Health Equity in the Digital Era: Digital Determinants of Health, Bioethics, and AI

Abstract: The increasing push for artificial intelligence (AI) in healthcare raises urgent ethical questions about how digital technologies shape health outcomes and disparities. While social determinants of health—such as neighborhood, socioeconomic status, and race—are widely recognized, digital determinants of health (DDOH) remain under-theorized as an interconnected system influencing health equity. Issues such as algorithmic bias, digital literacy, and access to digital tools have all been shown to exacerbate inequalities; however, these issues are often studied in isolation. This paper argues that DDOH should be understood as a critical bioethical concern. DDOH inform (and are informed by) key domains within bioethics, including the ethics of emerging technologies and research ethics, which are concerned with who benefits from and is harmed by technology and research, respectively. By integrating insights from bioethics, public health, sociology, and science and technology studies, this paper demonstrates how a DDOH framework provides a necessary ethical lens for evaluating AI and other digital technology’s impact on health equity. At the same time, engaging with bioethics deepens our understanding of digital infrastructures by foregrounding questions of justice, consent, and accountability in digital health research and policy. By bridging these fields, this paper contributes to ongoing debates about the ethical governance of AI in healthcare and the responsibilities of researchers and policymakers in ensuring that digital health technologies do not perpetuate harm. This interdisciplinary approach offers new pathways for addressing structural health inequities at a moment when AI’s role in medicine is rapidly expanding.

Keywords: Digital Technology, Health Equity