Digital technology and health inequalities – A scoping review

In June 2018, the Welsh Government published its strategic plan to deliver a whole-system approach to health and social care, A Healthier Wales (Welsh Government, 2018). Population health and wellbeing through better prevention and self-management is a core pillar of the transformation described in this plan, and digital technologies are expected to play an important part in its delivery.

Achieving this aspiration will need to take account of recognised inequalities in access to the internet, technology and the skills needed to benefit from them, alongside underlying social differences in levels of engagement with digital technology to support health. As highlighted in a nationally representative survey conducted by Public Health Wales, one in ten adults aged 16 years or over in Wales did not have access to the internet. While two-thirds of people reported using digital technologies for a range of health-related activities, there were marked differences across social groups. Those who were older, less affluent or reported poorer health were all less likely to engage with digital technologies for health purposes (Davies et al., 2019).

Harnessing the potential of digital technology to improve population health will require action to address underlying digital exclusion. Otherwise, a focus on technology may inadvertently lead to the unintended consequence of widening inequalities for the most vulnerable members of society.

To inform such action, in 2019 Public Health Wales commissioned The King’s Fund to complete a scoping review to map the evidence on differences in the use of digital technologies across population groups and identify examples where digital technologies have the potential to reduce health inequalities.

This review seeks to improve understanding and provide advice on how equality can be promoted, and risks mitigated, in the design and use of digital technologies. It is intended to support those seeking to better understand how digital and health inequalities intersect, including leaders in national and local public sector organisations, as well as those involved in the research and development of digital health technologies.