Digital health technologies and inequalities: A scoping review of potential impacts and policy recommendations

•Digital health technologies can reinforce inequalities within vulnerable populations.•Disparities in access and use related to individual characteristics have been well-documented.•The impact of digital health on health distribution needs to be explored.•Evidence on the impact of context on digital...

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Published in:Health policy (Amsterdam) Vol. 146; p. 105122
Main Authors: Badr, Janine, Motulsky, Aude, Denis, Jean-Louis
Format: Journal Article
Language:English
Published: Ireland Elsevier B.V 01.08.2024
Subjects:
Biomedical Technology
COVID-19 - epidemiology
Digital Health
Digital inequalities
Digital Technology
Health equity
Health Policy
Health Services Accessibility
Healthcare Disparities
Humans
Internal Medicine
SARS-CoV-2
Scoping review
Socioeconomic Factors
Telemedicine
Scoping review
Health equity
Digital health
Health policy
Digital inequalities
ISSN:0168-8510, 1872-6054, 1872-6054
Online Access:Get full text
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Summary:•Digital health technologies can reinforce inequalities within vulnerable populations.•Disparities in access and use related to individual characteristics have been well-documented.•The impact of digital health on health distribution needs to be explored.•Evidence on the impact of context on digital equity is limited.•Identifying mechanisms that sustain digital inclusion are necessary to promote digital equity. Digital health technologies hold promises for reducing health care costs, enhancing access to care, and addressing labor shortages. However, they risk exacerbating inequalities by disproportionately benefitting a subset of the population. Use of digital technologies accelerated during the Covid-19 pandemic. Our scoping review aimed to describe how inequalities related to their use were conceptually assessed during and after the pandemic and understand how digital strategies and policies might support digital equity. We used the PRISMA Extension for scoping reviews, identifying 2055 papers through an initial search of 3 databases in 2021 and complementary search in 2022, of which 41 were retained. Analysis was guided by the eHealth equity framework. Results showed that digital inequalities were reported in the U.S. and other high-income countries and were mainly assessed through differences in access and use according to individual sociodemographic characteristics. Health disparities related to technology use and the interaction between context and technology implementation were more rarely documented. Policy recommendations stressed the adoption of an equity lens in strategy development and multilayered and intersectoral collaboration to align interventions with the needs of specific subgroups. Finally, findings suggested that evaluations of health and wellbeing distribution related to the use of digital technologies should inform digital strategies and health policies. [Display omitted]
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ISSN:0168-8510
1872-6054
1872-6054
DOI:10.1016/j.healthpol.2024.105122