NURS-6051
Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
Social Determinants of Health
Introduction:
Use Walden White paper or the CDC
According to the Centers for Disease Control and Prevention (2022), “Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life… SDOH are one of three priority areas for Healthy People 2030, along with health equity and health literacy. Healthy People 2030 sets data-driven national objectives in five key areas of SDOH: healthcare access and quality, education access and quality, social and community context, economic stability, and neighborhood and built environment. Some examples of SDOH included in Healthy People 2030 are safe housing, transportation, and neighborhoods; polluted air and water; and access to nutritious foods and physical health opportunities”.
https://www.cdc.gov/about/sdoh/index.html
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
To Prepare:
Reflect on the concept of social determinants of health as presented in the resources.
Contemplate whether digital inclusion or broad band access should be added to the 5 key areas of social determinants of health.
Using the optional outside resources or other peer reviewed journal articles, consider how electronic health records, mobile health, patient portals, or telemedicine can impact and be impacted by the social determinants of health.
By Day 3 of Week 9
Post
a description of your views on whether or not digital inclusion or broad band access should be added as a key area to the social determinants of health. Be specific and provide examples that support your position. Explain how electronic health records, mobile health, patient portals, or telemedicine can impact and be impacted by the social determinants of health. Support your explanation with the required or optional resources.
NURS-6051
Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
Digital Inclusion as a Social Determinant of Health: A Reflection
The social determinants of health (SDOH), as defined by Healthy People 2030, encompass five key areas: economic stability, education access, and quality, health care access and quality, neighborhood and built environment, and social and community context (Office of Disease Prevention and Health Promotion [ODPHP], n.d.). These areas collectively highlight the societal factors influencing health outcomes. However, the growing reliance on technology for healthcare delivery raises a critical question: should digital inclusion and broadband access be formally recognized as a key area within the SDOH framework?
Reflecting on Digital Inclusion in SDOH
Digital inclusion transcends mere access to broadband; it encompasses the ability to afford, utilize, and derive meaningful benefits from technology. This concept aligns with the SDOH framework, particularly within “healthcare access and quality” and “education access and quality.” However, digital inclusion merits standalone recognition, given its pervasive impact across multiple domains. For example, access to broadband influences a person’s ability to engage in telemedicine, access educational resources, and participate in community support networks, all of which directly affect health outcomes.
Examples Supporting Digital Inclusion as a Key Area
Mitigating Rural and Urban Disparities
Rural communities often face limited broadband infrastructure, hindering access to telehealth services and exacerbating health disparities. A rural resident with a chronic condition may lack the connectivity needed for routine telemedicine check-ins, leading to delayed care and worsened outcomes (Ramsetty & Adams, 2020). Recognizing digital inclusion within the SDOH framework could spur targeted investments in rural broadband expansion.
Addressing Economic Barriers
Low-income households often struggle to afford broadband and digital devices. These economic barriers intersect with other SDOHs, such as financial stability and education quality. For instance, a study highlighted that households with broadband access were more likely to utilize patient portals and mobile health (mHealth) apps, facilitating better chronic disease management and preventive care (Campos-Castillo & Anthony, 2022). Without such access, economically disadvantaged individuals are excluded from these health benefits.
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Impact of Health Technologies on SDOH
The interplay between health technologies—such as electronic health records (EHRs), patient portals, mHealth, and telemedicine—and SDOH is profound. These tools can enhance healthcare access, improve patient engagement, and support chronic disease management. However, their success hinges on digital inclusion:
Electronic Health Records (EHRs)
EHRs streamline provider communication and offer patients access to health information through patient portals. However, patients without internet access or digital literacy skills cannot fully benefit from these systems, leaving them reliant on less efficient communication methods and at risk for fragmented care (Crawford & Serhal, 2020).
Mobile Health (mHealth)
Mobile health apps offer health monitoring, education, and chronic disease management opportunities. However, mHealth’s effectiveness depends on patients’ smartphones, internet access, and digital literacy. Research suggests that digital divides in income and education can limit the adoption of mHealth tools, particularly among older adults and underserved populations (Choi et al., 2020).
Patient Portals
Patient portals enhance transparency and empower patients to manage their health, yet their use is disproportionately low among individuals with limited education or lower income. Addressing these barriers requires integrating digital literacy training into healthcare systems to support equitable utilization of patient portals (Campos-Castillo & Anthony, 2022).
