Disparities in access to and use of digital health (Anderson & Kumar, 2019) mirror disparities in diabetes prevalence and outcomes. Barriers to effective use of digital health are experienced by underserved populations, defined as those who are socioeconomically disadvantaged (i.e., lower income, education, and underinsured or uninsured), persons from minoritized racial and ethnic groups, elderly persons, persons with stigmatized characteristics, and persons living in rural areas. Included in these barriers are access, comfort with and motivation to use technology to support health, privacy concerns, and trust. Structural inequities—such as disparities in income, internet access, and health insurance coverage—account for a portion of the differences in digital health access and use between White patients and Black and Latino patients. Efforts to use technology to redress disparities must accommodate individual characteristics like access to broadband and the person's health literacy but not let those activities distract from root causes driving disparities. Health technologies for diabetes must be codesigned by persons representing the groups at highest risk of diabetes and adverse diabetes outcomes. Attending to recent innovations in digital health and successes in reaching underserved populations with existing technology may help narrow disparities. Federal policies and research designs should explicitly focus on addressing disparities and must reflect the wide array of digital health tools in play.
Elsevier, Diabetes Digital Health and Telehealth, 2022, Pages 269-280