The concept of digital health, which encompasses the use of digital technologies to enhance health outcomes, has gained global recognition as a crucial means to promote wellbeing and ensure healthy lives for people of all ages all over the world (WHO, 2021). However, it has become apparent that while digital health has the potential to improve access to health services and information and enhance healthcare delivery, its advantages and opportunities are not uniformly available to all segments of population (COE, 2023). In the rapidly digitalizing world, the concept of digital inclusion has emerged as a prominent topic of discussion. This brief article by Mika Uitto, RDi Expert at
SeAMK – Seinäjoki University of Applied Sciences, CONNECTINGHEALTH partner, reflects on digital inclusion and what it means in the domain of health.
Digital inclusion – Three levels of digital divide
The United Nations (n.d.) defines digital inclusion as “equitable, meaningful, and safe access to use, lead, and design digital technologies.” Digital inclusion is needed to ensure that everyone can equally contribute and benefit from the digital world and no one is left behind. It is about having sufficient skills and opportunities to function smoothly in digital environments, including digital health. However, it is known that not everyone in society has the necessary means to use or benefit from these services, which means that the benefits of technology can accumulate for groups that already have better conditions for its utilization (Hänninen et al., 2022). This can result in inequalities, often referred to as digital divides, which can further be categorized into three levels (Hänninen et al., 2022):
- Those who use and those who do not use digital technology
This level of digital divide refers to access to digital technologies. Although the opportunities to acquire and use digital devices are generally good in modern societies, the problems related to the first-level digital divide have not completely disappeared but rather transformed (Hänninen et al., 2022). The utilization of the latest digital services requires newer and more capable technology, and if individuals do not have the means to acquire or use devices that meet the requirements, the risk of inequality increases (Hänninen et al., 2022). While the internal differences regarding access to digital technologies in countries like Finland are relatively small, the disparities between developed and developing countries internationally are significant. According to ITU (2021), 63 percent of the world’s population has access to the internet through personal devices. Of the 2.9 billion people without internet access, 96 percent live in developing countries. In the context of health, this can mean limited access to digital healthcare services or online health resources.
2. Abilities and opportunities to use digital technology in a skilful and diverse way
This level refers to individuals’ or groups’ level of digital competence, namely their skills, motivation, and opportunities to use digital services in a skilful and diverse way (Alasoini et al., 2022). Supporting the development of skills is needed to ensure that users maintain sufficient technical skills and the ability to grasp the digital reality (Hänninen et al., 2022). In the context of health, this level of digital divide can be associated with insufficient utilization of digital health services and health resources as well as low digital health literacy, leading to health information disparities.
3. Those benefitting and those whose position and potential are weakening from digitalization
The third level relates to the differences in how much people are able to benefit from digital services and technology in their lives (Alasoini et al., 2022). This is associated with the fact that the benefits of digital services and technology typically accumulate for those individuals who already have the best prerequisites for functioning in the digital society, while their non-utilization can lead people to even more unequal positions in society (Hänninen et al., 2022). In the domain of health, this can be linked to unequal health outcomes, with individuals and groups with poor readiness to adopt digital solutions being unable to engage with the necessary technologies.
Conclusions
Digital inclusion is a matter that has strong implications on digital health. It affects how citizens can utilize digital health resources and services and how health professionals are able to use them in healthcare and health promotion. It is a topic that digital health experts and innovators should keep in mind in the world filled with rapid advancements and new possibilities in technology.
Amidst the technology hype, it is important not to forget that not everyone has equal opportunities and skills to use digital health services and gain value from them in their daily lives. A significant amount of work still remains to be done to bridge the gap between digital health solutions and citizens.
Author:
Mika Uitto
RDi Expert
SeAMK, Seinäjoki University of Applied Sciences
CONNECTINGHEALTH Partner
References:
Alasoini, T., Ala-Laurinaho, A., Känsälä, M., Saari, E., & Seppänen, L. (2022). Työelämän digikuilujen yli: Digitalisaatio kaikkien kaveriksi. Työterveyslaitos. https://urn.fi/URN:ISBN:978-952-261-997-6
Council of Europe (COE). 2023. Guide to health literacy – contributing to trust building and equitable access to healthcare. Steering Committee for Human Rights in the fields of Biomedicine and Health (CDBIO).
Hänninen, R., Karhinen, J., Korpela, V., Pajula, L., Pihlajamaa, O., Merisalo, M., Kuusisto, O., Taipale, S., Kääriäinen, J., & Wilska, T. (2022). Digiosallisuus käsitteenä. In O. Kuusisto, M. Merisalo, & J. Kääriäinen (toim.), Digiosallisuus Suomessa (s. 17–22). (Valtioneuvoston selvitys- ja tutkimustoiminnan julkaisusarja 2022:10). Valtioneuvoston kanslia. http://urn.fi/URN:ISBN:978-952-383-182-7
ITU International Telecommunication Union. (2021). Measuring digital development: Facts and figures 2021. https://www.itu.int/en/ITU-D/ Statistics/Pages/facts/default.aspx
United Nations. (n.d.). Definition of Digital Inclusion. Retrieved 29.6.2023 from https://www.un.org/techenvoy/sites/www.un.org.techenvoy/files/general/Definition_Digital-Inclusion.pdf
World Health Organization (WHO) (2021). Global strategy on digital health 2020-2025. Geneva: Licence: CC BY-NC-SA 3.0 IGO.