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Digital Health and Health Equity Efforts

Written by Blaise O’Malley, MPH

The COVID-19 pandemic has exposed and exacerbated many health inequities in our society. Across Canada and the United States, people of colour have been contracting and dying from COVID-19 at a disproportionate rate (Quinn & Andrasik, 2021). A report assessing vaccine equity in Ontario found that in Toronto, neighbourhood poverty is negatively correlated with vaccination rates (Wellesley Institute, 2021). And research is showing that people with disabilities are at greater risk of poor health outcomes due to COVID-19 (Shakespeare et al., 2021).

At the same time, the pandemic has catalyzed the widespread acceptance of telemedicine and digital health processes. Stay-at-home orders and other measures enforced to minimize potential exposure to the virus have led to a massive increase in virtual health visits. For example, compared with the same time period in 2019, there was a 56-fold increase in virtual primary care appointments in Ontario during March-July 2020 (Glazier et al., 2021). 

Considering the extensive use of technology in today’s healthcare system and the urgent need to address disparities, the current moment presents us with an opportunity to use digital strategies to develop impactful health equity solutions. If we can effectively leverage technology to make patient education more accessible, appointments more efficient, and care more coordinated, we can help reduce health disparities that largely contribute to poor health outcomes. 

There are a number of ways that we can achieve this and many cases where this is already happening. For example, digital translation tools and visual resources can help address language barriers that may be present between a patient and provider. Additionally, virtual appointments can eliminate the need for transportation to the hospital or doctor’s office, which can be expensive, inconvenient, and time consuming. Digital health can even help patients outside of medical environments–for example, health apps can make tracking symptoms or behaviours simple, enabling them to take note of their health anywhere at any time. 

Given that IMD exists within the digital health world, we recognize that we have a role to play in this too. There is immense opportunity for our platform to widen accessibility for numerous patient groups, and we have already started taking steps to accomplish this. For example, we have created pages dedicated to patient populations that have been historically underserved by the healthcare system (see Indigenous Health and LBGTQ+ Health, or check out our Health Equity page).

As we develop these digital strategies to achieve health equity, we must be careful not to inadvertently widen health disparities instead. This is especially relevant for rural and/or low-income populations that may not have reliable Internet access or the means to purchase digital devices. It is also true for populations with low digital health literacy and limited technological engagement (Crawford & Serhal, 2020). As such, it is important to use technology where it’s most effective but also offer alternatives to tech-only features. For example, the IMD platform enables healthcare practitioners to email educational content home to patients, but resources can also be printed directly from the site for patients who don’t have an email address or a strong Internet connection. This ensures that patients will be able to take home informative health-focused resources no matter their access to technology. 

Of course, other problems exist and many do not have a simple solution, but if we regularly ask ourselves how we can make our services more accessible, we may start to generate innovative ideas that could make a real difference. 

References

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). doi:10.2196/19361

Glazier, R. H., Green, M. E., Wu, F. C., Frymire, E., Kopp, A., & Kiran, T. (2021). Shifts in office and virtual primary care during the early COVID-19 pandemic in Ontario, Canada. Canadian Medical Association Journal, 193(6). doi:10.1503/cmaj.202303

Iveniuk, J., & Leon, S. (2021). An uneven recovery: Measuring COVID-19 vaccine equity in Ontario (Rep.). Wellesley Institute.

Quinn, S. C., & Andrasik, M. P. (2021). Addressing Vaccine Hesitancy in BIPOC Communities — Toward Trustworthiness, Partnership, and Reciprocity. New England Journal of Medicine, 385(2), 97-100. doi:10.1056/nejmp2103104

Shakespeare, T., Ndagire, F., & Seketi, Q. E. (2021). Triple jeopardy: Disabled people and the COVID-19 pandemic. The Lancet, 397(10282), 1331-1333. doi:10.1016/s0140-6736(21)00625-5