Digital health interventions and inequalities: the case for a new paradigm
Open accessAbstract
Ischaemic heart disease, cerebrovascular disease (the most common cardiovascular diseases, CVD) and diabetes mellitus (DM) represent the 2nd, 3rd and 11th leading causes of disease burden1 in England. Both CVD and DM2 are targeted in high-level prevention policies, but variations in risk factors, diseases3 and outcomes,4 as well as treatment and access to services, persist on the basis of ethnicity, which has long been recognised as one of the ‘causes of the causes’ of health inequalities.5 Consideration of ethnicity in health policy has contributed to improved outcomes in ischaemic heart disease in South Asians in the last two decades in the UK,6 showing the benefits of targeted interventions. The NHS Outcomes Framework includes 11 metrics for health inequalities,7 but although ethnicity is mentioned, it is variably recorded in routine data, limiting the scope for measurement and analysis of healthcare use in black and minority ethnic (BME) individuals. Digital health interventions (DHIs), ‘interventions delivered via digital technologies such as smartphones, website, text messaging’,8 could improve healthcare nationally and internationally, facilitating healthcare’s ‘triple aim’ of better care, better health outcomes and reduced costs.9 Systematic reviews support DHIs for improving outcomes in DM10 and CVD,11 and they are actively promoted in national policies (eg, diabetes prevention programme digital stream, heart age calculator in the cardiovascular disease …
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Race and ethnicity have long been considered one of the causes of the causes of health inequities.
“Race and ethnicity have long been considered as one of the causes of the causes of health inequities”
From Inequities in Health Care Services Caused by the Adoption of Digital Health Technologies: Scoping Review (2022) · cites this paper as [51]
The acknowledged health benefits of eHealth or mobile health initiatives have seen limited application among Black communities.
“the acknowledged health benefits of eHealth or mobile health initiatives have seen limited application among Black communities”
From Inequities in Health Care Services Caused by the Adoption of Digital Health Technologies: Scoping Review (2022) · cites this paper as [51]
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Cites
Michie, S., van Stralen, M. M., & West, R. (2011) · Implementation Science · doi:10.1186/1748-5908-6-42 · Cited by 13,697 · see citing works
Closing the gap in a generation: health equity through action on the social determinants of health
Marmot, M. G., Friel, S., Bell, R., Houweling, T. A. J., & Taylor, S. A. J. (2008) · The Lancet · doi:10.1016/s0140-6736(08)61690-6 · Cited by 8,238 · see citing works
Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations
GREENHALGH, T., ROBERT, G., MACFARLANE, F., BATE, P., & KYRIAKIDOU, O. (2004) · The Milbank Quarterly · doi:10.1111/j.0887-378x.2004.00325.x · Cited by 7,448 · see citing works
The Triple Aim: Care, Health, And Cost
Berwick, D. M., Nolan, T. W., & Whittington, J. (2008) · Health Affairs · doi:10.1377/hlthaff.27.3.759 · Cited by 5,136 · see citing works
Greenhalgh, T., Wherton, J., Papoutsi, C., Lynch, J., Hughes, G., A'Court, C., Hinder, S., Fahy, N., Procter, R., & Shaw, S. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.8775 · Cited by 2,887 · cited 1× · see citing works
“The NASSS (Non-adoption, Abandonment, Scale-Up, Spread and Sustainability) framework is evidence-based and theory-informed, and allows sufficient flexibility to inform intervention design, to plan implementation and scale-up, or to evaluate DHIs(18).”
BackgroundEvaluating Digital Health Interventions
Murray, E., Hekler, E. B., Andersson, G., Collins, L. M., Doherty, A., Hollis, C., Rivera, D. E., West, R., & Wyatt, J. C. (2016) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2016.06.008 · Cited by 847 · see citing works
Health Information, The Internet, And The Digital Divide
Brodie, M., Flournoy, R., Altman, D. E., Blendon, R. J., Benson, J. M., & Rosenbaum, M. D. (2000) · Health Affairs · doi:10.1377/hlthaff.19.6.255 · Cited by 593 · see citing works
Newton, J. N., Briggs, A. D. M., Murray, C. J. L., Dicker, D., Foreman, K. J., Wang, H., Naghavi, M., Forouzanfar, M. H., Ohno, S. L., Barber, R. M., et al. (2015) · The Lancet · doi:10.1016/s0140-6736(15)00195-6 · Cited by 347 · see citing works
Self-citationComputer-based diabetes self-management interventions for adults with type 2 diabetes mellitus
Pal, K., Eastwood, S. V., Michie, S., Farmer, A. J., Barnard, M. L., Peacock, R., Wood, B., Inniss, J. D., & Murray, E. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008776.pub2 · Cited by 344 · see citing works
Pujades‐Rodríguez, M., Timmis, A., Stogiannis, D., Rapsomaniki, E., Denaxas, S., Shah, A. D., Feder, G. S., Mika Kivimaki, B., & Hemingway, H. (2014) · PLoS ONE · doi:10.1371/journal.pone.0104671 · Cited by 136 · see citing works
Beishuizen, C. R., Stephan, B. C., van Gool, W. A., Brayne, C., Peters, R. J., Andrieu, S., Kivipelto, M., Soininen, H., Busschers, W. B., Moll van Charante, E. P., et al. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5218 · Cited by 128 · see citing works
South Asians and coronary disease: is there discordance between effects on incidence and prognosis?
