Trends in Internet Infrastructure Development and Online Health Use in China: 10-Year Descriptive Longitudinal Study

Despite the rapid expansion of internet infrastructure and digital health initiatives in China, there remains a lack of longitudinal, nationally representative analyses that track the concurrent development of general internet access and the specific adoption of online health services over the past decade. Understanding these parallel trends is crucial for evaluating the reach and equity of the ongoing digital health transformation.

The aim of this study was to describe decade-long trends in internet infrastructure development and online health service adoption in China through a comprehensive secondary analysis of nationally representative, publicly available survey data from 2014 to 2025.

Data were retrieved from the official website of the China Internet Network Information Center for the period from June 2014 to June 2025. The study was conducted in 31 provinces, autonomous regions, and municipalities, excluding Hong Kong, Macau, and Taiwan. The participants were citizens aged 6 years and older who had a telephone or mobile phone. The China Internet Network Information Center conducted a stratified 2-stage sampling survey using a computer-aided telephone access system.

From 2014 to 2025, an increasing trend was observed in the number of internet users and the internet penetration rate in China. It also showed an upward trend in the number of internet users, both in urban and rural areas. A consistent increasing trend was detected in the number of mobile internet users. In contrast, desktops and laptops showed a declining trend. The number of online health users in China showed a V-shaped change from 2020 to 2025. In June 2025, the total number of online medical users reached approximately 393 million, representing 35% of all internet users.

This decade-long observational study demonstrates sustained and significant growth in internet access across China, accompanied by a substantial rise in online health service adoption. A notable V-shaped trajectory in online health use emerged after 2020, indicative of a rapid COVID-19 pandemic-driven acceleration followed by market consolidation. The converging trends of near-universal smartphone-based access and the massive popularity of mobile-centric services, such as short videos, have fundamentally reshaped the digital landscape. Consequently, the findings suggest that for digital health strategies to achieve broad impact, policymakers and health care providers could consider prioritizing the integration of health promotion and services into existing high-penetration mobile platforms and communication formats that the population already uses daily.