Telemedicine
Telemedicine reduces geographic and transportation barriers, particularly in rural areas. However, its reliance on broadband means that patients without access to high-speed internet are excluded from these services, perpetuating disparities. Moreover, social determinants like language proficiency and education can impact patients’ ability to navigate telemedicine platforms effectively (Ramsetty & Adams, 2020).
Conclusion
Digital inclusion and broadband access should be formally recognized as a distinct SDOH due to their widespread influence on health outcomes. This recognition would drive policy and funding initiatives to close the digital divide, ensure equitable access to health technologies, and address systemic inequities. Integrating digital literacy programs and expanding broadband infrastructure, particularly in underserved communities, is critical for achieving health equity in a digitally connected world.
References
Campos-Castillo, C., & Anthony, D. L. (2022). Digital inequality and participation in patient portals: Quantitative survey study of adults in the United States.
Journal of Medical Internet Research, 24
(3), e33342
NURS-6051
Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
.
Choi, N. G., DiNitto, D. M., & Marti, C. N. (2020). Older adults’ internet use for health information: Digital divide by race/ethnicity and socioeconomic status.
Journal of Applied Gerontology, 39
(1), 10–20.
https://doi.org/10.1177/0733464818770772
Crawford, A., & Serhal, E. (2020). Digital health equity and COVID-19: The innovation curve cannot reinforce the social gradient of health.
Journal of Medical Internet Research, 22
(6), e19361.
https://doi.org/10.2196/19361
Office of Disease Prevention and Health Promotion. (n.d.). Social determinants of health.
Healthy People 2030
. U.S. Department of Health and Human Services.
https://health.gov/healthypeople/priority-areas/social-determinants-health
Ramsetty, A., & Adams, C. (2020). Impact of the digital divide in the age of COVID-19.
Journal of the American Medical Informatics Association, 27
(7), 1147–1150.
https://doi.org/10.1093/jamia/ocaa078
Reply
According to the CDC, “Social determinants of health (SDOH) are the nonmedical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, worship, and age. These conditions include a wide set of forces and systems that shape daily life such as economic policies and systems, development agendas, social norms, social policies, and political systems.” These are things that people cannot control, which is why we have tried to make things such as access to healthcare better. I do feel that digital inclusion and broad band should be determinants of health because both include access to the internet, which some might not be able to afford.
EHR systems have been designed to help patients navigate their health, however some do not understand how to access, or have inability to access this resource from home either due to inability to pay for internet services or not having access to internet services in a rural area. Others might not understand how to log into these accounts, or how to navigate them if they do get logged in. For example, I work in the Emergency Department. We frequently have patients approach us trying to help them get into their patient portal. There is a separate area which solely focuses on portal access. This not only frustrates the patients but frustrates the staff because we are the ones who get negativity from the patients. The area I reside in is a big destination for tourists and those who are retired. If we have a tourist visit, they likely will not utilize their portal unless they need records for their providers back home. When they do finally get access, sometimes it is too late, or too troublesome to deal with, which adds an increase in frustration. Thinking about this population, some don’t even utilize cell phones because they don’t like technology. This means they likely do not use computers or email either. Another issue regarding this is tele-medicine. This is an up-and-coming health trend where a lot of specialties are going to telemedicine, one area being psych. Those who don’t have access, or don’t understand how to access the internet will not understand how to find tele medicine which can cause them to lose out on seeing doctors in a reasonable time.
I think about my local school, where almost 40% of the students are homeless or are living in poverty. With the number of things going digital and requiring some sort of access to the internet, there is a good chance some of these children do not have access to it. Although if they don’t have internet access, they might not have a car to get places either, turning everything digital will put a damper on education, resources, and understanding of healthcare all together. While I think that going digital is helpful, we need to also consider the minority populations who do not understand or who don’t have access to these. We must remember to care for patients in all aspects, not just online and ensure that no matter what, everyone has the same access to healthcare. I think in some areas, mobile primary care would be beneficial. Having a physician see homes and come to those who cannot make it into a doctor’s office might help with children and older adults being seen by a provider in a timely fashion, and it might help with welfare checks on those who might not be living in a way they should be.
References:
Benda, N. C., Veinot, T. C., Sieck, C. J., & Ancker, J. S. (2020).
Broadband internet access is a social determinant of health!Links to an external site.
.
