Abstract
Digital technologies shape the way in which individuals and health systems interact to promote health and treat illness. Their propensity to exacerbate inequalities is increasingly being highlighted as a concern for public health. Personal, contextual and technological factors all interact and determine uptake and consequent use of digital technologies for health. This article reviews evidence on the impact of digital technologies on health equity. Health literacy is presented as a lens through which to approach research and policy on access, uptake and use of digital technologies. In the short term, based on our review of published literature, we conclude that it is likely that digital technologies will increase health inequities associated with increased age, lower level of educational attainment and lower socio-economic status. Geographical inequity may increase as a result of poor infrastructure but may decrease if digital technologies can be effectively widely deployed to compensate for health workforce and health system deficiencies. Programmes to enhance health and digital literacy and monitoring of access, utilization and impact across all groups in society can help to ensure that digital technologies act to reduce rather than reproduce or exacerbate existent health inequalities.
Highlights
The ‘digital transformation of health services’ is viewed as an important and influential process, that is already exercising a substantial impact on health systems and is undoubtedly set to fundamentally alter the future of health systems.[1,2]
We propose the health literacy concept[13] as a lens through which to approach policy in the digital health arena as a means to ensure the transformation of health systems that deliberately seek to use digital health as a tool to combat health inequalities
Health 4.0—which basically means the digital transformation of health and medical care, both in its practice and its governance–– has its optimistic promoters and its pessimistic detractors
Summary
The ‘digital transformation of health services’ is viewed as an important and influential process, that is already exercising a substantial impact on health systems and is undoubtedly set to fundamentally alter the future of health systems.[1,2] Just as banking, retail or travel occur in a fully digital world without the ‘e’ prefix, this revolution will arrive to health systems. All of these interventions can have an impact on equity in health, the main focus of this paper pertains to direct interventions of digital technologies for clients (citizens, patients, careers). (ii) How do existing studies explain the potential relationship between innovative health technology and social inequalities in health?. The relationship between innovative health technology and social inequalities in health In 2016, Chauvin et al observed that there was a paucity of research and analysis on the impact of digital technology use on population health outcomes. The impact of social determinants of health on the uptake, use and effects of digital technology on human health was not adequately addressed in the literature and the evaluation of the potential impact of digital technology on population health outcomes and health equity was missing.[14]
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