Tina D Purnat

Public health

Healthy information environment

Infodemic management

Digital and health policy

Health information and informatics

Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat
Tina D Purnat

Public health

Healthy information environment

Infodemic management

Digital and health policy

Health information and informatics

Blog Post

Diving deeper into structural determinants of health in digital environment

October 14, 2024 Public health

As I’ve worked on understanding the harms of the digital information environment on health and well-being over the past few years, one realization keeps returning: we need to rethink what “community” means in today’s rapidly evolving digital landscape. This isn’t a small shift—it fundamentally changes how we think about solidarity, engagement, collective problem-solving, transformative action and sustained social and behavior change that promotes health.

We make meaning of our lives and the world through the spaces where we live, work, pray, play, study, and gather. But these spaces are no longer just analog. The digital information environment has changed this. Today, we form bonds, communities, and identities not only in our neighborhoods, workplaces, or schools, but also in virtual spaces that transcend geographical and cultural boundaries. We concurrently live and trust “glocally”. People now engage online, build relationships through platforms, and participate in global conversations that influence their behaviors as strongly as face-to-face interactions.

Digital spaces blur the lines between personal and public life, creating new opportunities for connection and collaboration, but also new vulnerabilities. These online communities have become crucial for how people exchange information, seek support, and organize around common goals.They’ve also transformed how commercial actors market products and provide services. However, digital spaces are still shaped by the same structural determinants of health—commercial, social, ecological, normative, and political factors—that influence physical communities, often in more complex and accelerated ways than we can fully grasp.

We’ve spent thousands of years adapting to the structural determinants of health in our physical environments, but we’ve only had around 20 years to adapt to the digital worlds we’ve created. At this scale, it’s hard to fully understand how innovation, shifts in commercial practices, and constant advancements in digital technologies are reshaping how we access, consume, and amplify information.

Consider this: at the dawn of the internet, it took the World Wide Web seven years to reach 100 million users. Fast forward to today, and it took ChatGPT just two months to reach the same milestone.

This rapid pace of adoption isn’t just about more people being online or owning digital devices. It’s about how quickly our digital environment is transforming—and with it, the way we interact with information, subscribe to narratives, shape our identities, express belonging, and make decisions.

Online communities form and dissolve, change and redefine themselves relatively rapidly – in ways we do not experience in our physical world.

The consequences are profound. The faster information flows—and the more fragmented it becomes—the harder it is for us to keep up. And public health systems are even slower to understand and address this.

Although we talk about digital divide and equity, we really haven’t even begun to define or address the structural determinants of health in digital spaces.

Unchecked commercial and fraudulent activities, deceptive marketing, and the constantly shifting digital landscape often go unnoticed at the individual level. This strains the systems of governance and accountability we’ve built that are too geographically constrained to put a dent on geographically unconstrained digital interactions and environments.

Just one example is how we rely on social cues to assess the trustworthiness and relevance of information, but the digital environment has distorted our perception of what is socially valued. This distortion reinforces beliefs and shared identities in ways that can mislead and harm public health efforts.

Because the digital information environment changes so rapidly, public health research, policies, and approaches are struggling to keep up. And that’s dangerous. We are falling behind in addressing the harmful impacts of this evolving space, while also missing opportunities to promote health in positive ways. I can’t help but feel this gap is increasing.

As someone who has spent time thinking about how information environments influence how we relate to each other, the kind of information we seek, how we understand it, and how we feel about it, I believe we must embrace a pluralistic understanding of knowledge and evidence.

But we need to embrace the complexity of people’s lived experiences and the environments they inhabit—how they relate to the natural, physical, and digital world, what they encounter, what they value, and what they trust.

If centering equity in research means creating knowledge systems that respect and engage with people’s lived realities and knowledge systems, we must also consider that for many, these realities are increasingly digital.

Life happens everywhere humans are—whether in the physical or digital world.

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