A new WHO/Europe study has found that digital health technologies are not accessible to all communities and areas in Europe equally, raising concerns over the equitable use of digital tools for health. The research shows that people with poor health are among the ones struggling the most in accessing these tools.
The study was carried out jointly with the Public Health Data, Knowledge and Research Directorate of Public Health Wales. It summarizes the evidence from 2016 to 2022 on inequity in access, use and engagement with digital health technologies.
“These findings are important, because they send a warning signal. Although we know that digital tools can go a long way in improving people’s access to health and health workers’ ability to care for people, we are now finding that the tools are not available to everyone equally, especially to people with underlying health conditions,” says Dr David Novillo-Ortiz, Regional Adviser on Data and Digital Health at WHO/Europe.
“We need a better understanding of why this inequity persists, and how we can improve people’s ability to access, use and engage with digital health tools. That is the only way we can truly leverage the power of digital solutions so that a more equitable future for digital health can be developed, ensuring no one is left behind,” he points out.
Digital technologies are smart devices and connected equipment that improve health. They include artificial intelligence, digital platforms, software, wearable devices, and tools that capture and share data and relevant health information across systems. These technologies can support health workers and improve diagnosis, treatment and quality of care.
Main drivers of inequity in access to and use of digital health tools
The study notes that patterns in access, use and engagement with digital technologies vary across populations. Digital health technologies tend to be used more widely in urban areas, and less by people from ethnic minorities and those facing language barriers.
The research also found higher use of digital health tools by people with more advanced education levels and higher economic status. Younger people were also found to use tools more than older adults.
Professor Alisha Davies, Head of Research and Evaluation at Public Health Wales, explains, “This is one of the most comprehensive scoping reviews of equity in digital health technologies in the WHO European Region. The findings highlight important evidence gaps across 10 domains of equity, and the importance of embedding equity into the development and integration of digital technology in health to ensure benefits are maximized and unintended consequences are prevented.”
The study warns that, while many health-care providers are increasingly using digital health technologies to enable patients and the public to better manage their health, a focus on these technologies “may inadvertently widen existing inequities in health, if known inequalities in access, use and engagement with digital technology are not considered and addressed”.
Some of the ways in which these challenges can be addressed include:
- finding a common framework to monitor engagement with digital technology for health across equity domains;
- mapping inequities in digital infrastructure;
- addressing barriers to access digital health;
- finding the most effective approaches to build digital skills for those most in need; and
- addressing access for those with disabilities or language barriers.
Regional digital health action plan
The uptake and development of digital health systems have the potential for widespread benefits through more efficient and targeted health care. Equitable, patient-centred approaches are at the centre of WHO/Europe’s regional digital health action plan.
WHO/Europe encourages countries in the Region to build repositories of good practices, strengthen health equity approaches and gender equality, and develop integrated solutions to monitor and evaluate digital health policies and interventions.