Bridging the Digital Divide: How Digital Literacy and Social Determinants of Health Impact Access to Digital Care
As digital health technologies rapidly evolve, the promise of a more connected and patient-centric healthcare system seems within reach. However, for many, access to these digital innovations is still out of grasp. The factors contributing to this gap often fall under what we call the Social Determinants of Health (SDOH)—the conditions in which people live, learn, work, and age—that shape health outcomes. Now, as digital health becomes increasingly important in managing care, another barrier has emerged: digital literacy.
What Is Digital Literacy?
Digital literacy refers to an individual’s ability to find, evaluate, and use information from digital sources effectively. In healthcare, this might mean understanding how to access and navigate patient portals, using telemedicine services, or even engaging with mobile health applications that track chronic conditions or provide education about treatment options.
Despite the increased availability of these tools, a significant portion of the population lacks the digital literacy skills needed to benefit from them. This divide is particularly pronounced among older adults, people from lower socioeconomic backgrounds, and those living in rural areas with limited broadband access.
The Impact of SDOH on Access to Digital Care
Social determinants of health, such as education level, income, and access to technology, heavily influence a patient’s ability to engage with digital healthcare tools. Patients from marginalized communities often face barriers like:
Lack of access to technology: Smartphones, tablets, and computers are essential for digital health, yet millions of people lack access to these devices. For many, the cost of technology is prohibitive, particularly among low-income households.
Limited internet access: Broadband availability is critical for telemedicine visits, accessing online health portals, and participating in virtual support groups. However, rural and low-income urban areas are disproportionately affected by poor or nonexistent internet infrastructure.
Low health literacy: Even with access to technology, patients may not have the education or experience to interpret medical information or communicate effectively with their providers using digital tools. This problem is exacerbated by the complexity of some health apps, which may not be designed with user accessibility in mind.
Introducing the Digital Determinants of Health (DDoH)
In response to these challenges, the concept of the Digital Determinants of Health (DDoH) has emerged as a critical framework in healthcare. DDoH focuses on the technological factors that influence a person’s ability to access and benefit from digital healthcare tools. This framework acknowledges that access to technology, digital literacy, and the infrastructure needed to support digital care are as essential to health outcomes as traditional social determinants like income, education, and housing.
How DDoH Is Shaping the Industry
The rise of DDoH highlights a new understanding within the healthcare industry: that equitable access to technology and the internet plays a crucial role in healthcare outcomes. Just as SDOH have long been recognized for their impact on health, DDoH emphasizes the need to address the digital barriers that limit patient access to care.
This concept has gained traction as digital health tools like telemedicine, mobile apps, and online patient portals become more widely used. Industry leaders are recognizing that without tackling DDoH, these innovations could inadvertently widen existing healthcare disparities. For example:
Access to broadband is crucial for patients to engage in telemedicine appointments or use health apps. Areas lacking strong internet infrastructure, such as rural communities, face greater challenges in adopting digital healthcare.
Digital literacy enables patients to navigate health technologies effectively. Even if patients have access to digital tools, low digital literacy can prevent them from reaping the full benefits of these innovations.
Community-based infrastructure is critical for ensuring that digital tools reach all populations. Health systems and tech companies are starting to partner with local governments to provide internet services and educational programs in underserved communities.
The Role of DDoH in Bridging Health Disparities
The growing recognition of DDoH has shifted the focus toward creating more inclusive and accessible healthcare systems. As healthcare becomes increasingly digital, the industry must ensure that patients have not only access to the necessary technologies but also the skills and infrastructure to use them effectively. Addressing DDoH can help reduce disparities by providing:
Digital access: Ensuring that all patients, regardless of location or income, have the devices and connectivity needed to access digital care.
Digital literacy education: Offering training programs that teach patients how to use healthcare apps, portals, and telemedicine platforms.
Inclusive digital health design: Developing health technologies that are accessible to all, with user-friendly interfaces and support for multiple languages and disabilities.
The Impact on Health Outcomes
The consequences of low digital literacy and poor access to technology are significant. Research has shown that individuals with low digital literacy are less likely to use telehealth services or engage with patient portals, missing out on the benefits of digital health interventions like improved communication with healthcare providers, access to personalized health information, and remote symptom monitoring.
More troublingly, patients who are unable to access or navigate digital tools may experience delays in care or reduced treatment adherence, leading to worse health outcomes. In oncology care, for example, where timely diagnosis and treatment adjustments are critical, patients without access to these technologies may face greater risks, exacerbating health disparities already present due to SDOH.
Bridging the Gap
To close this digital divide, efforts must be made at multiple levels. Healthcare organizations need to focus on:
Expanding broadband access: Ensuring that communities have reliable internet infrastructure is essential for equitable access to digital health.
Investing in digital literacy programs: Hospitals and clinics can help bridge the gap by offering training sessions and resources for patients to learn how to use digital tools effectively.
Designing inclusive digital platforms: Health apps and patient portals should prioritize user-friendly interfaces, available in multiple languages, and accessible to people with disabilities.
By addressing both the social and digital determinants of health, we can move closer to a more equitable healthcare system—one that ensures every patient can access the digital tools they need to manage their health.