Social Determinants of Health in Digital Health Policies: an International Environmental Scan

TL;DR

This study examines how social determinants of health are included in digital health policies across different countries and regions.

Contribution

The study provides a global environmental scan of digital health policies and identifies gaps in the integration of social determinants of health.

Findings

28 digital health policies across 16 regions were analyzed, showing significant variation in SDoH inclusion.

Global initiatives like WHO's focus on SDoH are not consistently reflected in continental policies.

Standardization and data collection frameworks for SDoH in digital health remain underdeveloped.

Abstract

Introduction
: Social Determinants of Health (SDoH) include factors such as economic stability, education, social and community context, healthcare access, and the physical environment, which shape an individual's health and well-being. Given that the inclusion of SDoH factors is essential in improving the quality and equity of digital health, this study aims to examine how SDoH is incorporated within digital health policies internationally.

Methods
: An environmental scan of digital health policies was conducted, including relevant documents from multiple countries and global organizations. Key content related to SDoH was extracted from the documents, and a content analysis was conducted to identify seven different SDoH domains (i.e., target audience, SDoH inclusion, addressing health inequities, SDoH-related key performance indicators, data collection on SDoH, interoperability standards, and data privacy and security). Data were aggregated at the global and continental levels to integrate and synthesize information from different countries and regions.

Results
: A total of 28 digital health policies or strategies were identified across 16 international regions. The comparative analysis of health policies regarding SDoH reveals a pronounced disparity between the continental regions. Although the World Health Organization recognizes the significance of key performance indicators for monitoring SDoH and emphasizes the assessment of national digital health maturity, there's a noticeable lack of continent-specific policies reflecting these global initiatives at the continental level.

Conclusion
: While some regional digital health strategies recognize SDoH, integration varies, and standardization is lacking. Future research should focus on data collection frameworks and comprehensive insights for policymakers.