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弥合差距:如何核算健康的社会决定因素可改善心血管医学中的数字健康公平。

Bridging the Gap: How Accounting for Social Determinants of Health Can Improve Digital Health Equity in Cardiovascular Medicine.

机构信息

Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94304, USA.

Wu Tsai Human Performance Alliance, Stanford University School of Medicine, Stanford, CA, 94305, USA.

出版信息

Curr Atheroscler Rep. 2024 Nov 22;27(1):9. doi: 10.1007/s11883-024-01249-9.

Abstract

PURPOSE OF REVIEW

In this review, we discuss the importance of digital health equity and how social determinants of health (and intersectionality with race, ethnicity, and gender) affect cardiovascular health-related outcomes in digital health trials. We propose strategies to improve digital health equity as we move to a digitally-connected world for healthcare applications and beyond.

RECENT FINDINGS

Digital health has immense promise to improve population health by reaching individuals in their homes, at their preferred times. However, initial data demonstrate decreased patient engagement and worse cardiovascular outcomes for racial and ethnic minorities, leading to unequal uptake of digital health technologies. In addition, while women generally have higher uptake of technology, they are less likely to be referred by clinicians for digital health interventions. We highlight several exemplar trials and analyze their methodology for replication in future digital health research. The promise of digital health equity has not been reached due to exclusionary practices. Specific focus must be placed on societal/governmental policies that enable digital inclusion, particularly of racial and ethnic minority populations and women, to ensure that the expansion of digital health technologies does not exacerbate existing health disparities.

摘要

目的综述

在本次综述中,我们讨论了数字健康公平的重要性,以及健康的社会决定因素(以及与种族、民族和性别交叉)如何影响数字健康试验中与心血管健康相关的结果。我们提出了一些策略,以在我们迈向数字化连接的医疗保健应用世界及其他领域时,改善数字健康公平。

最近的发现

数字健康具有巨大的潜力,可以通过将个人在其家中、在其喜欢的时间联系起来,来改善人口健康。然而,最初的数据表明,种族和族裔少数群体的患者参与度降低,心血管结局更差,导致数字健康技术的采用不平等。此外,尽管女性普遍更愿意接受技术,但她们不太可能被临床医生推荐接受数字健康干预。我们强调了几个范例试验,并分析了它们在未来数字健康研究中复制的方法。由于排斥性做法,数字健康公平的承诺尚未实现。必须特别关注能够实现数字包容的社会/政府政策,特别是针对种族和族裔少数群体以及女性,以确保数字健康技术的扩展不会加剧现有的健康差距。

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