Digital health: The challenge of the 21st century

Digital health promotes a healthy, safe, critical and responsible use of Information and Communication Technologies (ICT). Its fundamental objectives are: to promote healthy habits, to detect risks early and to carry out adequate treatment.

The digital world impacts health at any age from primary childhood to the last stages of life. Childhood and adolescence are vulnerable stages as they are developing and have access to technology that may be early and unsupervised.

The digital world, in terms of health, has benefits such as telemedicine. Remote medical assistance allows, for example, that people who live in places with access problems due to geography or who do not have sufficient health personnel can receive or complement said care, improving equity. However, technology also has risks that negatively impact all spheres of health.

So what can we do to reduce the risks?

How does technology impact health?

To understand how technology impacts health, we have to define what we mean by health and what we consider technology.

There are many definitions of health. Terris, in the 1980s, defined health as “a state of physical, mental, and social well being, with the ability to function, and not merely the absence of disease.”

In the concept of digital health, technology is considered to be smartphones, tablets, computers and television.

The problem is that technology can affect all spheres of health. To understand it, let’s give some examples:

• On a physical level: decreased hours and quality of sleep; increased risk of overweight and obesity; poor postural hygiene…
• At a psychological level: addictive behaviors on the internet, difficulty in managing frustration, affectation in emotional development…
• At a social level: cyberbullying, grooming, sexting…
• At a functional level: this is the part that most concerns us pediatricians. On many occasions there is no severe sleep disturbance, the criteria for addictive behavior are not met, or there is no cyberbullying victim. However, the use of technology affects physical, mental and social well being, preventing proper functioning of the person according to their age and development. Functional impairment is common in childhood and adolescence.

Why is the term digital health important?

In paediatrics, as in other sectors such as education, we have spent more than 10 years trying to help families in the digital education of their children.

The messages have been changing and we have gone from the term digital native to digital health, going through early digital immersion. In addition, we have had stages of focusing only on risks without a significant impact on changes in habits in the population.

More than ten years ago, pediatricians talked about the digital native and launched a message focused on the risks. This situation caused parents to feel even more alienated from technology. The union of children and technology caused fear.

Subsequently, early digital immersion involved the parents somewhat more as they were the supervisors, but they forgot the neurological development of the child. Contracts between children and parents were also recommended at this time. The problem with the contracts is that the limits on the use of technology were only established for the children.

In the last decade, many scientific articles have been published on the impact of the digital world on health throughout life. The scientific evidence was so overwhelming that the concept of digital health began to be used. Several pediatric scientific societies compiled the available information and gave recommendations with common points:

• They warned of the risks from an early age, especially in those under two years of age.
• They explained the importance of free play for proper neurodevelopment and fostering interaction with other children and adults.
• They developed the need to establish digital limits according to age in: time of use, time of disconnection and places where the devices are used.
• They encouraged parents to be the best example for their children in the use of technology.
• They recommended that pediatricians report both the risks and the benefits of technology according to age.

The term digital health was a great advance, making parents the protagonists of their children’s digital education and helping to establish limits according to age by taking into account the development of the child.

What can we do to improve the digital health of our children?

Here are some ideas to start gaining digital well being:

• Ask us what role we want technology to have in our home.
• Be aware that the change has to start from the parents and if it is maintained over time, it will gradually generate changes in the digital habits of children.
• Be critical of the use we make of technology as parents and think about whether it is the model that we believe is the most appropriate for our children.
• Be consistent and know that the limits that we establish at home have to be for everyone, also for us.
• Be humble and let our children help us regulate ourselves. If we set clear limits at home, our children will remind us when we break the rules. Accept our mistake and redirect the situation.
• Being present and available when our children use technology. Reduce the time that adults use technology as a “babysitter” for our children.

Do you take on the challenge we have as parents in the 21st century? Accept that digital health is something else to educate.

Cover photo by: National Cancer Institute on Unsplash