Davis Sara L M
Centre for Interdisciplinary Methodologies, University of Warwick, Coventry, CV4 7AL, United Kingdom.
Health Promot Int. 2025 Mar 5;40(2). doi: 10.1093/heapro/daaf014.
In 2021, the World Health Organization issued its first global strategy on digital technologies and health, calling on member states to develop their own national digital health strategies. However, the normative tools that guide the development of these strategies do not prompt member states to consider how broader political factors, such as law and policy, governance, and civic engagement, could shape health outcomes in the digital age. The digital gender divide, algorithmic biases linked to race, transnational private sector actors, and more must be thoroughly addressed in future digital health strategies. Experiences from the global HIV response have demonstrated that it is possible to do this, by mobilizing diverse government and non-governmental actors to systematically assess and act to strengthen the legal and political environment for health. This essay draws on the HIV response to critically engage with recent literature on the digital determinants of health, proposing an approach to analyzing broader political determinants of health, including commercial determinants of health, and other laws, policies, governance, and civic engagement relevant to digital health strategies. By rendering visible the role of politics, governance, and civic engagement in digital health, strategies can be tools to mobilize broad collaborations and advocacy that creates an enabling environment.
2021年，世界卫生组织发布了其首份关于数字技术与健康的全球战略，呼吁各成员国制定各自的国家数字健康战略。然而，指导这些战略制定的规范性工具并未促使成员国考虑更广泛的政治因素，如法律与政策、治理以及公民参与，这些因素如何在数字时代塑造健康结果。数字性别鸿沟、与种族相关的算法偏见、跨国私营部门行为体等等，在未来的数字健康战略中都必须得到彻底解决。全球应对艾滋病的经验表明，通过动员不同的政府和非政府行为体系统地评估并采取行动来加强健康方面的法律和政治环境，做到这一点是可能的。本文借鉴应对艾滋病的经验，批判性地探讨近期关于健康数字决定因素的文献，提出一种分析健康更广泛政治决定因素的方法，包括健康的商业决定因素，以及与数字健康战略相关的其他法律、政策、治理和公民参与。通过揭示政治、治理和公民参与在数字健康中的作用，战略可以成为动员广泛合作与倡导的工具，从而创造有利环境。
