Disparities in Health Care and the Digital Divide
Open accessAbstract
Purpose of review Disparities in health outcomes are a well documented and worrisome part of our health care system. These disparities persist in spite of, and are occasionally exacerbated by, new technologies that are intended to improve health care. This results in a "digital divide" in which populations that have poorer health outcomes continue to have poorer health outcomes despite technological improvements.Recent findings In many ways, the digitical divide is already shrinking via improved access to internet and technology/process improvements. For example, people with schizophrenia, PTSD, and bipolar disorder have had their care successfully augmented by new technology. However, problems persist- being impoverished, female, and black all correlate with decreased probability of completing a telehealth visit, and millions of americans have insufficient internet access to complete telehealth visits. We must continue to utilize new technology in health care to improve outcomes, but we must also be wary to ensure those outcomes are equitable across different populations.
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In 2013, a mobile medical app (WellDoc's BlueStar Rx) was cleared by the FDA as a prescription digital therapeutic (PDT) to support the management of type 2 diabetes by analyzing patient data, formulating personalized guidance, and summarizing data analytics to the healthcare team for clinical decision support.
“In 2013, a mobile medical app (WellDoc's BlueStar Rx) was cleared by the FDA as a prescription digital therapeutic (PDT) to support the management of type 2 diabetes by analyzing patient data, formulating personalized guidance, and summarizing data analytics to the healthcare team for clinical decision support.56”
From Digital health technologies and major depressive disorder (2023) · cites this paper as [56]
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“92 Plastic surgery, already grappling with existing concerns regarding diversity and inclusion, must make considerations regarding the price and availability of genAI technologies such that its integration advances and does not hinder health equity.”
Telehealth use in maternity care during a pandemic: A lot of bad, some good and possibility
Collins, E., Keedle, H., Jackson, M., Lequertier, B., Schmied, V. A., Boyle, J. A., Kildea, S. V., & Dahlen, H. G. (2024) · Women and Birth · doi:10.1016/j.wombi.2023.12.008 · Cited by 24 · see citing works
Virtual and Augmented Reality in Spine Surgery: An Era of Immersive Healthcare
Hasan, S. M., Miller, A., Higginbotham, D., Saleh, E. S., & McCarty, S. (2023) · Cureus · doi:10.7759/cureus.43964 · Cited by 24 · see citing works
“For instance, mobile-based VR solutions, which are relatively more affordable, can be an entry point for institutions in resource-limited settings [10].”
BackgroundInfluentialHe, J., Ahmad, S. F., Al‐Razgan, M., Ali, Y. A., & Irshad, M. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e28778 · Cited by 23 · see citing works
“This not only tries to cover the multifaced nature of technology adoption but also examine the differences in access, abilities, and utilization patterns across different demographics and their role in the metaverse adoption [46, 136 – 140].”
BackgroundRetractedGavette, H., McDonald, C. L., Kostick, K. M., Mullen, A., Najafi, B., & Finco, M. G. (2024) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2023.1335966 · Cited by 23 · see citing works
Khosravi, M., & Azar, G. (2024) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2024.39 · Cited by 23 · see citing works
“…within the literature of telehealth tools, which denotes the significant challenge of accessibility of telehealth tools to vulnerable populations with limitations in the access to the digital and inter-net-based tools (Ramsetty and Adams, 2020; Alkureishi et al., 2021; Saeed and Masters, 2021).”
BackgroundTarabichi, Y., Higginbotham, J., Riley, N., Kaelber, D. C., & Watts, B. (2023) · Journal of General Internal Medicine · doi:10.1007/s11606-023-08209-0 · Cited by 22 · see citing works
Jia, X. D., & Xing, H. (2025) · BMC Public Health · doi:10.1186/s12889-025-23411-x · Cited by 21 · see citing works
“The digital divide in society is the fact that the information disadvantaged have not fully benefited from information technology and society [19], emphasizes the uneven distribution of opportunities to access digital technology[20].”
Worldwide Survey on Digital Assistive Technology (DAT) Provision
Margot‐Cattin, I., Deblock-Bellamy, A., Wassmer, J., Ledgerd, R., von Zweck, C., & World Federation of Occupational Therapists (2024) · Occupational Therapy International · doi:10.1155/2024/9536020 · Cited by 21 · see citing works
“A digital divide is recognized where there is an unequal distribution of access to technology and the Internet between di ff erent groups of people [33], which can a ff ect DAT provision.”