American Journal of Public Health
,
110
(8), 1123-1125. https://doi.org/10.2105/AJPH.2020.305784
Cynthia J. Sieck, Amy Sheon, Jessica S. Ancker, Jill Castek, Bill Callahan, & Angela Siefer. (2021). Digital inclusion as a social determinant of health.
Npj Digital Medicine
,
4
(1), 1–3.
https://doi.org/10.1038/s41746-021-00413-8
Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital Inclusion as a Social Determinant of Health.
NPJ Digital Medicine
,
4
(1), 52.
https://doi.org/10.1038/s41746-021-00413-8
Social Determinants of Health (SDOH). (2024, January 17).
CDC
.
https://www.cdc.gov/about/priorities/why-is-addressing-sdoh-important.html
Reply
Digital inclusion and broadband access should absolutely be added as a key area to the social determinants of health (SDOH). The World Health Organization (WHO) defines social determinants of health as the conditions in which people are born, grow, live, work, and age. These factors shape the health and well-being of individuals and communities. Access to digital technologies, including the internet, smartphones, and broadband, increasingly influences people’s health outcomes by providing or limiting access to healthcare services, information, and support networks. In today’s interconnected world, where digital health tools like electronic health records (EHR), mobile health (mHealth), patient portals, and telemedicine are becoming the norm, having access to reliable broadband is essential for equitable health opportunities.
Digital inclusion refers to the ability of individuals to access, adopt, and use information and communication technologies (ICT), including high-speed internet, which is a critical tool for accessing health services and information. Without digital access, individuals may face challenges in accessing health-related services that could improve their outcomes. For example, individuals in rural or low-income areas, where broadband infrastructure may be limited, may experience higher barriers to receiving timely medical care, leading to worse health outcomes (Rural Health Information Hub, 2023). Moreover, people with limited digital access are less likely to benefit from advancements in telemedicine or digital health interventions, such as virtual consultations, remote monitoring, and health apps. This digital divide exacerbates health inequities and impedes overall public health progress.
EHR systems are designed to streamline healthcare delivery by centralizing patient data and improving the communication between healthcare providers. For patients, EHRs allow for more coordinated and efficient care, but they can only be effective if patients can access them. Without the necessary digital literacy or broadband access, patients may struggle to manage their health information or communicate effectively with their healthcare providers through digital portals. For instance, if a patient cannot access their health records through a patient portal, they may miss crucial information related to treatment plans or medication changes.
Similarly, telemedicine provides healthcare services remotely, making it more accessible to people in underserved areas. For individuals without broadband access, telemedicine is a nonviable option. According to the National Telecommunications and Information Administration (2021), a significant portion of the population in rural areas lacks reliable broadband, hindering their ability to engage in telemedicine services, which are especially valuable for individuals in rural or underserved communities where access to healthcare facilities may be limited.
Mobile health (mHealth) technologies—such as apps for monitoring chronic conditions, tracking fitness, and accessing telehealth services—have become essential tools for improving healthcare. These platforms can empower patients to take control of their health, but digital inclusion is required to use them effectively. A lack of broadband or access to the latest mobile technology can undermine the potential benefits of mHealth tools. For example, an individual with limited internet access may not be able to use a health tracking app or participate in remote health monitoring programs, which could result in poorer health management and outcomes.
Moreover, patient portals—platforms that allow patients to interact with their healthcare providers, schedule appointments, access test results, and refill prescriptions—are essential for improving the quality and convenience of care. However, these portals are typically designed for users with internet access and digital literacy. Those without access to broadband may miss out on these services, thus contributing to health disparities.
In conclusion, broadband access and digital inclusion are not just technological issues but also public health issues. Integrating broadband access into the SDOH framework is crucial because access to digital resources directly influences health outcomes. Technologies such as EHRs, telemedicine, and mobile health apps have the potential to improve healthcare delivery and health equity, but only for those who have the necessary digital infrastructure. Ensuring that broadband access is available to all communities, especially marginalized and underserved populations, is key to addressing health disparities and achieving equitable healthcare.
References
National Telecommunications and Information Administration. (2021).
The state of broadband in America: 2021 report
.
https://www.ntia.gov/press-release/2021/ntia-releases-2021-broadband-report
Rural Health Information Hub. (2023).
Telehealth and rural health care
.
https://www.ruralhealthinfo.org/topics/telehealth
World Health Organization. (2020).
