"Digital Health Earth": towards a global healthcare management geolocating human health condition by means of space technology

Healthcare providers such as the World Health Organization, transnational and global health initiatives, the national healthcare systems, down to the smallest villages and individual practitioners and professionals could benefit from geo referential data and metadata and 3D digital assets provided by space technology. Health prevention and literacy programs, mortality and morbidity rates, including contextual statistical data about populations and territories are being already produced and accessible. The hypothetical frame of a Digital Health Earth hereto presented could be performed as the interoperability of 3D representations of sectors of territories and geolocalized layers about health and environment. SDG Goals crossed with WHO programs and available data can become the premises for the design and development of a global representation of healthcare situations, highlighting priorities and disseminating data by intuitive and interactive modes of visualization as it is already happening with 2D dashboards about COVID-19 pandemic. Healthcare practitioners, professionals, health managers, but also patients, proxy, social workers, laypeople, stakeholders and media could benefit from visualizing and comparing Digital Earth health data. Concerns about privacy, digital divide and social exclusion from primary care services and how quality of lives might occur are considered here. As a consequence of Space Technology, especially for its connection with the Satellite industry, Digital Health Earth, will contribute to the development of a new added value economic branch inside the increasing market of the Space Economy Revolution.

Has traditional medicine had its day? The need to redefine academic medicine

Investments in digital health technologies such as artificial intelligence, wearable devices, and telemedicine may support Africa achieve United Nations (UN) Sustainable Development Goal for Health by 2030. We aimed to characterize and map digital health ecosystems of all 54 countries in Africa in the context of endemic infectious and non-communicable diseases (ID and NCD). We performed a cross-national ecological analysis of digital health ecosystems using 20-year data from the World Bank, UN Economic Commission for Africa, World Health Organization, and Joint UN Programme on HIV/AIDS. Spearman’s rank correlation coefficients were used to characterize ecological correlations between exposure (technology characteristics) and outcome (IDs and NCDs incidence/mortality) variables. Weighted linear combination model was used as the decision rule, combining disease burden, technology access, and economy, to explain, rank, and map digital health ecosystems of a given country. The perspective of our analysis was to support government decision-making. The 20-year trend showed that technology characteristics have been steadily growing in Africa, including internet access, mobile cellular and fixed broadband subscriptions, high-technology manufacturing, GDP per capita, and adult literacy, while many countries have been overwhelmed by a double burden of IDs and NCDs. Inverse correlations exist between technology characteristics and ID burdens, such as fixed broadband subscription and incidence of tuberculosis and malaria, or GDP per capita and incidence of tuberculosis and malaria. Based on our models, countries that should prioritize digital health investments were South Africa, Nigeria, and Tanzania for HIV; Nigeria, South Africa, and Democratic Republic of the Congo (DROC) for tuberculosis; DROC, Nigeria, and Uganda for malaria; and Egypt, Nigeria, and Ethiopia for endemic NCDs including diabetes, cardiovascular disease, respiratory diseases, and malignancies. Countries such as Kenya, Ethiopia, Zambia, Zimbabwe, Angola, and Mozambique were also highly affected by endemic IDs. By mapping digital health ecosystems in Africa, this study provides strategic guidance about where governments should prioritize digital health technology investments that require preliminary analysis of country-specific contexts to bring about sustainable health and economic returns. Building digital infrastructure should be a key part of economic development programs in countries with high disease burdens to ensure more equitable health outcomes. Though infrastructure developments alongside digital health technologies are the responsibility of governments, global health initiatives can cultivate digital health interventions substantially by bridging knowledge and investment gaps, both through technology transfer for local production and negotiation of prices for large-scale deployment of the most impactful digital health technologies.

BACKGROUND Climate change progressively endangering human health, particularly in areas such as Saudi Arabia, where extreme hot weather, air pollution, and weather changeability are prevalent. Integrating environmental data with digital health systems offers a promising approach to improve surveillance, awareness, and health system resilience. OBJECTIVE THis study aims to investigate insights, practices, and recommendations related to the integration of digital health data with environmental health monitoring METHODS A cross-sectional survey was conducted among (227) participants, together with healthcare experts, academic researchers, policy-makers, and environmental experts across Saudi Arabia. The survey explored awareness of digital and environmental health data, up-to-date practices, system readiness, and support for integration. RESULTS While 85% of respondents acknowledged the importance of integrating environmental and health data, only 25.6% reported using such systems in practice. Observations of system readiness were low, with just 17.2% considering the health system ready for integration. Occupation significantly predisposed insights of readiness (χ² (6) = 14.41, p = 0.025). Familiarity with digital systems and awareness of environmental health data were both strong interpreters of support for integration (p < 0.01). CONCLUSIONS The findings show widespread support for incorporating environmental data into digital health systems, notwithstanding concerns about readiness and infrastructure. Addressing interoperability difficulties and investing in digital capability are significant ways to increase health system resilience in the face of environmental change.