BackgroundBiggs, M. A., Ehrenreich, K., Morris, N., Blanchard, K., Bustamante, C. K., Choimorrow, S. Y., Hauser, D., Hernandez, Y., Kapp, N., Kromenaker, T., et al. (2022) · Obstetrics & Gynecology · doi:10.1097/aog.0000000000004757 · Cited by 20 · see citing works
eHealth literacy in the general population: a cross-sectional study in China
Sun, C., Meijer, E., Chavannes, N. H., Dai, H., Li, X., Wang, Y., Wu, L., Zhang, Q., & Kasteleyn, M. J. (2025) · BMC Public Health · doi:10.1186/s12889-025-21389-0 · Cited by 20 · see citing works
Telemedicine in Care of Sarcoma Patients beyond the COVID-19 Pandemic: Challenges and Opportunities
Tsagkaris, C., Trygonis, N., Spyrou, V., & Koulouris, A. (2023) · Cancers · doi:10.3390/cancers15143700 · Cited by 22 · see citing works
“Therefore, telecare for sarcoma can achieve its potential providing that both patients and physicians have sufficient command of and access to digital services [128,129].”
BackgroundRavi, S., Meyerowitz-Katz, G., Yung, C., Ayre, J., McCaffery, K., Maberly, G., & Bonner, C. (2025) · BMC Health Services Research · doi:10.1186/s12913-025-12496-0 · Cited by 19 · see citing works
Tiago, R. D. S., & Mitchell, A. (2024) · Digital Transformation in Higher Education, Part B · doi:10.1108/978-1-83608-424-220241004 · Cited by 51 · see citing works
Gainer, D. M., Wong, C., Embree, J. A., Sardesh, N., Amin, A., & Lester, N. A. (2023) · Substance Use & Misuse · doi:10.1080/10826084.2023.2167496 · Cited by 19 · see citing works
“While the use of telehealth may improve access to SUD treatment at the population level and reduce barriers to treatment, it risks further marginalization of those in need by exacerbating the digital divide (Early & Hernandez, 2021; Saeed & Masters, 2021).”
BackgroundArtificial intelligence: Applications in cardio-oncology and potential impact on racial disparities
Echefu, G. C., Shah, R., Sanchez, Z., Rickards, J., & Brown, S.-A. N. (2024) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2024.100479 · Cited by 19 · see citing works
Stimpson, J. P., Park, S., Wilson, F. A., & Ortega, A. N. (2024) · JMIR Public Health and Surveillance · doi:10.2196/56881 · Cited by 18 · see citing works
“Social media platforms can serve as conduits for disseminating health-related disinforma-tion, often aimed at these specific communities [44].”
The Role of Artificial Intelligence in Managing Bipolar Disorder: A New Frontier in Patient Care
Milić, J., Zrnic, I., Grego, E., Jovic, D. P., Stanković, V. V., Djurdjevic, S., & Šapić, R. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14072515 · Cited by 18 · see citing works
“Additionally, ensuring that AI tools are designed to be user-friendly and accessible to a wide range of users, regardless of their technical expertise, is essential for increasing adoption [47].”
Cummins, M. R., Wong, B. G., Wan, N., Han, J., Shishupal, S., Gouripeddi, R., Ivanova, J., Franklin, A., Johnny, J. D., Ong, T., et al. (2025) · JAMIA Open · doi:10.1093/jamiaopen/ooaf056 · Cited by 18 · see citing works
“14–16 However, our results indicate that the relationship of these factors to tele-medicine use is intricate and context-dependent.”
Zöllner, J. P., Noda, A. H., McCoy, J., Schulz, J., Tsalouchidou, P., Langenbruch, L. M., Kovac, S., Knake, S., von Podewils, F., Hamacher, M., et al. (2022) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2022.0238 · Cited by 18 · see citing works
Berry, J. G., Ferrari, L. R., Ward, V. L., Hall, M., Desmarais, A., Raval, M. V., Tian, Y., Mathieu, D., Incorvia, J., & Meara, J. G. (2023) · Academic Pediatrics · doi:10.1016/j.acap.2023.08.012 · Cited by 18 · see citing works
Bareis, N., Tepper, M. C., Wang, R., Tang, F., Olfson, M., Dixon, L. B., Kimhy, D., Wall, M. M., Medalia, A. A., Finnerty, M. T., et al. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115497 · Cited by 18 · see citing works
Belmonte, I. A., Collado, R. S., Yuguero, O., Oliva, J. A., Martínez-Millana, A., & Pérez, C. S. (2024) · Atención Primaria · doi:10.1016/j.aprim.2024.102880 · Cited by 27 · see citing works
Li, Z., Liu, X., Tang, Z., Jin, N., Zhang, P., Eadon, M. T., Song, Q., Chen, Y., & Su, J. (2024) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocae158 · Cited by 19 · see citing works
The Impact of Clinical Decision Support on Health Disparities and the Digital Divide
Douthit, B. J., McCoy, A. B., & Nelson, S. D. (2023) · Yearbook of Medical Informatics · doi:10.1055/s-0043-1768722 · Cited by 17 · see citing works
“Population differences in physical health, mental health, and life expectancy are well-documented [1-4].”