Social determinants of health
.
https://www.who.int/social_determinants
Reply
Digital Inclusion as a Social Determinant of Health
Digital inclusion, encompassing access to broadband internet, digital devices, and skills to use them effectively, should be considered a key social determinant of health (SDOH). The COVID-19 pandemic highlighted disparities in healthcare access due to the digital divide, as many marginalized populations lacked reliable broadband and digital literacy to access telehealth services (Rodriguez et al., 2022). For example, low-income households and rural areas often face barriers to broadband access, limiting their ability to engage with essential health resources such as telemedicine and patient portals. Including digital inclusion as an SDOH would allow policymakers to prioritize infrastructure investments, like broadband expansion programs, to bridge these gaps and improve health equity (Sieck et al., 2021).
Electronic health records (EHRs), mobile health applications, and telemedicine depend heavily on digital access and literacy. Telemedicine, for instance, has proven valuable for managing chronic conditions remotely, but individuals without internet access or technological proficiency are left behind (Price & Simpson, 2022). Digital exclusion exacerbates existing health disparities, particularly among elderly, rural, and socioeconomically disadvantaged populations. Integrating digital inclusion initiatives, such as providing subsidized devices or community-based digital literacy programs, can help more patients use mobile health apps and access EHRs effectively, enhancing care coordination and patient engagement (Sieck et al., 2021).
Digital inclusion initiatives can also address broader challenges in healthcare delivery. For example, expanding broadband access enables telehealth consultations, reducing travel burdens for patients in remote areas and increasing access to specialists (Rodriguez et al., 2022). Simultaneously, health systems that adopt patient portals can empower individuals to manage their health, schedule appointments, and access test results. However, these tools are only effective if patients have the necessary resources and skills. By recognizing digital inclusion as an SDOH, healthcare systems can implement targeted interventions, ensuring that digital health innovations reach underserved populations and promote health equity (Price & Simpson, 2022).
References
Price, J. C., & Simpson, D. C. (2022). Telemedicine and health disparities.
Clinical Liver Disease
,
19
(4), 144-147.
https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/cld.1171
Rodriguez, J. A., Shachar, C., & Bates, D. W. (2022). Digital inclusion as health care—supporting health care equity with digital-infrastructure initiatives.
New England Journal of Medicine
,
386
(12), 1101-1103.
https://doi.org/10.1056/nejmp2115646
Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital inclusion as a social determinant of health.
NPJ Digital Medicine
,
4
(1), 52.
https://doi.org/10.1038/s41746-021-00413-8
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Reply
Concepts of social determinants of health
Social determinants of health are the circumstances around a person’s birth, development, living, employment, and aging (Center for Disease Control and Prevention (CDC), 2022). These factors determine an individuals’ access to healthcare globally. These factors can create obstacles to seeking and receiving necessary medical care, which can ultimately result in disparities in health outcomes across different populations (CDC, 2022). People with lower socioeconomic status frequently have more difficulty accessing quality healthcare because of things like cost, geographic accessibility, and lack of health insurance. Expanding access to healthcare, improving clinical results, and raising the standard of care are all possible with health information technology (HIT) (Sharma & Patten, 2022).
Considering digital inclusion or broad band access addition to the 5 key areas of social determinants of health.
Economic stability, access to high quality healthcare and education, a healthy neighborhood and built environment, and social and community context are the five key areas of social determinants of health. But due to historical financial, social, and other socioeconomic inequalities, the promise and potential of HIT have not been realized, and there is still a digital divide, whereby internet and technology use patterns vary by socioeconomic status and race/ethnicity (Sharma & Patten, 2022). Having dependable internet access has a big impact on people’s capacity to use telehealth services, obtain healthcare information, and effectively manage their health, especially for vulnerable populations who could otherwise experience inequities in care because of a lack of digital connectivity
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Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
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The COVID 19 pandemic is among the most recent instances of the digital disparity, which is characterized by unequal access to health care due to limited technology. It was difficult for millions of Americans to obtain affordable digital access to essential health care services (Lai & Widmar, 2021). Because the pandemic brought the digital divide to prominence, President Biden pledged $100 billion to provide high-speed internet at a reasonable cost to all Americans.
Impact of Electronic Health Record, Telemedicine, and mobile health on social determinants of health.
