Advancing health equity through digital equity

COVID-19 exposed more than health inequities; it also showed us the importance of digital equity, defined by the National Digital Inclusion Alliance as “a condition in which all individuals and communities have the information technology capacity needed for full participation in our society, democracy, and economy.” As Americans and people around the world engage with digital tools and learning more than ever before, the importance of access to and capacity to engage with information technology has become critical. In the health equity space, digital engagement ranges from accessing telehealth, to social media campaigns, to practitioner learning and sharing through web-based platforms.

So, what strategies can you take to ensure digital equity across these spaces? 

Design accessibly. Accessibility benefits all users, not just those with a disability. When designing websites or creating documents to share with the public (or specific audiences), such as flyers, tip sheets, or briefs, be sure to use white space and color contrast. A page full of text can feel overwhelming to read. Break text up with graphics, tables, and charts, and be sure to leave space between imagery and text. Using colors and hues that are high in contrast helps to ensure that people with color insensitivity, color blindness, or an astigmatism can better distinguish items. 

Note: Section 508 of the Rehabilitation Act of 1973 requires federal agencies to “give disabled employees and members of the public access to information comparable to the access available to others.” While 508 compliance is not required outside of the federal space, its principles and associated tools can help you ensure your work is shared in an accessible way that increases usability for your audience. Click here to see a list of free accessibility checkers.

Consider how digital content is accessed. Audiences are not limited to reading materials in print or on a computer. In fact, most news is accessed today via smartphone or tablet, and for some, these tools are a primary means of accessing the internet. Mobile devices help alleviate the burden of having no internet access, residing in a location with an unstable connection, or not owning a computer. This makes mobile platform accessibility a critical consideration for the equitable transfer of knowledge. Additional resources for ensuring mobile accessibility and understanding its importance can be found at www.digital.gov. 

Use plain language. Plain language refers to clear, concise, well-organized writing that follows best practices appropriate to topic area and intended audience. Technical language about a particular topic is sometimes necessary but avoiding overly technical terminology and jargon helps eliminate confusion and possible misinterpretation. To make sure you are using plain language, ask yourself:

• Am I using passive rather than active voice?
• Can I simplify my statements further?
• Did I use acronyms or jargon?

If yes, there is room to make changes to improve your use of plain language.

Choose the right platform. If you’re holding a web-based meeting or event, such as a teleconference or webinar, be intentional about the technology you use. When a platform feels cumbersome or confusing, it may dissuade people from fully participating. When choosing your platform, consider options for engagement and accessibility.

Think about the engagement options the platform provides, such as polling, video, whiteboards, and other tools. While there are a multitude of options available, not every tool is appropriate for every type of engagement. Review these offerings in the context of your audience’s general skill set and the goals of your event. Ask yourself: 

• Will these tools increase participant engagement?
• Will they feel challenging to new users?
• Will they be easy to use or feel clunky? 

For example, virtual whiteboarding that requires lots of audience participation may be great in some spaces, but cumbersome and stress-inducing in others. Know your audience and allow their needs to dictate the platform, pace, and structure of your meeting.

To ensure meetings are accessible for all participants, make sure that the platform you choose offers transcription and closed captioning. This ensures that users who have a hearing impairment, are working in loud environment, or are non-native speakers of the language can fully participate. Having technical support on standby is also ideal to assist with technology issues such as connectivity problems, loss of visual, and loss of sound. Recording helps ensure accessibility through allowing individuals who were not able to participate or attend the live engagement to watch what they missed later.

A final word on language. Equity in virtual environments goes beyond providing the right tools; it is also about ensuring that users feel comfortable and included. Language is critical in meeting this need. In all digital engagements, with all types of audiences, use inclusive language. If your audience feels excluded or stigmatized by the language you use, your message will be lost. Some common phrases and terms carry historical biases. Using inclusive language builds trust and encourages engagement. While best practices are always to use the terminology preferred by the community you are speaking about, our team has identified the following terms to help you get started.

1. Instead of minorities, say racial and ethnic minority groups (or political; linguistic; sexual, etc., minority groups). The blanketed use of “minority” does not acknowledge the experience of specific populations.
2. Instead of stakeholders, try population of focus, allies, collaborators, or partners. The word “stakeholder” is rooted in colonization and can have a violent connotation for Native American/American Indian populations.
3. Rather than differently abled or handicapped, consider people with disabilities. This helps eliminate stigmatized connotations about the community (note: while "people with disabilities" is best practice, language is dependent on the individual and their preference). 
4. Instead of homosexual or gay community, use LGBTQ or LGBTQIA+, which showcase the diversity of individuals within the community. 
5. Rather than poverty-stricken, the poor, or low-income people, say people with low incomes; households below the federal poverty level. It is dehumanizing to define a person or group by their condition or circumstance. 
6. Instead of alien or illegal immigrant, say undocumented immigrants or foreign-born person. People are not illegal; these terms can scapegoat individual immigrants for much larger, systemic problems. 

Taking steps to ensure digital equity requires those creating virtual engagements and online resources to be intentional about their choices. In all domains this includes designing accessibly, ensuring mobile compatibility, and using plain and inclusive language. For virtual engagements, this also means choosing the best platform for your audience and ensuring accessibility for all participants through the use of recording, transcription, and closed captioning. Below are two next steps you can take to advance health equity through digital equity.

Be reflective. Ask yourself if you have incorporated these tips for digital equity the next time you create a resource or schedule a virtual event. 

Share your knowledge. Expand digital equity through sharing promising practices for accessibility and with others, especially those working in the health equity space. For more information, see the Partners for Advancing Health Equity’s Guide to Digital Equity.