This scoping review brings together evidence about the relationship between digital health technology and health inequalities to inform a theoretical framework for considering how lack of access, skills and motivation for using digital technologies (digital exclusion) could affect health outcomes. The theoretical model considers the way that digital exclusion may affect health outcomes, and therefore how systematic digital exclusion of groups could exacerbate health inequalities. This should help organise and inform future strategic policymaking and research on digital health technologies. Evidence was found to suggest that some of the divides in access and use have narrowed in recent years, for example between ethnic groups in the UK, giving some cause for optimism. However, some gaps between age and income groups, for example, persist. To mitigate this risk, there is a need for greater participatory practices when designing digital services, and an expansion of research on digital health inequalities. Health services should consider the access, use and engagement patterns in their local populations. They should design interventions by involving users, designing and developing them in partnership with people from the groups in question, using a process underpinned and structured by formal models of behaviour change and health improvement.
Authors: M. Honeyman, D. Maguire, H. Evans, A. Davies
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