Cholera prevention, control strategies, challenges and World Health Organization initiatives in the Eastern Mediterranean Region: A narrative review

Transparent sharing of digital health data: A call to action

Jenny Pronczuk de Garbino: A Global Champion for Children’s Health

To describe the development and early implementation of the Digital Health Equity & Literacy Program (D-HELP), a student-led quality improvement initiative to promote digital health engagement in the emergency department (ED). Trained student volunteers at Rush University Medical Center delivered in-person education on Epic MyChart and Rush On Demand telehealth services in English and Spanish. Eligible adult patients were identified through the EHR and engaged when clinically appropriate. Over 4 months, 94 patients were approached, with 64 (68%) patients receiving some level of intervention. Volunteers documented encounter type, interpreter use, and unsolicited patient feedback. MyChart invitations were sent to 27 patients, with 7 registering on-site. D-HELP demonstrated feasibility, flexibility, and strong patient receptiveness in the ED setting. The model's low-resource, student-driven design supports scalability and provides a framework for expanding digital health literacy initiatives across diverse clinical settings while addressing social determinants of digital access.

Enhancing digital public health (DiPH) terminology may foster a better understanding of the legal framework that grounds the use of personal health data within and outside public health policy and public health systems. Terminology accuracy is, therefore, relevant to understanding the data protection regulations that apply to DiPH interventions. The broader or narrower possibilities for using personal health data in digital health interventions depend on the legal basis that justifies (or not) the access to personal health data, whether inside public health policy or outside (e.g., in private health companies). In the context of digital health policy for DiPH, using personal health data is based on public law, analyzing proportionality, necessity, and the legitimacy of the interest. In contrast, for digital health interventions outside public health policy or in an individual clinical approach (like in digital health), the use of personal health data is based on informed consent. Brazilian data protection law (LGPD) and European GDPR provide the legal basis for public health systems’ use of health data in health policy. As a result, the DiPH approach highlights the relevance of using digital technologies and health data to strengthen public health systems within the platform economy and the context of surveillance capitalism. This presentation will shed light on the expansion of digital technologies and health data in health policy in the face of data science, highlighting the need to delve into the terminology of DiPH, understanding its boundaries and legal differences from its neighbors (not twins) outside health policy. Clarifying the DiPH approach, potentially leading to standards in terminology and embedding a data protection perspective, may maximize the accuracy of the legal justification for personal health data use in health policies. DiPH, therefore, may foster data protection, public health systems, and policies strengthening with health data.

The World Health Assembly Resolution on Digital Health unanimously approved by WHO Member States in May 2018 demonstrated a collective recognition of the value of digital technologies to contribute to advancing universal health coverage (UHC) and other health aims of the Sustainable Development Goals (SDGs). The World Health Organization has just released first ever guideline on digital interventions for health system strengthening. Et the European level, in June 2018 the WHO Regional Office for Europe launched the WHO/Europe initiative for Digitalization of Health Systems and in February 2019 organized the first Symposium on the Future of Digital Health Systems in the European Region. The European Commission in April 2018 published a Communication on Digital transformation of health and care in the digital single market and requested the Expert Panel on effective ways of investing in health (EXPH) to release an evidence-based opinion on how to assess the impact of digital transformation of health services. In such context, the European Public Health Association (EUPHA) has at an early stage acknowledged and understood the crucial importance of applying the potential offered by digitalization to public health. Not only its most prominent members work and research as WHO and EC experts on how to plan, implement and evaluate effective digital public health interventions, but EUPHA itself - as umbrella organization representing public health associations and institutes across Europe had: i) actively participated to the WHO Euro Symposium successfully co-organizing a session on the ‘beautiful marriage’ between digitalization and public health, ii) supported the publication of a EJPH supplement on digital health and iii) has planned to create a EUPHA Section on Digital Health. With the overall goal of positioning the proposed EUPHA Section on Digital Health in the enriching and constructive context of the European Public Health Conference the workshop specifically aims to: present a comprehensive conceptual framework for the application of digital technologies to public health in Europe;present and report on EUPHA collaborative action on digital health, aligned with European institutions;present the structure and content of the EJPH supplement on digital health;present the general aim, specific objectives, scope, mission and preliminary outputs of the proposed EUPHA Section on Digital Health, as well as its synergy with other EUPHA’s Section workPresent the results of two/three specific projects on digital public health to serve as concrete examples of the application of digital solutions to public healthEngage with the audience to promote the active participation of the broader EUPHA community to the activities of the Section, collect interests and best practices, and share ideas and projects worth scaling up at the Section-level. Key messages The ‘beautiful marriage’ between digitalization and public health has to be concretely planned, implemented and evaluated. EUPHA action on digital public health can be further strengthened through the collaborative action and work of its dedicated Section.