The delivery of healthcare has been transformed by telemedicine, electronic health records, and mobile health apps. These developments have impacted social determinants of health (SDOH) by increasing access to healthcare services. Traditional obstacles that prevented most rural areas from receiving care have been removed via telemedicine. Challenges such as remote locations, transportation problems, and a shortage of medical professionals in rural areas. Through telemedicine, patients in distant locations can communicate with their personal care providers, increasing access to care (McGonigle & Mastrian, 2022). Telemedicine improves accessibility, which directly addresses SDOH like geographic location and economic stability, which eventually results in improved health. Through the provision of tools for monitoring, documenting, and communicating health outcomes with healthcare practitioners, mobile health applications have improved how people manage their health. One important social determinant of health is health literacy. People who have higher levels of health literacy are more equipped to take preventative measures and make educated decisions regarding their health (McGonigle & Mastrian, 2022).
Coordinated and efficient patient care is ensured by the easy exchange of patient data between healthcare providers made possible by electronic health records. Healthcare professionals can make better decisions and lower the risk of medical errors by having access to a patient’s entire medical information (McGonigle & Mastrian, 2022). Health systems can carry out focused interventions due to the EHR’s data-driven approach to identifying health inequities, which tracks patient demographics and health outcomes. Inequalities including financial class, race, and ethnicity are addressed contributing to a fairer healthcare experience.
In conclusion, social determinants of health are significantly impacted by telemedicine, mobile health apps, and electronic health records (EHRs) because they increase accessibility, improve health literacy, and improve care quality. These technologies enable everyone to take control of their health in addition to removing obstacles to healthcare access.
References
Centers for Disease Control and Prevention. (n.d.).
Social determinants of health: Know what affects health
. U.S. Department of Health and Human Services. https://www.cdc.gov/about/sdoh/index.html
Lai, J., & Widmar, N. O. (2021). Revisiting the Digital Divide in the COVID-19 Era.
Applied economic perspectives and policy
,
43
(1), 458–464.
https://doi.org/10.1002/aepp.13104
McGonigle, D., & Mastrian, K. G. (2022).
Nursing informatics and the foundation of knowledge
(5th ed.). Jones & Bartlett Learning
Saeed, S. A., & Masters, R. M. (2021). Disparities in health care and the digital divide
. Current psychiatry reports
, 23, 1-6.
Sharma, P., & Patten, C. A. (2022). A Need for Digitally Inclusive Health Care Service in the United States: Recommendations for Clinicians and Health Care Systems.
The Permanente journal
,
26
(3), 149–153.
https://doi.org/10.7812/TPP/21.156
Reply from Olusegun Peter Olawale
Main Discussion: Digital Inclusion and Broadband Access as Key Social Determinants of Health
Introduction:
I believe that digital inclusion and broadband access should be recognized as important factors in the social determinants of health (SDOH). In today’s interconnected world, having access to technology is not just important for daily life—it’s essential for accessing healthcare, information, and services. Digital inclusion ensures that everyone, regardless of their background, has the tools and skills to fully participate in society, especially when it comes to managing their health.
Why Digital Inclusion Matters
Access to broadband and digital tools is crucial for effective communication, education, employment, and healthcare. Without these resources, individuals are at a significant disadvantage in accessing necessary services and managing their health, which only deepens existing health disparities. Digital inclusion directly impacts people’s ability to get timely medical care, manage their health, and connect with support networks—all essential for improving health outcomes (Sharp, 2024).
How Digital Inclusion Affects Health
Telemedicine
: Telemedicine allows patients, especially those in rural or underserved areas, to have medical consultations remotely, reducing the need for travel and improving access to healthcare. However, those without reliable broadband may not benefit from this service, potentially leading to unmet health needs. For example, a person in a rural area might need to travel long distances to see a doctor, but without internet access, telehealth could be out of reach, delaying essential care. This issue is even more pronounced for people from lower socioeconomic backgrounds or marginalized groups (Sharp, 2024).
Electronic Health Records (EHRs):
EHRs allow healthcare providers to share patient information electronically, improving care coordination. However, people without internet access or the necessary digital literacy may struggle to use patient portals, which are vital for managing medical records, booking appointments, and communicating with providers. This can result in delayed care, confusion, or missed appointments (Sharp, 2024).
Patient Portals
: Patient portals allow individuals to access their health records, schedule appointments, and communicate with providers—key components of managing their health. Unfortunately, low-income individuals or those in rural areas without broadband access may be unable to use these portals, potentially leading to delays in diagnoses, missed appointments, or poor medication adherence (Sharp, 2024).
