Compounding inequalities in accessing digital health services

A third of people who are offline find that the NHS is one of the most difficult organisations to interact with (Lloyds, 2022). In addition, those who are offline are twice as likely to indicate a health condition compared to those who are online (Lloyds, 2023). 

These statistics tell us that not only do those who are digitally excluded struggle to interact with health services, they are also more likely to need to. 

This overlap between digital exclusion and access to healthcare has been well researched by member organisations within the VCSE (Voluntary, Community and Social Enterprise) Health and Wellbeing Alliance, a partnership between voluntary sector representatives and the health and care system focused on improving services for communities. Our recent ‘Designing For Digital Inclusion in Healthcare’ seminar series was a project supported by the alliance, with the aim of drawing together this research and learning, to help reduce barriers to accessing health care.

For me what became clear whilst working on this project was one cross cutting theme amongst the alliance members’ work; digital exclusion compounds health inequalities. In other words, for some groups digital exclusion can exaggerate existing challenges in:

• accessing health care
• using and navigating health services
• accessing resources and information for managing health

Digital barriers to accessing health services among those with protected characteristics

Analysis of Ofcom data (Yates, 2023) shows that non-users of the internet compared to extensive users are:

• 2x more likely to have a disability or health condition
• 12x more likely to be over the age of 65

Among older people, barriers to accessing digital health services may include: lack of interest, lack of confidence, and a preference for in-person support particularly for those who are experiencing isolation or loneliness. There are potentially different barriers faced by those with a disability or health condition, from being able to access appropriate accessibility software, to anxiety or lack of trust, particularly if people have had negative past experiences with digital health services. 

In the first seminar, the Gypsy, Roma and Traveller consortium highlighted that the Gypsy, Roma and Traveller community have the worst general health outcomes of any ethnic group in the UK. Also, British Red Cross presented their research with refugees and people seeking asylum, another group likely to experience poorer health than the general population. Although the circumstances and characteristics of these two groups are unique, both VCSE Health and Wellbeing Alliance members indicated that some common digital barriers are worsening the inequalities these communities face. These barriers include:

• lack of access to appropriate data and devices
• low digital literacy levels
• language barriers 
• fears about sharing personal data

What does this mean for digital health services? 

These are just some examples of how digital barriers may prevent people from being able to access digital health services, having the potential to worsen existing health inequalities. This isn’t to say all digital services are bad, as we heard from the Learning Disability Alliance (Seminar 1), sometimes digital services can make healthcare more accessible for some groups. 

But, it serves as a reflection on the need to develop a depth of understanding about the specific needs of the target population. Whether that’s by working with local community organisations, accessing research insights from VCSE experts, or learning from those who are a few steps ahead, this depth of understanding could be the difference in supporting equitable access to healthcare services. 

You can access recordings, slides and key takeaways from the three Designing for Digital Inclusion in Healthcare seminars here.