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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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“However, most of these materials are primarily text-based, which poses significant accessibility challenges for disadvantaged populations, such as individuals with low income or limited health literacy [5].”
Pharmacy closures and the expansion of pharmacy deserts in Ohio: A 2021–2024 analysis
Chatzipanagiotou, O. P., Catalano, G., Khalil, M., & Pawlik, T. M. (2025) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2025.102422 · Cited by 6
Medical jargon is often misunderstood by emergency department patients
Wahrenbrock, T. N., Landry, K., Amin, D. P., Rizvanolli, L., Chandrasekaran, R., Mycyk, M. B., & Routsolias, J. C. (2025) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2025.06.012 · Cited by 6
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Hematabadi, A., Rashidlamir, A., Radfar, B., Shourabi, P., Hajimousaei, S., Schauer, M., & Motevalli, M. S. (2025) · Youth · doi:10.3390/youth5040111 · Cited by 9
“Individuals from lower-income backgrounds, with limited education, or belonging to marginalized ethnic communities often lack reliable internet access or digital devices, creating substantial barriers to participating in digital health platforms (Saeed & Masters, 2021).”
Cheung, T. H. R., Elliott, M. T., Stephens, G., & Mansfield, M. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-102887 · Cited by 6
Adusumalli, R., & Banala, R. R. (2025) · Egyptian Journal of Medical Human Genetics · doi:10.1186/s43042-025-00790-9 · Cited by 7
“Additional ethical challenges include the potential misuse of prenatal technologies for gender selection and the exacerbation of socioeconomic disparities in access to testing, which further deepens existing health inequities [284–286].”
Ambient AI Scribes and the Quintuple Aim
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Just-in-Time Adaptive Interventions (JITAIs) for Suicide Prevention: Tempering Expectations
Bryan, C. J., Wastler, H. M., Allan, N. P., Khazem, L. R., & Rudd, M. D. (2022) · Psychiatry · doi:10.1080/00332747.2022.2132775 · Cited by 7
“…are disproportionately affected by limited access to reliable, high-quality broadband internet and cellular services (i.e., “the digital divide”) (Saeed & Masters, 2021) and are less likely to have the financial resources needed to purchase and maintain the devices required for continuous…”
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“…for disadvantaged populations [96], high-functioning devices and the service plans required to support them are still out of reach for many, creating a “digital divide” [97,98]. the evidence-based medical guidelines of today are the product of decades of data-gathering and organized evaluation.”
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Beyond the clinical context: the process of losing oneself living with Huntington’s disease
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“They could develop strategies such as clinical and psychological assistance through telephone calls, targeting people with a digital gap, that is, those who do not have internet service [46].”
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“7 In contrast to prior studies linking higher social distress or lower educational levels to lower telemedicine utilization, 22–24 higher SDI had independently higher odds of completing telemedicine visits, which may be due to the preconception that telemedicine visits may be associated with lower…”
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Concept of digital health literacy revisited: Using text network and topic model analysis
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“12,13,38 Given that reducing health disparities remains a central objective of the global health agenda, 39 research on the inequities associated with DHL is anticipated to grow rapidly, aligning with efforts to promote equitable access to digital health resources worldwide.”
Homelessness, Patient Navigation, and Lung Cancer Screening in a Health Center Setting
Baggett, T. P., Sporn, N. J., Teixeira, J. B., Rodriguez, E. C., Anandakugan, N., Little, B. R., Chang, Y., Park, E. R., Rigotti, N. A., & Fine, D. R. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.19780 · Cited by 6
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“Broader literature highlights that while digital platforms (e.g., mobile apps, tele-counselling) could expand access, the digital divide in rural and low-income communities creates inequities in uptake [77].”
Haimi, M., & Inchi, L. (2025) · Healthcare · doi:10.3390/healthcare13233107 · Cited by 5
“Rural residents experience more barriers to telehealth access than non-rural residents [99,100].”
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“At the same time, the digital divide — de fi ned as systematic differences in resources and capabilities required to access and effectively use digital technologies — poses signi fi cant barriers, especially for marginalized and underrepresented groups 26,27 .”
Digital health determinants & divide in the Arab world: A cross-sectional study
Qasrawi, R., Tayyem, R., Thwib, S., Issa, G., Amro, M., Ghoush, R. A., Sabbah, H. A., Bookari, K., Alawadhi, N., Allehdan, S., et al. (2025) · PLoS ONE · doi:10.1371/journal.pone.0338299 · Cited by 5
“Populations that experience poorer health outcomes often continue to face these disadvantages despite technological advancements, as the digital divide can limit their ability to benefit from improvements in healthcare technology and access to digital health resources [6].”
Garuma, D., Lamba, D., Abessa, T. G., & Bonnechère, B. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1377482 · Cited by 5
“Unequal access to technology can exacerbate existing health disparities and impede the equitable distribution of cognitive assessments (48).”
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“Access to the web and use of technology have now been identified as social determinants of health [32,60,61].”
Thompson, A., Naidoo, D., Becker, E., Trentino, K. M., Rooprai, D., & Lee, K. (2024) · Healthcare · doi:10.3390/healthcare12202084 · Cited by 7
“The digital divide may be more prevalent in patients with mental health conditions, who are more likely to encounter lower socio-economic status [54,55].”
BackgroundEthical Considerations Regarding Digital Health Services in Home-Based Palliative Care
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Shaikh, C. F., Woldesenbet, S., Munir, M. M., Moazzam, Z., Endo, Y., Alaimo, L., Azap, L. E., Yang, J., Katayama, E., Lima, H. A., et al. (2023) · Journal of Gastrointestinal Surgery · doi:10.1007/s11605-023-05711-y · Cited by 5
Matthews, E. B., Lushin, V., & Rzewinski, J. (2023) · Community Mental Health Journal · doi:10.1007/s10597-023-01166-2 · Cited by 5
“Many groups are disproportionately affected by this digital divide, including those with unstable housing, individuals with acute mental health challenges, older adults, and racial and ethnic minorities (Saeed & Masters, 2021; Qian et al., 2022; Zhang et al., 2021).”
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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