It’s been a digital year like no other due to COVID-19, causing Americans to rely on telehealth, virtual learning, and video chats as their new normal for health care, education, and social interaction. But the heightened reliance on digital tools has increased disparities and inequities among individuals without digital skills and access to internet, computers, or mobile devices.


In a recent research study published by Nature Partner Journals (npj) Digital Medicine, practitioners experienced in the intersection of digital inclusion and health explored the need to address digital inclusion as a leading social determinant of health (SDoH) due to its powerful impact on other SDoH.

When it comes to health care, digital tools such as health apps and patient portals encourage patient engagement, support patients outside of clinical offices, and improve health outcomes, wrote study authors. But the role of digital inclusion goes far beyond health care. Digital literacies and Internet connectivity also have powerful influences on other SDoH, such as acquiring employment, housing, or other assistance programs through online applications, explained the authors.

A February 2020 research brief from Brookings Institute found those least likely to have broadband internet service in America due to systemic barriers are communities of color and low-income communities. Some key findings from the brief include:

  • Fifteen percent of American households do not have subscriptions to any form of broadband internet service.
  • White (90 percent), Asian American (94 percent), and Latino or Hispanic (86 percent) households all have broadband adoption rates above the national average (84 percent), but Black households have a lower adoption rate (82 percent).
  • Households earning less than $20,000 have a broadband adoption rate of 62 percent, those earning between $20,000 and $74,999 have an adoption rate of 83 percent, and households earning more than $75,000 have an 85 percent adoption rate.

“The costs of equipping a person to use the internet are substantially lower than treating health conditions and the benefits are persistent and significant, making the efforts to improve digital literacy skills and access valuable tools to reduce disparities,” wrote npj Digital Medicine co-authors.

  1. To address digital inclusion and increase equitable access, the study authors suggest health care systems: Adopt “digital inclusion-informed strategy” around mobile health to better understand access to digital tools and internet connectivity throughout their communities and support patients in sustainable technology use.
  2. Systematically assess individual patients’ access and digital literacies by asking questions about what devices they own and how they access the internet and document population-level metrics, examine disparities, and monitor change over time.
  3. Partner with community organizations experience in training in digital literacy skills and facilitating connectivity, such as community health workers, patient navigators, or other local resources.