BackgroundClosing the Digital Divide in Interventions for Substance Use Disorder
Hampton, J., Mugambi, P., Caggiano, E. G., Eugene, R., Valente, A., Taylor, M. M., & Carreiro, S. (2024) · Journal of Psychiatry and Brain Science · doi:10.20900/jpbs.20240002 · Cited by 17 · see citing works
“Quality improvements on healthcare disparities have been consistently documented to improve the treatment, diagnosis, and health outcomes of a variety of conditions [5].”
BackgroundYoon, E., Hur, S. I., Curtis, L. M., Benavente, J. Y., Wolf, M. S., & Serper, M. (2024) · JAMIA Open · doi:10.1093/jamiaopen/ooae026 · Cited by 16 · see citing works
Schwartz, J. B., Liu, R., Boscardin, W. J., Liu, Q., Lau, S. W. J., Khatri, S., & Tarn, D. M. (2024) · Journal of the American Geriatrics Society · doi:10.1111/jgs.18857 · Cited by 16 · see citing works
“There still exists a digital divide that contributes to health disparities 24 with lower socioeconomic status and higher age-associated digital challenges.”
BackgroundLi, M., Patel, J., & Katapally, T. R. (2025) · PLoS ONE · doi:10.1371/journal.pone.0315313 · Cited by 15 · see citing works
“However, a potential limitation is that participating in XR-CBT interventions requires access to advanced technologies, which may not be available to certain populations, particularly in low-income areas [91,92].”
What we can learn from selected, unmatched data: Measuring internet inequality in Chicago
Saxon, J., & Black, D. A. (2022) · Computers Environment and Urban Systems · doi:10.1016/j.compenvurbsys.2022.101874 · Cited by 15 · see citing works
Is the Rural Population Caught in the Whirlwind of the Digital Divide?
Kerras, H., Rosique, F., Bautista, S., & Gómez, M. D. D. M. (2022) · Agriculture · doi:10.3390/agriculture12121976 · Cited by 15 · see citing works
Impact of sleep quality and physical activity on blood pressure variability
de Havenon, A., Falcone, G. J., Rivier, C. A., Littig, L., Petersen, N., de Villèle, P., Prabhakaran, S., Kimberly, W. T., Mistry, E. A., & Sheth, K. N. (2024) · PLoS ONE · doi:10.1371/journal.pone.0301631 · Cited by 15 · see citing works
Huang, B. (2024) · Current Psychology · doi:10.1007/s12144-024-06106-1 · Cited by 15 · see citing works
“Saeed and Masters ( 2021 ) aimed to explore disparities in healthcare access related to the digital divide.”
The Impact of Digitization on Legal Systems in Developing Countries
Bakhtiyorovich, D. I., Baratov, A., Ugli, K. S. A., Yakubova, I., Рахмонова, М., Mukumov, B., & Абдурахманова, Н. (2025) · Qubahan Academic Journal · doi:10.48161/qaj.v5n1a1246 · Cited by 15 · see citing works
“Both authorities arguably would not have authority to sanction a social media company that provides profiles of users to third-party advertisers when it is not clear whether the social media company provides the user profiles from its own database in the country [29].”
Nivethitha, V., Daniel, R., Surya, B., & Logeswari, G. (2025) · Journal of Postgraduate Medicine · doi:10.4103/jpgm.jpgm_634_24 · Cited by 15 · see citing works
“[28] Ensuring universal access to AI-driven healthcare is vital to prevent widening inequities.”
The impact of digital inequities on gastrointestinal cancer disparities in the United States
Fei‐Zhang, D. J., Moazzam, Z., Ejaz, A. M., Cloyd, J. M., Dillhoff, M., Beane, J. D., Bentrem, D. J., & Pawlik, T. M. (2023) · Journal of Surgical Oncology · doi:10.1002/jso.27257 · Cited by 15 · see citing works
“32,33 The implementation of telephone ‐ and internet ‐ based connected health technologies has been associated with greater patient and provider satisfaction, as well as improved cancer symptom management outcomes, particularly in rural communities.”
BackgroundPrevention of Pre-Eclampsia: Modern Strategies and the Role of Early Screening
Alipova, G., Ablakimova, N., Tussupkaliyeva, K., Bermagambetova, S., Космуратова, Ш. Б., Karimsakova, B., Gaiday, A. N., Gaiday, A., Dinets, A., & Tussupkaliyev, A. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14092970 · Cited by 18 · see citing works
“The digital divide poses another barrier, as limited internet access, lack of technical support, and inadequate training of healthcare personnel can hinder the deployment and maintenance of ML tools [132].”
