Access to the internet, availability of digital devices and digital literacy are among the most urgent digital determinants of health, according to a new joint study led by WHO/Europe and the London School of Economics, and with the contribution of other international institutions. The study, available both as a scientific paper and a WHO report, offers an analysis of health determinants in a digital era, highlighting the complex ways in which digitalization shapes health outcomes.
Digital determinants of health refer to any factor rooted in or contingent on the digital world that can directly or indirectly influence health or well-being. With technology becoming more deeply embedded in our daily lives, digital determinants of health can affect an existing relationship between social, political, or commercial determinants and health, or create entirely new ways to influence individual or population health.
Mapping the digital determinants of health
“The new study points to the important fact that digital health is shaped by more than just access to devices and the internet. It is influenced by a wide range of factors, from digital literacy to the transparency of algorithms and policies on misinformation,” said Dr Natasha Azzopardi Muscat, Director of the Division of Country Health Policies and Systems at WHO/Europe. “As our health systems increasingly intertwine with technology, we need a comprehensive approach to digital health governance to ensure equitable and effective solutions in this new era.”
The review identified 127 health determinants that emerged or changed in a digital age, with internet access and connectivity, device and software availability, and digital literacy being the most impactful. Other key factors include the moderation of harmful online content, data accuracy and algorithmic transparency, as well as misinformation and disinformation policies. Such a diverse nature of health determinants in a digital context highlights the need for a comprehensive approach to digital health governance.
“Digital determinants are changing the ways we understand health and navigate health systems. It’s not just about the availability of technology – it’s about ensuring that digital tools are aligned with public health goals and can truly enhance health outcomes. Our research shows a multidimensional nature of health determinants in the digital age, emphasizing the need for stronger collaboration across sectors,” said Dr David Novillo Ortiz, Regional Adviser on Data, Evidence and Digital Health at WHO/Europe, and a lead co-author of the study.
Digital transformation of society
WHO views health not merely as an absence of disease, but also as a product of everyday conditions and decisions, influenced by a wide array of determinants, from policy to personal behaviour. Traditionally, social determinants of health such as age, education, employment, and housing have been recognized as key influences on health status.
“Digital transformation impacts health in ways that may not always be immediately apparent to non-health experts, yet their decisions – whether in technology design, data governance, or policy – can have profound consequences for individual and population health. Therefore, it is important to involve people from outside the health sector in the conversation,” said Dr Robin van Kessel, Senior Health Policy Research Associate at the London School of Economics and lead author of the study.
Digital divides
The study found that younger and healthier people are better equipped to use digital tools, but they are also more vulnerable to the adverse effects of these technologies, such as misinformation or the misuse of personal data. On the other hand, groups at higher risk of digital exclusion – older adults, persons with disabilities, and migrants – stand to gain the most from digital health solutions, but are often shielded from the negative effects due to their low access to digital platforms.
This points to a growing concern over digital divides, where inequalities in access to technologies exacerbate existing health disparities. As the digital landscape evolves with innovations like artificial intelligence and blockchain, a second digital divide is emerging – one that adds new complexities to existing inequalities. Ensuring that all populations, particularly vulnerable groups, have equitable access to digital health tools is a key priority of the Regional digital health action plan for the WHO European Region 2023–2030 and the WHO Global strategy on digital health 2020–2025.