Most of us aspire to live a life which is happy, healthy, and ends at a good old age. This aspiration should be achievable by everyone equally. Moreover, it would be available sustainably for those alive today and those who are born tomorrow.
The World Health Organisation sets out this aspiration in its definition of health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”.
It has long been known that the services and sciences traditionally considered the constituency of healthcare represent only a component part of society’s armoury in the fight against ill-health. The so-called social determinants of health: where we live, our community, what we eat, how we work, and our level of education determine the lion’s share of any individuals health.
In our digital lives, the power of interventions which are explicitly referred to as ‘digital health’ represent only a component part of the influence technology plays on our health and wellbeing. For every example of how technology can make us happier, healthier and live longer there are others where it can be weaponised against those core values. We can make nuclear medicine or we can make nuclear weapons. The technology itself is agnostic of the principles.
Search engines can make incredible algorithms which detect eye disease. They may also have directed you to the fast food that gave you the diabetes which led you to the eye disease in the first place. Photo Sharing applications may consume our time ‘connecting’ us to people we have never met, while exacerbating the loneliness that is well known to drive disease. Social networks may provide us with ‘community’ whilst its clients encourage us to vote for political parties which do not prioritise collective responsibility for human welfare.
It is increasingly possible for the aggregators of our data to record and analyse the way we; vote, shop, eat, move, communicate, and even the way we breath. Moreover, it is increasingly possible for the aggregators of our data to use it, and the digital communication channels they have into our senses to influence the way we vote, shop, eat, move, communicate and the way we receive healthcare. Artificial intelligence promises a step change in the speed at which such automation can happen.
As every element of our lives is increasingly digitised and digitisation increasingly influences every element of ours lives, the net impact of ‘digital’ on human health and the things that drive it, the digital determinants of health, are almost impossible to elucidate. But given their omnipotence, that shouldn't stop us trying. It is perhaps one of the most important considerations for the health and wellbeing of current and future generations.
Many of the most influential technology companies have just had to make things the world wanted. However, in healthcare we first have to make things that do no harm and then we should aim to maximise the good. In the race to change the world, our ability to understand the digital determinants of health will determine if we changed it for the better.
