Following Social determinants of Health and ICT for Health (eHealth) conceptual framework and the results from Citizens and ICT for Health in 14 EU countries: results from an online panel survey I have been exploring the difussion of mHealth in Europe.  Internet users were asked about the use of health/wellness application on their mobile phone:

• 77% stated that they never use it;
• 7% stated that they were not aware of it;
• 6% stated that they use it less than once a month
• 5% stated that they use it at least once a month (but not every week)
• 4% stated that they use it at least once a week (but not every day)
• 1% stated that they use it every day or almost every day

Socio-demographics’ characterisation revealed that internet users who at least once have used mHealth are more likely to be male; 16-24; students; living in a densely-populated area; reported good health status and not suffering a chronic condition. Therefore, it looks like we are talking mainly about health prevention and promotion opportunities; wellness and healthy life styles. I’m now analysing the data following the conceptual framework to better understand mHealth users and empowerment; trigger; barriers; impact… Comments are always welcome!

A few months ago I posted about a report titled A Composite Index for the Benchmarking of eHealth Deployment in European Acute Hospitals Distilling reality into a manageable form for evidence-based policy co-author with Cristiano Codagnone. On 23th March I was invited by the Catalan Agency for Health Information, Assessment and Quality to present the benchmarking exercise, including in the analysis data about Acute hospital in Catalonia gathered by TicSalut.

I wonder if this benchmarking exercise could be understood as a meaningful use of eHealth in Acute Hospital in Europe. The composite indicator is presented in a transparent manner so any practitioner or policy-maker can utilise the weights to benchmark its acute hospital within its country and with other European countries. This can naturally lead to the definition of a different approach to the construction of eHealth deployment and usage composite indicators and may at any rate produce standardised and comparable longitudinal and cross-sectional data.

Lately I have been designing, launching and gathering an online panel survey to a representative sample of Internet users in 14 European countries (approximately 14,000 responses). To ground the questionnaire I have developed a conceptual framework inspired and based on the two main sources. On the one hand, the Marmot Review team:

• Solar O & Irwin A (2007). A conceptual framework for action on the social determinants of health. Discussion paper for the Commission on Social Determinants of Health. Geneva, World Health Organization.
• Commission on Social Determinants of Health. (2008).  Closing the gap in a generation: health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva, World Health Organization.
• Marmot M et al. (2010). Interim first report on social determinants of health and the health divide in the WHO European Region. Copenhagen, WHO Regional Office for Europe.
• Marmot M et al. (2011). Interim second report on social determinants of health and the health divide in the WHO European Region. Copenhagen, WHO Regional Office for Europe.

On the other hand, a Framework for Digital Divide Research developed by Jan van Dijk in several publications:

• Jan van Dijk and Ken Hacker (2003). The ‘Digital Divide’ as a Complex and Dynamic Phenomenon. The Information Society. Vol. 19, Nr. 4, 315-326.
• Jan van Dijk (2005).The Deepening Divide, Inequality in the Information Society. Thousand Oaks, London, New Delhi: Sage, 240 p.

In a recent presentation about Health and Web 2.0 I tried to match both frameworks and I have posted about Inverse care law 2.0  several times using different scientific and statistical sources.  It is worth pointing out (and obviously reasonable) that I have not found any references or mentions to ICT for Health in the literature about social determinants of Health gathered through Marmot Review team website.

However, both frameworks (see red boxes in both figures) mention individual and social characteristics as social determinants of health and of the Internet usage. Furthermore, van Dijk includes HEALTH and ABILITY as a personal category (and I have added Health as a sphere of participation in Society and emphasis the Divides).

Based on and inspired by this two frameworks I have developed Social determinants of Health and ICT for Health (eHealth) conceptual framework.

All concepts and boxes  of this framework are based on scientific references and the relationships established by arrows have been empirical or theoretical driven. I’m currently working on it, however I have shared this framework to gather inputs to improve it. I would love to know your comments and ideas.

UPDATE: Citizens and ICT for Health in 14 EU countries: results from an online panel survey