Dysphagia in Older Adults is Associated With Food Insecurity and Being Homebound
Jones, H. N., Leiman, D. A., Starr, K. N. P., North, R., Pieper, C. F., Robison, R., & Cohen, S. M. (2023) · Journal of Applied Gerontology · doi:10.1177/07334648231177568 · Cited by 14 · see citing works
“While telehealth services may offer a method to improve healthcare access, there is evidence that disparities exist in this sphere as well (Sachs et al., 2021; Saeed & Masters, 2021).”
Telemedicine in an adolescent and young adult medicine clinic: a mixed methods study
Barney, A., Mendez-Contreras, S., Hills, N. K., Buckelew, S. M., & Raymond‐Flesch, M. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-09634-x · Cited by 14 · see citing works
“These may include limited technology access, low health or digital literacy, patient acceptance, cost, healthcare infrastructure and policy barriers [36, 37, 39, 40].”
BackgroundQuality measures of virtual care in ambulatory healthcare environments: a scoping review
Petrie, S., Laur, C. V., Rios, P. D. L., Suarez, A., Makanjuola, O., Burke, E., Bhattacharyya, O. K., & Mukerji, G. (2024) · BMJ Open · doi:10.1136/bmjopen-2023-078214 · Cited by 14 · see citing works
“20 This lack of consideration of equity is concerning, as virtual care has the potential to improve access to care for some typically underserved populations and worsen access for others, 21 making it an essential consideration in understanding the quality of care.”
BackgroundInternet Devices and Internet Access Among Migrant and Seasonal Farmworkers, North Carolina, 2023
Lee, J. G. L., Roby, M., Cofie, L. E., LePrevost, C. E., Harwell, E. L., Reed, E. C., Nieuwsma, J., Bloss, J., Anderson, G. C., Santillán-Deras, J. R., et al. (2024) · Public Health Reports · doi:10.1177/00333549241295632 · Cited by 14 · see citing works
Louch, G., Albutt, A., Smyth, K., & O'Hara, J. K. (2022) · BMC Health Services Research · doi:10.1186/s12913-022-07954-y · Cited by 14 · see citing works
“Our findings also add important novel details to the more common debates about digital exclusion [45], by suggesting that ‘hidden’ issues such as coercive or controlling behaviour could be compounded by providing access to EHRs.”
BackgroundPersonalized medicine and health equity: overcoming cost barriers and ethical challenges
Francisco, K. K. Y., Apuhin, A. E. C., Maravilla, N. M. A. T., Byers, M. C., Karim, H. B. A., Tan, M. J. T., & AlDahoul, N. (2025) · International Journal for Equity in Health · doi:10.1186/s12939-025-02710-0 · Cited by 27 · see citing works
“This perspective supports the idea that technology should be optimized to improve health outcomes for all [123].”
Noble Metal Nanoparticles for Point-of-Care Testing: Recent Advancements and Social Impacts
Luciano, K., Wang, X., Liu, Y., Eyler, G., Qin, Z., & Xia, X. (2022) · Bioengineering · doi:10.3390/bioengineering9110666 · Cited by 13 · see citing works
Sunshine, I., Kysh, L., & Lakshmanan, A. (2023) · mHealth · doi:10.21037/mhealth-23-10 · Cited by 13 · see citing works
Morgan, P., & Cogan, N. A. (2024) · Journal of Public Mental Health · doi:10.1108/jpmh-07-2024-0095 · Cited by 15 · see citing works
- Authors
- Saeed, S. A., & Masters, R. M.
- Affiliations
- East Carolina University (US)
- Corresponding author
- Saeed, Sy Atezaz
- ORCID
- Saeed, Sy Atezaz
- Venue
- Current Psychiatry Reports
- Published
- 2021-07-23
- Volume
- 23
- Issue
- 9
- Pages
- 61-61
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- PMC
- PMC8300069
- OpenAlex
- W3185220037
- Cited by
- 578
- References
- 22
- Citations by year
- 2026: 131 · 2025: 177 · 2024: 149 · 2023: 80 · 2022: 37 · 2021: 3
- FWCI
- 37.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Health Professions › General Health Professions › Health Literacy and Information Accessibility
- Keywords
- health care disparities, digital divide, telemedicine, internet access, health equity, schizophrenia, post-traumatic stress disorder, bipolar disorder, socioeconomic status, racial disparities, gender disparities, health technology
- MeSH terms
- Black or African American, Female, Humans, Telemedicine, Internet, Healthcare Disparities, Digital Divide
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