Zaman, M., Philipson, P., Chen, R., Farag, A., Shipley, M. J., Marmot, M. G., Timmis, A., & Hemingway, H. (2013) · Heart · doi:10.1136/heartjnl-2012-302925 · Cited by 80 · see citing works
Isaacs, T., Hunt, D. S., Ward, D. M., Rooshenas, L., & Edwards, L. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.6374 · Cited by 53 · see citing works
Diabetes Mellitus m-Health Applications: A Systematic Review of Features and Fundamentals
Bellei, E. A., Biduski, D., Cechetti, N. P., & Marchi, A. C. B. D. (2018) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2017.0230 · Cited by 49 · see citing works
Interventions to Improve Management of Chronic Conditions Among Racial and Ethnic Minorities
Doshi, R., Aseltine, R. H., Sabina, A. B., & Graham, G. N. (2017) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-017-0431-4 · Cited by 15 · see citing works
Shather, Z., Laverty, A. A., Bottle, A., Watt, H., Majeed, A., Millett, C. J., & Vamos, E. P. (2018) · The American Journal of Medicine · doi:10.1016/j.amjmed.2018.07.003 · Cited by 6 · see citing works
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Yao, R., Zhang, W., Evans, R., Cao, G., Rui, T., & Shen, L. (2022) · Journal of Medical Internet Research · doi:10.2196/34144 · Cited by 451 · see citing works
Goswami, A., Poole, L., Thorlu-Bangura, Z., Khan, N., Hanif, W., Khunti, K. K., Gill, P. S., Sajid, M., BLANDFORD, A. E., Stevenson, F. A., et al. (2022) · Journal of Medical Internet Research · doi:10.2196/40630 · Cited by 22 · see citing works
Self-citationWarner, J. J., Crook, H. L., Whelan, K., Bleser, W. K., Roiland, R. A., Lopez, M. H., Saunders, R. S., Wang, T. Y., Hernandez, A. F., McClellan, M., et al. (2020) · Circulation Cardiovascular Quality and Outcomes · doi:10.1161/circoutcomes.120.006606 · Cited by 19 · see citing works
Adams, J. (2024) · Digital Society · doi:10.1007/s44206-024-00110-5 · Cited by 14 · see citing works
Engelsma, T., Heijmink, S., Hendriksen, H. M. A., Visser, L. N. C., Lemstra, A. W., Jaspers, M., & Peute, L. (2024) · JMIR Human Factors · doi:10.2196/54032 · Cited by 8 · see citing works
Robbins, T., Kyrou, I., Arvanitis, T. N., Randeva, H. S., Sankar, S., Sutherland, S., & Booth, L. (2022) · Future Healthcare Journal · doi:10.7861/fhj.2021-0177 · Cited by 6 · see citing works
Interventions for the prevention and management of cardiometabolic multiple long-term conditions
Valabhji, J., Hope, D. C. D., SAYED, N. A. E., Godia, P. M., Lawson, C. A., Seidu, S., & Khunti, K. K. (2026) · The Lancet · doi:10.1016/s0140-6736(26)00608-2 · Cited by 5 · see citing works
Ramasawmy, M., Persson, D. R., Sunkersing, D., Gill, P. S., Khunti, K. K., Poole, L., Hanif, W., BLANDFORD, A. E., Sajid, M., Stevenson, F. A., et al. (2024) · JMIR Human Factors · doi:10.2196/57338 · Cited by 6 · see citing works
Self-citationRamasawmy, M., Persson, D. R., Sunkersing, D., Gill, P. S., Khunti, K. K., Poole, L., Hanif, W., BLANDFORD, A. E., Sajid, M., Stevenson, F. A., et al. (2024) · doi:10.2196/preprints.57338 · Cited by 1 · see citing works
Self-citationPatient Safety Informatics: Meeting the Challenges of Emerging Digital Health (Preprint)Preprint
McInerney, C. D., Benn, J. J., Dowding, D., Habli, I., Jenkins, D. A., McCrorie, C., Peek, N. B., Randell, R., Williams, R., & Johnson, O. A. (2021) · doi:10.2196/preprints.27206
Chaudhry, B. M., Dasgupta, D., & Chawla, N. V. (2022) · doi:10.2196/preprints.40195
Goswami, A., Poole, L., Thorlu-Bangura, Z., Khan, N., Hanif, W., Khunti, K. K., Gill, P. S., BLANDFORD, A. E., Stevenson, F. A., Banerjee, A., et al. (2022) · doi:10.2196/preprints.40630
Self-citationWalker, H., Robbins, T., El-Osta, A. A. R., Stirland, L., Taylor, D., Jones, A., McBride, E., & Aslam, A. (2025) · BMJ Open · doi:10.1136/bmjopen-2025-108435
- Authors
- Banerjee, A.
- Affiliations
- University College London (GB)
- Corresponding author
- Banerjee, Amitava
- ORCID
- Banerjee, Amitava
- Venue
- BMJ Evidence-Based Medicine
- Publisher
- BMJ
- Published
- 2019-11-21
- Volume
- 26
- Issue
- 3
- Pages
- 77-78
- ISSN
- 1356-5524 (ISSN-L)
- 2515-446X
- 2515-4478
- OpenAlex
- W2989995880
- Cited by
- 13
- References
- 16
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 4 · 2022: 5 · 2021: 1 · 2020: 1
- FWCI
- 2.40
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- BMJ Evidence-Based Medicine (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health and Care Research (CL-2010-09-002, RP-DG-0117-10003)
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- digital health interventions, health disparities, ethnicity, black and minority ethnic populations, ischemic heart disease, cerebrovascular disease, diabetes mellitus, cardiovascular disease prevention, targeted interventions, digital health policy
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