How Digital Inclusion Relates to Other Social Determinants of Health
Digital inclusion connects with several other SDOHs, such as:
Economic Stability: Limited access to technology can hinder job searches, online education, or the ability to access healthcare services. Without the Internet, individuals may struggle to find work or participate in job training programs, which can lead to financial instability. Economic hardship often translates into poor health outcomes due to limited access to care or healthier food options (Faik, Sengupta, & Yimeng, 2024).
Education
: Education is a well-established determinant of health. People without broadband access may struggle to pursue online education, find health literacy resources or complete job training programs. This can limit opportunities for advancement, reinforcing existing health disparities (Faik, Sengupta, & Yimeng, 2024).
The Social Determinants of Health’s Impact on Digital Health Technologies
DOH also affects how individuals engage with digital health technologies, such as telemedicine, EHRs, and mHealth apps:
Health Literacy:
Low health literacy can make it difficult for individuals to use digital tools effectively, even if they have access. For example, patient portals and EHRs require users to understand medical terminology and navigate online systems. Those without digital literacy may struggle, leading to confusion about treatment plans or miscommunication with healthcare providers, ultimately affecting health outcomes (Tomczyk et al., 2023).
Income and Affordability
: Low-income individuals may lack the financial resources to afford smartphones, internet service, or data plans needed for mobile health apps. This lack of access further deepens health inequities, as these individuals miss out on the benefits of digital health technologies (Tomczyk et al., 2023).
Conclusion:
Recognizing digital inclusion and broadband access as central to the social determinants of health is crucial to addressing health disparities in today’s digital world. If people have access to technologies like telemedicine, patient portals, and mobile health apps, they can improve health outcomes. By ensuring more equitable access to technology, we can help reduce health disparities and give everyone, especially those in rural or low-income communities, the tools they need to manage their health.
To make this a reality, governments, healthcare providers, and tech companies must work together to implement policies that guarantee universal broadband access, promote digital literacy, and create health technologies that are user-friendly and accessible to all. We can improve health outcomes across diverse populations by bridging the digital divide
NURS-6051
Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
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References
Sharp, M. (2024). Revisiting the Measurement of Digital Inclusion. World Bank Research Observer, 39(2), 289–318.
https://doi.org/10.1093/wbro/lkad007
Faik, I., Sengupta, A., & Yimeng Deng. (2024). Inclusion by Design: Requirements Elicitation with Digitally Marginalized Communities. MIS Quarterly, 48(1), 219–244.
https://doi.org/10.25300/MISQ/2023/17225
Tomczyk, L., d’Haenens, L., Gierszewski, D., & Sepielak, D. (2023). Digital inclusion from an intergenerational perspective: promoting the development of digital and media literacy among older people from a young adult perspective. Pixel-Bit, Revista de Medios y Educacion, 68, 115–154.
https://doi.org/10.12795/pixelbit.97922
Reply
I strongly believe that digital inclusion and broadband access should be recognized as essential components of the social determinants of health. The COVID-19 pandemic has highlighted the essential importance of reliable internet access in achieving health equity. For instance, a single mother in a rural area relies on dependable internet to access vital health information during crises, which significantly impacts her family’s health outcomes. In times of emergencies, such as a pandemic, natural disaster, or personal health crisis, having reliable broadband access enables her to quickly find information about symptoms, treatment options, and local healthcare resources. This access not only allows her to make informed decisions for her family’s health but also ensures she can connect with healthcare providers and support systems when physical access to services is limited.
Telemedicine highlights the necessity of broadband access, enabling patients, such as seniors living far from specialists, to receive care at home. However, individuals without broadband access are cut off from essential services, which can exacerbate health disparities. The increasing reliance on digital tools, like health apps and patient portals, improves patient engagement and health outcomes. Yet, those lacking the skills or access to these tools may find themselves at a disadvantage. Broadband Internet access (BIA) must be recognized as a social determinant of health, as it affects “the health of people and communities where they live, learn, work and play” (Benda et al., 2020). Moreover, electronic health records (EHRs) and mobile health applications (mHealth) further illustrate this point. Patients depend on EHRs for appointment reminders and lab results, while mHealth apps assist in managing chronic conditions. However, those without internet access miss out on these benefits, leading to disengagement in their healthcare. Reports indicate that 15–24% of Americans lack broadband access, with higher rates among low-income households (Sieck et al., 2021). This lack of connectivity can contribute to poorer health outcomes due to missed health information and medical care.
