Introduction
The term “social determinants of health” (SDOH) has long been recognized in the healthcare industry, encapsulating the various conditions affecting health outcomes. However, as healthcare undergoes a digital transformation, the focus shifts towards understanding the “digital determinants of health” (DDOH). These determinants relate to health IT and significantly influence an individual’s ability to access and utilize healthcare services.
Understanding Digital Determinants of Health
What are Digital Determinants of Health?
Unlike SDOH, the concept of DDOH is still emerging, and a unified definition has yet to be established. While SDOH includes the conditions in environments where people live and work that affect their health and quality of life, DDOH acknowledges the role of technology in healthcare access and outcomes.
According to a group of researchers in a literature review published in PLOS Digital Medicine, DDOH are the technological factors that impact sociodemographic disparities, health inequities, and challenges with care accessibility, affordability, and quality outcomes.
Key Factors Influencing Digital Determinants
Specific factors that contribute to DDOH include:
– Ease of Use: The simplicity with which individuals can use technology.
– Usefulness: The practical benefits provided by the technology.
– Interactivity: The level of engagement and interaction the technology offers.
– Digital Literacy: The ability to understand and use digital tools.
– Digital Accessibility: Access to necessary digital infrastructure such as broadband.
– Digital Availability: The presence of digital resources and services.
– Digital Affordability: The cost associated with accessing digital tools.
– Algorithmic Bias: The impact of biased algorithms on healthcare delivery.
– Technology Personalization: The extent to which technology can be tailored to individual needs.
– Data Poverty and Information Asymmetry: The disparities in data access and understanding.
Connection Between Social and Digital Determinants of Health
Overlap and Distinctions
While SDOH and DDOH are closely linked, they are not identical. SDOH includes factors like income and education, which influence health outcomes. In contrast, DDOH focuses on the technology itself. For instance, a patient with limited English proficiency might struggle to use a patient portal only available in English. Language proficiency is a social determinant, but the technology’s lack of language support is a digital determinant.
Strategies to Address Digital Determinants
Linking DDOH with SDOH Efforts
Since DDOH and SDOH are intertwined, integrating efforts to address both can be effective. The Dahlgren and Whitehead rainbow model, which outlines five layers of SDOH, can also apply to DDOH interventions. These layers range from general socioeconomic conditions to individual lifestyle factors, indicating that digital transformation permeates most aspects of life.
Implementing Better Public and Payment Policies
Public policies must evolve to ensure digital health tools are accessible to underinvested communities. This includes subsidizing broadband, providing health IT tools, and offering technology training. Enhancing cybersecurity standards is also critical to protect patient data, especially for vulnerable populations.
Improving Health IT Design and Development
Health IT vendors play a crucial role in addressing DDOH by designing products that consider users from marginalized communities. User-centered design, which involves collaboration with underserved populations, can ensure these tools meet diverse needs. Additionally, making apps compatible with low-cost devices and offline modes can enhance accessibility.
Refining Health IT Implementation and Adoption
Healthcare organizations must carefully select health IT systems that meet their patients’ needs. Criteria should include usability, personalization, language access, and compatibility with low-tech devices. Support services, such as patient navigators, can help patients and staff adapt to new technologies, promoting trust and engagement.
Conclusion
Understanding and addressing digital determinants of health is essential for achieving health equity in the digital age. By integrating efforts to address both DDOH and SDOH, implementing supportive public policies, improving health IT design, and refining adoption strategies, the healthcare industry can mitigate disparities and improve health outcomes.
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FAQs
Q1: What are digital determinants of health?
A1: Digital determinants of health refer to technological factors that influence health outcomes, including ease of use, digital literacy, and access to digital tools.
Q2: How does DDOH differ from SDOH?
A2: While SDOH includes social and environmental factors, DDOH focuses on the impact of technology on healthcare access and outcomes.
Q3: Why is it important to address digital determinants of health?
A3: Addressing DDOH is crucial for ensuring equitable access to healthcare in a digital world, preventing the perpetuation of existing health disparities.
Q4: What strategies can help address digital determinants of health?
A4: Strategies include linking DDOH efforts with SDOH work, implementing supportive public policies, improving health IT design, and refining health IT adoption processes.