This position paper could be used by oral health stakeholders to convince their government to implement digital oral health program.

International Push Under Way To Improve Drug-Trials Data

There are poorly documented variations in the journey a skin cancer patient will follow from diagnosis to treatment in the European Union. To investigate the possible difficulties or obstacles that a person with a skin malignancy in the European Union may have to overcome in order to receive adequate medical screening and care for his/her condition. In addition, we wished to explore differences in European health systems, which may lead to health inequalities and health inequities within Europe. Ten European countries took part in this investigation (in alphabetical order): Finland, Germany, Greece, Italy, Malta, Poland, Romania, Spain, the Netherlands and the U.K. The individual participants undertook local and national enquiries within their own country and completed a questionnaire. This exercise has identified important differences in the management of a skin cancer patient, reflecting major disparities in health care between European countries. Further investigation of health disparities and efforts to address health inequalities should lead to improvements in European health care quality and reduction in morbidity from skin cancer.

Background:Adult education targeting health literacy (HL) may bring added value in the form of improved health.Objective:This study evaluated the effects of a HL program as part of an adult education curriculum for adults with low literacy and numeracy.Methods:This was a partial-cluster randomized controlled trial among 308 adults enrolled in basic education programs in Australia. Of the 308 participants, 141 (46%) were randomized to either the standard program (language, literacy, and numeracy [LLN]), or the HL intervention (LLN with embedded health content); the remainder (n = 167) were allocated to standard intervention programs by the education provider at the class level. The main outcomes were functional HL, self-reported confidence, patient activation, generic HL (ie, HLQ, health knowledge, and self-reported health behavior). Data were collected at baseline, immediately after, and at 6 months post-intervention.Key Results:Of the 308 participants, 71% had limited literacy and 60% spoke a language other than English at home. Both interventions benefited participants, with improvements from baseline to immediate follow up on individual-level functional HL (e.g., reading a thermometer; HL group 18.4% vs. standard group 7.2%; p = .001), confidence (HL group 0.34 vs. standard group 0.06; p = .014) and health literacy questionnaire (HLQ) subscales. At 6 months, improvements in confidence (p < .001) and some HLQ measures were retained. A consistent pattern of increased improvement in the HL program was observed compared to the standard program, although only some measures reached statistical significance: reading a food label (HL group 6.03/10 correct vs. standard group 5.49/10 correct; p = .022); confidence (p = .008); ability to actively manage health (HLQ) (p = .017), and health knowledge at 6 months (HL group 68% vs. standard group 60% correct, p = .052). HL participants reported being more likely to share course information and rated the program more useful to understand their health.Conclusions:Improving language, literacy, and numeracy generally has potential public health benefits that are retained at 6 months. Integrating health content adds further value to adult basic learning, is feasible, and potentially scalable. [HLRP: Health Literacy Research and Practice. 2019;3(Suppl.):S42–S57.]Plain Language Summary:We compared the effect of an adult education-based health literacy (HL) program versus a standard language, literacy, and numeracy program on students' HL skills and psychosocial outcomes. Although students in both trial arms improved their skills, students in the HL program had better outcomes with higher HL, greater confidence, and higher health knowledge scores at 6 months.

The global rise of digital health is reshaping healthcare delivery and improving outcomes, especially for noncommunicable diseases (NCDs) post-pandemic. Guided by the World Health Organization (WHO) Global Strategy on Digital Health 2020-2025, this study examined digital health applications in Western Pacific Region (WPR) primary care, focusing on NCD management and related challenges. A scoping review following the Arksey and O'Malley framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines was conducted. Using the PICO framework, studies on digital interventions in WPR primary care were identified through PubMed, Scopus, ScienceDirect, Web of Science and the Journal of Medical Internet Research (2022-2024). Eighteen studies were synthesized using the WHO digital health intervention and Health System Challenge frameworks. The review included studies from Australia (n=10), Singapore (n=5), South Korea (n=1), and China (n=2), encompassing randomized, observational, qualitative, and pragmatic designs. Digital interventions-telehealth, mobile health (mHealth) and electronic health (eHealth)-targeted NCDs such as diabetes, mental health, and cardiovascular diseases, addressing information quality, acceptability, efficiency, cost, accountability, and equity. The scoping review identified several digital health interventions, predominantly telehealth, mHealth and eHealth, deployed across Australia, Singapore, South Korea and China for NCD management in primary care. The studies demonstrated improvements in information quality, acceptability and efficiency, while highlighting persistent barriers such as technology integration issues, data quality concerns and inequities.