Research shows that social determinants significantly influence the use of mHealth technologies, with users exhibiting more regular physical activity habits. These findings suggest that interventions involving wearable devices and smartphone apps can promote better health, emphasizing the need to integrate social determinants into health technology (Ye and Ma, 2021). Patient portals exemplify the impact of digital access on health engagement. They allow patients to view health records and communicate with providers; however, those lacking access are hindered, further exacerbating health disparities.
Ultimately, digital inclusion is a matter of health equity. By integrating broadband access into the framework of social determinants of health, we can advocate for policies that promote equitable access to technology, ensuring that everyone can participate fully in their healthcare journey.
References
Benda, N. C., Veinot, T. C., Sieck, C. J., & Ancker, J. S. (2020). Broadband Internet Access is a Social Determinant of Health!
American Journal of Public Health
,
110
(8), 1123-1125.
https://doi.org/10.2105/AJPH.2020.305784
Ye, J., & Ma, Q. (2021). The Effects and Patterns Among Mobile Health, Social Determinants, and Physical Activity: A Nationally Representative Cross-Sectional Study.
AMIA Summits on Translational Science Proceedings,
653-662.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8378627/
Sieck, C. J., Sheon, A., Ancker, J. S., Castek, J., Callahan, B., & Siefer, A. (2021). Digital Inclusion as a Social Determinant of Health.
NPJ Digital Medicine
,
4
(1), 52.
https://doi.org/10.1038/s41746-021-00413-8
Reply
The issue of digital inclusion and broadband should be a part of the SDOH.
We live in a digital age where people need internet and technology to talk to current health care system.
Internet connectivity has a direct bearing on someone’s ability to do telemedicine, view EHRs and patient portals.
Currently existing healthcare disparities cannot exist without digital connectivity, especially in rural and poor areas where there is poor broadband connectivity (Roberts et al., 2021).
Telemedicine, for example, is one of the biggest ways to ensure care continuity in the face of a COVID-19 pandemic where patients can reach providers from anywhere.
But the person without super-fast connection can find it hard to access them.
We see this best in the rural areas that don’t have a lot of broadband availability.
Rural households with broadband internet (63%) far lags urban households (75%) in the same category, leaving rural residents without access to telehealth and online healthcare resources (Feldman et al., 2021).
The digital revolution would end these discriminations and let people who are not currently able to benefit from these medical advances benefit.
Other points where broadband access meets SDOH are in EHRs and patient portals.
Also, EHRs can be securely shared by providers for better care coordination and outcomes.
Patients also have their own pages through which they book appointments, see lab results and talk to specialists.
But they can’t be used by those who aren’t digitally literate or internet-connected, so care can always fragment and be worse off.
This chasm would be brimming with digital inclusion programmes through easy internet access and technological education, and more people could become the control of their health (Srinivasan et al., 2020).
Digital inclusion plays into health education and prevention too.
When it comes to mobile health (mHealth) apps – the ones that remind you to take your pills or monitor chronic disease – you will need an internet connection.
Few people with little incomes or who are virtual aridities will have access to these tools, which exacerbates health inequalities.
If broadband is integrated into SDOH, governments can build infrastructure and deliver a level playing field in digital health.
Projects such as the Federal Communications Commission’s (FCC) Affordable Connectivity Program, for instance, tackle the digital divide by subsidising low-income households to get online, all for the sake of health equity
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Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
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Ultimately, digital inclusion and broadband access are part of the delivery of healthcare in the modern world and must be recognised as key social determinants of health.
When these challenges are addressed, we’ll have better telemedicine, EHRs, patient portals and mHealth apps for a more accessible healthcare infrastructure.
Governments and health institutions should also ramp up digital reach and literacies so that the technology does the same for everyone.
References
Feldman, S., Su, G., & Wasserman, M. (2021).Digital divide in telemedicine: A matter of access equity.
Journal of the American Medical Informatics Association, 28(8): 1816-1820.
Roberts, E T, Mehrotra, A, & McWilliams, J M (2021).
Disparities in health and telemedicine: Digitalisation, the next big thing.
Health Affairs, 40(2), 323-329.
Romain, C. V., Trinidad, S., & Kotagal, M. (2022).
The effect of social determinants of health on telemedicine access during the COVID-19 pandemic
Links to an external site.
