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CC BY-NC-ND 4.0 · Yearb Med Inform 2022; 31(01): 020-032
DOI: 10.1055/s-0042-1742512
Special Section: Inclusive Digital Health
Survey

Digital Health Equity: Addressing Power, Usability, and Trust to Strengthen Health Systems

Han Koehle‡   *
1   Student Affairs Health Equity Initiative, University of California Santa Barbara, Santa Barbara, California, USA
,
Clair Kronk‡   *
2   Center for Medical Informatics, Yale University School of Medicine, Connecticut, USA
,
Young Ji Lee‡   *
3   School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
› Author Affiliations
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Summary

Background: Without specific attention to health equity considerations in design, implementation, and evaluation, the rapid expansion of digital health approaches threatens to exacerbate rather than ameliorate existing health disparities.

Methods: We explored known factors that increase digital health inequity to contextualize the need for equity-centered informatics. This work used a narrative review method to summarize issues about inequities in digital health and to discuss future directions for researchers and clinicians. We searched literature using a combination of relevant keywords (e.g., “digital health”, “health equity”, etc.) using PubMed and Google Scholar.

Results: We have highlighted strategies for addressing medical marginalization in informatics according to vectors of power such as race and ethnicity, gender identity and modality, sexuality, disability, housing status, citizenship status, and criminalization status.

Conclusions: We have emphasized collaboration with user and patient groups to define priorities, ensure accessibility and localization, and consider risks in development and utilization of digital health tools. Additionally, we encourage consideration of potential pitfalls in adopting these diversity, equity, and inclusion (DEI)-related strategies.

Keywords

Health equity - gender identity - informatics - health inequities - healthcare disparities

* All authors contributed equally to this work. Authors are listed in alphabetical order by surname.


1 We use the term Latine here instead of Latinx, as it has been called “a more organic alternative” to Latinx, being designed to work with the Spanish language, as it can be more easily pronounced and conjugated in Spanish than “Latinx” [[84]]. Additionally, the usage of “e” in Latine is native to gender-neutral words in Spanish, such as in the term “estudiante” [[85]]. However, we would like to emphasize that it is important to consider the terminology individuals utilize themselves in individual contexts.




Publication History

Article published online:
04 December 2022

© 2022. IMIA and Thieme. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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