Article
Reference
The digital technology revolution and its impact on the public's health
CHAUVIN, James, LOMAZZI, Marta
CHAUVIN, James, LOMAZZI, Marta. The digital technology revolution and its impact on the public's health. European Journal of Public health , 2017, vol. 27, no. 6, p. 947
DOI : 10.1093/eurpub/ckx134 PMID : 29088447
Available at:
http://archive-ouverte.unige.ch/unige:126912
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The European Journal of Public Health, Vol. 27, No. 6, 947
ß The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
doi:10.1093/eurpub/ckx134 Advance Access published on 23 October 2017
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Editorial
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The digital technology revolution and its impact on the public’s health
James Chauvin1, Marta Lomazzi2
1 Public health consultant and advocate, Gatineau, QC, Canada
2 Executive Manager, World Federation of Public Health Associations, Geneva, Switzerland
Correspondence:James Chauvin, Past-President (2012–2014), World Federation of Public Health Associations, Tel: +1 (819) 918-2936, e-mail: jamesbchauvin@gmail.com
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T
he use of health-related digital technologies (DT) has skyrocketed over the past two decades. DTs transcend all of the Sustainable Development Goals and are seen to play a crucial role within human development. They have the potential to transform not only health care but the way we live. The Internet is replete with stories about the use of DT within clinical medicine and health care. Within the public health domain, DT is used, among other applications, to improve immunization uptake and coverage, to deliver medicines to remote clinics, to encourage and help people adopt healthier lifestyles, to monitor the environment and to improve civil registration.Reducing inequalities and developing resilient and secure health systems is one of the main goals of the World Federation of Public Health Associations (WFPHA), as expressed through its Global Charter for the Public’s Health.1The charter provides a framework for public health associations to improve their organizational per- formance and effectiveness by enhancing their advocacy, leadership and operational/programmatic capacities to have an impact on population health and health equity.
The WFPHA, through its Global Health Equity Working Group and within the Charter’s framework, wished to promote the use of DT within the public health community, and specifically, within the global community of public health associations. The federation was, nonetheless, concerned about the lack of published literature on assess- ments of the impact of DT on population health and health equity.
While hundreds of health-related digital initiatives have been launched around the world, there did not appear to be a lot of information about their associated health and health equity outcomes.
In late 2014, the WFPHA launched, in cooperation with the Aetna Foundation, the project ‘Exploring the use of digital health technology for population health and health equity gains’. To the best of the federation’s knowledge, this was the first review of the use of digital technology within the public health domain, and in particular by public health associations. The initiative served to highlight challenges to the effective use of DT by public health associations.2 It also highlighted the need to define a public health approach to the use of DT, and the challenges related to assessing the impact of DT on population health and health equity.3The project identified several issues regarding the use of DT within the health sector:
Its scalability, reproducibility, transferability and sustainability.
The risk of getting swept up in the hype about technology.
Ignoring the community’s needs and perspectives.
The strong industry-push for the development and application of health-related DT.
The focus on personalized medicine/health.
A failure to take into consideration local resource constraints.
The dominance of northern/western-driven initiatives that can fail to integrate with local contexts.
The creation of a ‘digital divide’ and especially a ‘digital gender divide’ across and within countries.
Difficulty in demonstrating impact of DT on population health and health equity.
The latter point is the most significant challenge. The Lancet reported in 2012 that evidence of DT effectiveness gleaned from the nine randomized controlled trials in low-income countries was
‘weak’.4The World Bank Report (2011) reviewed 500 pilot eHealth/
mHealth studies and found that health outcomes were not reported.5A more recent Cochrane review of health workers’ per- ceptions (2015) about digital technology found an inconsistent use of indicators and methods, and a lack of evidence about DT effectiveness.6
Digital technologies are now part of our daily world. The challenge is to demonstrate their impact on health and health equity, and, if effective, to promote their adoption and use. The WFPHA invites and encourages public health associations in the European region and the EUPHA to participate in this initiative. We also call upon the World Health Organization to engage with national public health associations, their regional networks (such as EUPHA) and the WFPHA to identify and put into place effective DT health and health equity assessment protocols. Otherwise, our focus remains on the means rather than on the desired collective global end.
Conflicts of interest: None declared.
Funding
The WFPHA project referred to in the article was funded by the Aetna Foundation (grant #14-10547).
References
1 World Federation of Public Health Associations.Global Charter for the Public’s Health. Geneva: WFPHA, 2016.
2 Chauvin J, Perera Y, Clarke M. Digital technologies for population health and health equity gains: the perspective of public health associations.J Public Health Pol 2016;37(Suppl 2):232–48.
3 Chauvin J, Rispel LC. Digital technology, population health, and health equity.
Public Health Pol2016;37(Suppl 2):145–53.
4 Howitt P, Darzi A, Yang G-Z, et al. Technologies for global health.Lancet 2012;380:507–35.
5 Qiang CZ, Yamamichi M, Hausman V, Altman D.Mobile Applications for the Health Sector. Washington (DC): The World Bank, 2011.
6 Odendaal WA, Goudge J, Griffiths F, et al. Healthcare workers’ perceptions and experience on using mHealth technologies to deliver primary healthcare services: qualitative evidence synthesis.Cochrane Database of Systematic Reviews 2015; Art. No.: CD011942. Available at: https://doi.org/10.1002/14651858.
CD011942 (20 July 2017, date last accessed).
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