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Pediatric Annals
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(8), e311-e315. https://doi.org/10.3928/19382359-20220606-04
Srinivasan, M., Phatak, H. & Alwan, M. (2020).Broadband connectivity for equal healthcare delivery?
Telemedicine and e-Health, 26(7): 852-857.
Reply
Main Post
According to the CDC, the term “Social Determinants of Health” (SDOH) refers to a broad category of non-medical factors that have a substantial impact on health outcomes. These factors include neighborhood and built environment, social and community context, economic stability, healthcare availability and quality, and education access and quality. Every one of these categories has a significant influence on people’s health and well-being, influencing the environments in which people live and prosper (CDC, 2024).
Reflection on Digital Inclusion and Broadband Access
The importance of Internet access and digital inclusion in the current healthcare environment cannot be overstated. These resources are critical for delivering services like online learning, which helps close educational gaps, and telemedicine, which provides healthcare to rural and underprivileged people. Because technology makes remote work and employment prospects possible, having access to a dependable internet connection is also essential for maintaining economic stability. Digital platforms are also crucial for improving community involvement and social ties, both of which are critical for social support and mental health. Furthermore, digital tools make it possible for communities to take part in local planning, guaranteeing that their requirements are satisfied to create surroundings that promote health. Health disparities could be effectively addressed by taking digital inclusion into account as a crucial component of Social Determinants of Health (SDOH) (Bauerly et al., 2019). Digital Inclusion and Broadband Access as Social Determinants of Health
Examples Supporting Digital Inclusion as a Key SDOH
For telemedicine to provide remote consultations, broadband availability is essential, particularly in underserved or rural locations (Haleem et al., 2021). To prevent inequalities in educational attainment, dependable internet access is crucial for online learning. Broadband promotes economic stability by enabling distant work and employment options. Digital platforms facilitate social and community interaction, hence mitigating the negative health effects of social isolation. Furthermore, strong digital infrastructure makes it possible for communities to participate in local administration and planning, guaranteeing that their requirements are satisfied (Suzuki et al., 2023).
Impact of Health Information Technologies on SDOH
In addition to having a major impact on health outcomes and societal variables influencing health, broadband connectivity is crucial in many other aspects of life. Enabling telemedicine is crucial, particularly in impoverished and rural areas where medical facilities are few. For students to fully engage in online learning, complete their assignments, and have access to course resources, consistent internet connectivity is essential. Reduced unemployment and underemployment are two outcomes of increased economic stability brought about by broadband connections, which allow for remote work, job training programs, and job searches. According to Suzuki and colleagues in 2023. When it comes to mental health, nothing is more important than avoiding social isolation and keeping in touch with loved ones and support systems; digital platforms are a great tool for this. Communities with robust digital infrastructure are better able to participate in urban planning and local governance processes, having their needs and preferences considered as we work to create places where people may thrive. According to Bauerly et al. (2019), to successfully address and reduce health disparities, it is crucial to acknowledge digital inclusion and broadband access as significant social variables impacting health.
References
Bauerly, B. C., McCord, R. F., Hulkower, R., & Pepin, D. (2019). Broadband Access as a Public Health Issue: The Role of Law in Expanding Broadband Access and Connecting Underserved Communities for Better Health Outcomes.
The Journal of Law, Medicine & Ethics, 47
(2_suppl), 39–42.
https://doi.org/10.1177/1073110519857314
Centers for Disease Control and Prevention. (2024, January 17). Why is addressing social determinants of health important for CDC and public health? U.S. Department of Health and Human Services. Retrieved July 21, 2024, from
https://www.cdc.gov/about/priorities/why-is-addressing-sdoh-important.html
Haleem, A., Javaid, M., Singh, R. P., & Suman, R. (2021). Telemedicine for healthcare: Capabilities, features, barriers, and applications.
Sensors International, 2
, 100117.
https://doi.org/10.1016/j.sintl.2021.100117
Suzuki, T., Mizuno, A., Yasui, H., Noma, S., Ohmori, T., Lienert, J., Kawai, F., Nakayama, T., Kondo, N., & Tsukada, Y. (2023). Scoping Review of Screening and Assessment Tools for Social Determinants of Health in the Field of Cardiovascular Disease.
Circulation Journal
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https://doi.org/10.1253/circj.cj-23-0443
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Module 4: Week 9: Discussion Digital Inclusion and Broadband Access as Social Determinants of Health
