Commentary] Building a digital republic to reduce health disparities and improve population health in the United States

Abstract

Income, schooling, and healthcare are key ingredients for optimizing human’s ecological niche for survival. But most government programs that are designed to provide a hand up in these domains are difficult to access. While many Americans struggle to pay taxes, few understand the difficulties associated with enrolling in Medicaid, Temporary Assistance for Needy Families. A remarkably small percentage of needy families receive the social benefits to which they are entitled, and that percentage is smaller for those most in need (those with physical disabilities, caregiving responsibilities). To address this problem, the Child Tax Credit in the American Rescue Plan provided automatic enrollment and worked hard to locate more low-income families. But until everyone has a digital footprint that allows automated enrollment, the sickest and most vulnerable citizens will remain in the informal sector. By expanding data systems so that all Americans have a digital identity across multiple datasets, it not only becomes possible for all Americans to simplify their lives but for welfare services to work for the most vulnerable, as they are intended. This commentary explores how creating a digital republic might improve population health and reduce health disparities in the US.