The digital health capital framework: cross-cutting digital health inequality and smart-aging in post-COVID Hong Kong

The COVID-19 pandemic has accelerated the adoption of e-health technologies while simultaneously amplifying existing digital health disparities. To identify the digital health divide, we propose the Digital Health Capital (DHC) framework, an integrated multidimensional measure including usage, literacy and transformative capacity, to scrutinize the digital health divide in the emerging technology landscape. Utilizing a mixed-mode dataset that combines a quota-sampled online survey with an offline sample of elderly participants, we apply this framework to examine the digital health capital divide in post-COVID Hong Kong. Our data reveals three findings. First, consistent with previous studies, substantial disparities in DHC scores correlated with socioeconomic status (SES): individuals with higher education, wealthier, and employment consistently exhibit stronger digital health capacities. Second, the impacts of SES on the divide vary by different dimensions of DHC, revealing that the mechanisms driving inequalities in transformative capacity differ significantly from those affecting usage and literacy. Third, the findings challenge the stereotype of the homogeneity of digital disadvantage among the elderly and highlight the overlooked disadvantage faced by the middle-aged ‘sandwiched generation.’ These findings call for more refined policies for smart aging initiatives, emphasizing the need for targeted strategies to bridge the digital health capital divide when developing techcare for diverse demographic groups.