7.D. Scientific session: Digital health divide in access, use, and effectiveness: Examples from three countries
Authors:   Organised by: Leibniz ScienceCampus Digital Public Health Bremen (Germany),   Chair persons: Saskia Muellmann (Germany), Chungwan Lo (Germany)
Published: October 2024

Abstract

The increasing digitalisation of the healthcare system opens up a wide range of opportunities but also poses challenges in reducing inequalities due to unequal technological access as well as social and demographic differences of populations. This so-called digital divide is the opposite of digital inclusion, defined by the United Nations as “equitable, meaningful, and safe access to use, lead, and design of digital technologies, services, and associated opportunities for everyone, everywhere”. Indeed, digitalisation is a global phenomenon that permeates all levels of determinants of health inequities, leading to several populations being more disadvantaged. Age, gender, education, and economic status are significant factors amplifying the digital divide’s impact, with older individuals, women, less educated individuals, and economically deprived populations bearing disproportionate effects. Prior literature suggests three levels of digital divide: 1) access to internet and digital technology, 2) individual cognitive and technical competencies in utilizing digital tools, and 3) effectiveness or the optimal functionality and reach of digital technologies. Although there is less consensus with regards to the scope of the divide in the health sector, the three levels are the common reference. Nonetheless, this lack of agreement resulted in existing literature to be concentrated around digital health literacy, or the cognitive and technical abilities to use digital technologies. In addition, while tools such as the Global Digital Health Monitor are valuable to track, monitor, and assess the enabling environment for digital health worldwide, it does not capture the lived experience of the population, including the disadvantaged population groups. This workshop aims to 1) generate discussion on digital health divide and how it can be operationalized and 2) reflect on potential actions to counteract these injustices. Case studies from Germany, Indonesia and Argentina will be presented to diversely contextualize the inequities in digital health and assess plausible interventions. The workshop will be divided into four parts. First, an introduction to the digital health divide will be presented as well as its public health relevance (10 minutes). Second, researchers representing three countries (i.e., Germany, Indonesia, and Argentina) will present digital health divide case studies within their context of expertise (15 minutes). Third, a case-based discussion will be conducted with participants. Participants will be allocated into groups based on the three levels of the digital health divide (i.e., access, use, and effectiveness) and work on recommendations to best operationalize and narrow the digital health divide (25 minutes). Finally, the workshop will conclude with a wrap-up of the group discussion results (10 minutes).

Key messages
• The digital health divide affects all regions, regardless of income levels. Narrowing the gap is crucial to reduce health inequity and achieve universal health coverage.
• By clearly defining the scope and operationalization of the digital health divide, its measurability and usefulness to inform health policies and programs to address this issue can be enhanced.