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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.56”
From Digital health technologies and major depressive disorder (2023) · cites this paper as [56]
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“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].”
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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
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
“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 22
Stimpson, J. P., Park, S., Wilson, F. A., & Ortega, A. N. (2024) · JMIR Public Health and Surveillance · doi:10.2196/56881 · Cited by 18
“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 21
“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
“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
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
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
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
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
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
“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 20
“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
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
“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
“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
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
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
Huang, B. (2024) · Current Psychology · doi:10.1007/s12144-024-06106-1 · Cited by 15
“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
“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 18
“[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 16
“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 21
“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 15
“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
“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
“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
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
“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 29
“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
Sunshine, I., Kysh, L., & Lakshmanan, A. (2023) · mHealth · doi:10.21037/mhealth-23-10 · Cited by 13
Morgan, P., & Cogan, N. A. (2024) · Journal of Public Mental Health · doi:10.1108/jpmh-07-2024-0095 · Cited by 15
Metadata
- 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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