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    Successful Aging Across Middle Versus High-Income Countries: An Analysis of the Role of eHealth Literacy Associated With Loneliness and Well-Being
    (Oxford Univ Press Inc, 2025) Ivan, Loredana; Marston, Hannah R.; Prabhu, Vishnunarayan Girishan; Grossschadl, Franziska; Silva, Paula Alexandra; Buttigieg, Sandra C.; Calikoglu, Halime Ozturk
    Background and Objectives Successful aging concerns the process of growing older while maintaining physical, cognitive, and social well-being, emphasizing independence for overall satisfaction and quality of life. We investigate the impact of eHealth literacy on reducing loneliness and sustaining well-being during the pandemic, comparing middle- and high-income countries.Research Design and Methods Online surveys were conducted between April 4, 2020, and September 30, 2021, collecting responses (N = 2,091) from medium- and high-income countries in Europe, Asia, and North America. T-tests and ANOVAs were used to test how sociodemographic predictors were associated with differences in e-Health literacy, loneliness, and well-being.Results Respondents from high-income countries reported significantly higher well-being scores than those from middle-income countries and respondents from high-income countries had significantly higher e-HEALS (e-Health literacy) scores compared to middle-income countries. No significant difference was observed in loneliness scores between high-income and middle-income country respondents. Well-being is associated with age, with younger adults (18-29 years) and those aged 40+ reporting higher levels. Higher education and income are linked to greater well-being. Gender differences are observed, with females and those with a partner reporting higher well-being. In middle-income countries, higher education levels are more linked to loneliness, while in higher-income countries, loneliness is observed across education levels.Discussion and Implications Future interventions by governments and policymakers should consider intersectionality in e-Health planning and offer digital literacy and digital skills training to those with lower education levels.