What is digital inequality and the digital divide? 

Digital inequality, or the digital divide, refers to the gap between those who have access to modern information and communications technology (ICT) and those who don’t. 

A person’s ability – or inability – to access computers and smart devices, can impact many facets of their life from paying bills to receiving emergency SMS alerts. It can also impact their health.  

In an increasingly digital world, more and more patients and their health providers are using digital health services: For example, online booking platforms, telehealth video consultations, electronic health records, remote patient monitoring tools, practice management systems, AI-assisted diagnostic tools, e-prescriptions, digital results, mobile phone apps, vaccine bookings, and patient portals for accessing health education tools. 

While the digitisation of healthcare creates new ways to access health services, it also threatens to further marginalise some groups. The critical barriers to digital inclusion are related to: 

• Accessing networks – living in urban areas where high-speed broadband is usually available, versus rural environments where internet connectivity could be problematic or even non-existent. 
• The cost of devices or data – socioeconomic factors including income and employment can limit a person’s ability to purchase and access digital technology. 
• Skills and literacies – education, experience, language, racial background, gender, and age can impact a person’s ability and experience to navigate the digital realm to find, evaluate, create, and communicate information. 

A recent article published in The Lancet examined research that tracked the use of telehealth visits in the US during the height of the COVID-19 pandemic. Results found that Black patients were more than four times more likely than White patients to seek healthcare in the emergency department over telehealth services, even when adjusting for co-morbidities and preferred language. 

This study, as well as other literature, offers the potential explanation that the lack of pre-established relationships with physicians, as well as mistrust of digital platforms, could drive this reluctance to pursue telemedicine. 

Digital inequality – the Australian experience

According to the Australian Digital Inclusion Index, digital inclusion across Australia is continuing to increase for most social groups and regions, but the number of highly excluded Australians remains substantial at 11 percent of the population. 

The divide between metropolitan and regional areas has also narrowed but remains marked: Regional areas recorded an index score in 2021 of 67.4. This is 3.6 points less than the national average (71.1), and 5.5 points less than metropolitan Australia (72.9). 

From a global perspective, reports calculate that widespread access to the internet is still elusive. Just 45 percent of people are connected in developing countries, and in the least developed countries the proportion is just 20 percent. 

The biggest concern is that digital disparities are becoming a key social determinant of health because a widening digital divide can result in health inequalities, and ultimately, significant health disparities.  

Closing the digital divide

A May 2022 online forum on closing the digital divide for regional Victorians was organised by Health Issues Centre, Victoria’s peak health consumer organisation. The event was attended by consumers, health and community services workers, state government representatives and technology industry representatives.  

The forum listed five high-level approaches that are required to enhance digital inclusion for those most affected: 

• Support for consumers to enhance digital literacy and transition to telehealth. 
• Direction to health services in the provision of digital alternatives and choice. 
• Prioritising rural consumer and community engagement processes. 
• Equitable provision of data to those living rurally to access health services. 
• Care coordination for those rural health consumers with complex needs. 

You can find a full copy of the Health Issues Centre report here.

Learn more about the UN’s perspective on the current state of global digital inequality.

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