Chidambaram Swathikan, Jain Bhav, Jain Urvish, Mwavu Rogers, Baru Rama, Thomas Beena, Greaves Felix, Jayakumar Shruti, Jain Pankaj, Rojo Marina, Battaglino Marina Ridao, Meara John G, Sounderajah Viknesh, Celi Leo Anthony, Darzi Ara
Department of Surgery & Cancer, Imperial College London, St. Mary's Hospital, London, United Kingdom.
Institute of Global Health Innovation, Imperial College London, South Kensington Campus, London, United Kingdom.
PLOS Digit Health. 2024 Jan 4;3(1):e0000346. doi: 10.1371/journal.pdig.0000346. eCollection 2024 Jan.
In recent years, technology has been increasingly incorporated within healthcare for the provision of safe and efficient delivery of services. Although this can be attributed to the benefits that can be harnessed, digital technology has the potential to exacerbate and reinforce preexisting health disparities. Previous work has highlighted how sociodemographic, economic, and political factors affect individuals' interactions with digital health systems and are termed social determinants of health [SDOH]. But, there is a paucity of literature addressing how the intrinsic design, implementation, and use of technology interact with SDOH to influence health outcomes. Such interactions are termed digital determinants of health [DDOH]. This paper will, for the first time, propose a definition of DDOH and provide a conceptual model characterizing its influence on healthcare outcomes. Specifically, DDOH is implicit in the design of artificial intelligence systems, mobile phone applications, telemedicine, digital health literacy [DHL], and other forms of digital technology. A better appreciation of DDOH by the various stakeholders at the individual and societal levels can be channeled towards policies that are more digitally inclusive. In tandem with ongoing work to minimize the digital divide caused by existing SDOH, further work is necessary to recognize digital determinants as an important and distinct entity.
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