Bridging the digital divide: How can we keep healthcare accessible in the digital age?
When I needed to retrieve some medical records from my old small-town pediatrician, I had expected to make a simple request over the phone and receive an email copy right away. I quickly learned that this was not going to happen. “Can’t your parents come get them for you?... It’ll have to be a fax then, honey. We don’t have email.”
In our post-pandemic age of telehealth and online patient portals, I was surprised – and a little annoyed. When was the last time I even saw a fax machine? It didn’t occur to me then that this pediatrician’s traditional communication methods could be one of the last strongholds to accessible healthcare for many in my hometown community.
Evolutions in healthcare
Healthcare took a giant leap into the digital world over the last few years, and the rapid generation of new online tools has continued since.12 As the technology advances, so must the skills people need to engage effectively with these systems.1
Without a threshold level of digital literacy, it’s impossible to fully benefit from most medical services, let alone other services outside of healthcare. To put it simply, meaningful participation in society at large now requires a basic degree of digital literacy.1 The UN has even started considering meaningful access to digital spaces as a basic human right.11
What is digital health literacy?
Digital health literacy is the ability to locate, access, and understand information from digital sources to make health-related decisions.1 More than just a helpful skill, digital literacy has become a super determinant of health. 1,8
Social determinants of health are non-medical factors that influence health outcomes, such as educational attainment.6 Digital literacy is set apart as “super” thanks to its profound connection to and influence over other social determinants of health.1 Its ubiquitous nature cuts across many other factors, giving it the ability to fundamentally impact socioeconomic status, employment, education, and of course, healthcare access.
And why is it important?
Numerous studies have established correlations between digital health literacy and health-related quality of life, disease prevalence, and disease control.7,8 Social determinants of health can have astounding effects, accounting for between 30 and 55% of individual health outcomes. In fact, these determinants sometimes exert even more influence than lifestyle choices or health care itself.6
Digital literacy isn’t only a gateway into the modern healthcare system. It is an absolute prerequisite to participation in higher education, and increasingly K-12 education, thanks to the sudden adoption of online learning tools. More broadly, it also provides opportunities for social connection and self-actualization through its vast social media networks, online communities, and free educational content. Without digital literacy, our ability to participate in society at large is compromised.11
References
- van Kessel, R., Wong, B. L. H., Clemens, T., & Brand, H. (2022, February 7). Digital Health Literacy as a super determinant of health: More than simply the sum of its parts. Internet interventions. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8861384/
- Vigilante, K. (2023, February 3). The digital determinants of health: How to narrow the gap. Forbes. https://www.forbes.com/sites/forbestechcouncil/2023/02/02/the-digital-determinants-of-health-how-to-narrow-the-gap/?sh=60d4ccde59ba
- Honeyman, M., Maguire, D., Evans, H., & Davies, A. (2020). Digital Technology and Health Inequalities: A Scoping Review. Public Health Wales. https://phw.nhs.wales/publications/publications1/digital-technology-and-health-inequalities-a-scoping-review/
- Paige, S. R., Stellefson, M., Krieger, J. L., Anderson-Lewis, C., Cheong, J., & Stopka, C. (2018, October 2). Proposing a transactional model of eHealth Literacy: Concept Analysis. Journal of medical Internet research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231800/
- Kessel1, R. van, Hrzic, R., O’Nuallain, E., Weir, E., Wong, B. L. H., Anderson, M., Baron-Cohen, S., Mossialos, E. (2022). Digital Health Paradox: International policy perspectives to address increased health inequalities for people living with disabilities. Journal of Medical Internet Research. https://www.jmir.org/2022/2/e33819/
- World Health Organization. (n.d.). Social Determinants of Health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1
- Liu, S., Lu, Y., Wang, D., He, X., Ren, W., Kong, D., & Luo, Y. (2023, May 26). Impact of digital health literacy on health-related quality of life in Chinese community-dwelling older adults: The mediating effect of health-promoting lifestyle. Frontiers. https://www.frontiersin.org/articles/10.3389/fpubh.2023.1200722/full
- López, M. del P. A., Ong, B. A., Frigola, X. B., Fernández, A. L., Hicklent, R. S., Obeles, A. J. T., Rocimo, A. M., & Celi, L. A. (2023, October 12). Digital Literacy as a new determinant of health: A scoping review. PLOS Digital Health. https://journals.plos.org/digitalhealth/article?id=10.1371%2Fjournal.pdig.0000279
- Spanakis, P., Peckham, E., Mathers, A., Shiers, D., & Gilbody, S. (2021, October). The digital divide: Amplifying health inequalities for people with severe mental illness in the time of covid-19. The British journal of psychiatry : the journal of mental science. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8111186/
- Mee, P., Gussy, M., Huntley, P., Kenny, A., Jarratt, T., Kenward, N., Ward, D., & Vaughan, A. (2023, January 1). Digital exclusion as a barrier to accessing healthcare: A summary composite indicator and online tool to explore and quantify local differences in levels of exclusion. medRxiv. https://www.medrxiv.org/content/10.1101/2023.07.12.23292547v2.full
- United Nations. (n.d.). Digital Inclusion. United Nations. https://www.un.org/techenvoy/sites/www.un.org.techenvoy/files/general/Definition_Digital-Inclusion.pdf
- Salome, D. (2023, September 10). The Rise of Digital Healthcare Post Covid-19. HealthEdge. https://healthedge.com/resources/blog/the-rise-of-digital-healthcare-post-covid-19
- Sivakumar, V. (2023, August 21). Canadian government investing $17.6 million to improve digital literacy. CIC News. https://www.cicnews.com/2023/03/canadian-government-investing-17-6-million-to-improve-digital-literacy-0333885.html#gs.1mbz7x
- Bandura, R., & Méndez Leal, E. I. (2022, July 18). The Digital Literacy Imperative. Center for Strategic and International Studies. https://www.csis.org/analysis/digital-literacy-imperative
- Providing Internet Access Through Public Libraries: An investment in Digital Inclusion and Twenty-First Century Skills. International Federation of Library Associations and Institutions. (2012, November). https://www.ifla.org/wp-content/uploads/2019/05/assets/clm/WSIS/libraries_public_access.pdf
- Chevalier, J. (2020, March 31). Good samaritans helping students with supplies, computers. CBC News. https://www.cbc.ca/news/canada/ottawa/good-news-ottawa-gatineau-cbc-1.5516608
- Schwartzbach, K. (2022, May 5). How government can make broadband more affordable. Rockefeller Institute of Government. https://rockinst.org/blog/how-government-can-make-broadband-more-affordable/
About the Author
Sophie Cleff
Sophie is an Associate at The Decision Lab. She holds a Bachelor of Science in Microbiology and Immunology from McGill University. She is passionate about applying her research background to interdisciplinary problems, especially related to public health. Before joining The Decision Lab, Sophie worked with the Montreal Children’s Hospital and Translating Emergency Knowledge for Kids (TREKK) to increase the quality, safety, and integrity of research in pediatric medicine. In her free time, she enjoys crocheting and playing the guitar.
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