher rates of telemedicine visits than White beneficiaries. Hispanic individuals had about 35% more telehealth visits per person than White individuals. Black individuals had about 18% more. This likely reflects differences in access to in-person care: when a virtual option exists, people who face greater barriers to seeing a doctor in person, whether from transportation, work schedules, or provider shortages, are more inclined to use it.
Education and Income
Education is one of the strongest predictors of telehealth adoption. In 2021 data on adults receiving treatment for substance use disorders, college graduates were nearly eight times more likely to use telehealth than those without a high school diploma. The pattern held in a clear staircase: each step up in education corresponded with higher virtual care use. High school graduates were about 2.5 times more likely to use telehealth than those with less education, and people with some college were about 3.7 times more likely.
By 2022, that education gap had narrowed considerably, suggesting that comfort with the technology spread over time. Income, interestingly, shows a weaker relationship. People earning more than twice the federal poverty level were somewhat more likely to use telehealth, but the differences weren’t statistically significant in most analyses. The real barrier appears to be digital literacy and comfort with technology rather than ability to pay.
Rural Residents Use It More
People in rural areas are significantly more likely to use telehealth than their urban counterparts. One Missouri-based study found rural residents were 4.2 times as likely to use telemedicine as urban residents, despite making up only 37% of the state’s population. This makes intuitive sense: rural Americans often live an hour or more from the nearest specialist, and telehealth collapses that distance entirely. For follow-up appointments, medication management, or mental health therapy, a virtual visit can save an entire day of driving.
Rural and urban populations also use telehealth for different reasons. Rural patients more often use it to access specialists who simply aren’t available locally, while urban patients tend to use it for convenience, fitting a quick appointment into a busy workday.
Mental Health Drives the Majority of Visits
Mental and behavioral health is, by a wide margin, the dominant use case for telehealth. In 2023, 58% of all telehealth visits were for mental health reasons, up from 47% in 2020. This wasn’t a pandemic fluke. Even before COVID-19, behavioral health made up the largest share of telemedicine visits because therapy and psychiatric consultations are conversation-based and rarely require physical examination.
Psychiatry leads all medical specialties in telehealth adoption. One analysis found that 99.4% of psychiatry patients had at least one video or audio telemedicine visit, far ahead of other specialties. General surgery, by contrast, had the lowest proportion at 49.9%. Family medicine, internal medicine, gastroenterology, and oncology fell somewhere in between, using telehealth primarily for follow-ups and results discussions rather than initial evaluations.
Among people with chronic conditions, about 52% reported using telehealth in the past year as of 2022. Those with depression had the highest rate at 61.6%, while people managing high blood pressure had the lowest at 47.6%. Conditions that require ongoing medication adjustments and symptom monitoring lend themselves well to virtual check-ins.
Video Versus Phone-Only Visits
Not everyone using telehealth is on a video call. About one in five telehealth services among Medicare beneficiaries are delivered by phone alone, with roughly 10% of all Medicare beneficiaries having at least one audio-only visit in 2021. Phone visits are especially common among older adults, people with limited internet access, and those in rural areas where broadband is unreliable. Among people with chronic diseases who used telehealth in 2022, 34.7% relied on audio-only visits.
This matters because audio-only telehealth is often the version that reaches the people who need it most. Patients without smartphones, reliable Wi-Fi, or comfort navigating video platforms can still access care through a regular phone call. Policies that restrict telehealth to video-only risk cutting off exactly the populations that benefit most from virtual care.
Post-Pandemic Usage Has Settled
After peaking during the pandemic, telehealth use has declined but stabilized at a level far above pre-2020 norms. The percentage of U.S. adults who used telemedicine dropped from 37% in 2021 to 30.1% in 2022. That decline was expected as in-person care became fully available again, but 30% represents a permanent shift in how Americans access healthcare. Before the pandemic, telehealth use was in the low single digits for most specialties outside of psychiatry.
The people who continue to use telehealth are those for whom it solves a real problem: distance from providers, mobility limitations, mental health needs, or the challenge of fitting frequent chronic disease management appointments into a work schedule. Convenience alone keeps some users engaged, but the core telehealth population is defined by need more than preference.