Bremen – An older woman sits in front of her smartphone. The app that her doctor recommended is supposed to help her organize her medication. But after several attempts, she gives up in frustration: “This isn't for me.” This scene is emblematic of a fundamental problem with digital health in Germany: a lot of things are technically feasible, but access is not the same for everyone.
The position paper published in the Federal Health Bulletin by the Digital Public Health department of the German Society for Public Health shows how digital health solutions can be implemented nationwide and in a socially just way. The researchers call for strategies that reach all citizens, regardless of age, income or technical affinity.
Opportunities and risks of digitalization
Digital health services such as telemedicine or health apps offer enormous opportunities. They can make healthcare more efficient and facilitate access. However, the position paper warns that if vulnerable groups – such as older people or the socially disadvantaged – are not considered when developing such solutions, the digital divide threatens to grow.
Dr. Laura Maaß, spokesperson of the department and postdoc at the Leibniz ScienceCampus Digital Public Health Bremen, puts it clearly: “I am very pleased that the Bundesgesundheitsblatt is giving us the platform to focus on the digitalization of public health, because time is of the essence! Germany needs digital solutions that are accessible to everyone. We need to promote health literacy and overcome the digital divide, otherwise we will lose the potential of digitalization for prevention and care.”
Health literacy as the key
One of the core problems is digital health literacy: many people cannot use apps or other digital tools properly. Yet the ability to understand and use such applications is crucial to making health services truly accessible. Interactive and participatory approaches could help to better involve patients and thus strengthen personal responsibility for health.
Stephanie Hoffmann, co-spokesperson for the department, adds: “New digital services for prevention, health promotion and health care must take into account people's health needs and individual requirements. Only then can they truly reach people and contribute to equal health opportunities.”
What is missing: research and teaching
The position paper also criticizes the fact that the field of digital public health is still in its infancy in Germany. Degree programs rarely address the topic, and research focuses too heavily on clinical applications. Prevention and health promotion are often left out – both in research and teaching, as well as in health policy, which focuses almost exclusively on the digitalization of medical health care. This must be addressed urgently in order to think about digitalization more broadly and sustainably.
One system for all
The researchers emphasize: Digitization in healthcare must not be an end in itself. The aim is to reduce health inequalities, strengthen prevention and make care more efficient – without excluding anyone. To achieve this, politics, science and practice must work together.
The Leibniz ScienceCampus Digital Public Health Bremen
The Leibniz Institute for Prevention Research and Epidemiology – BIPS, the Fraunhofer Institute for Digital Medicine MEVIS and the University of Bremen have been cooperating in the research network since the beginning of the funding. The University of Oldenburg and OFFIS – Institute for Information Technology have been won as new partners for the second funding phase.
The Bremen Leibniz ScienceCampus Digital Public Health is one of 21 ScienceCampi focusing on a specific topic and serving to strategically network Leibniz institutes with universities and other regional partners. The aim is to create networks to further develop the respective research area and to strengthen the scientific environment. Leibniz ScienceCampi conduct strategic research, promote interdisciplinarity in topics, projects and methods, raise the profile of the respective location and strengthen its research profile.
Original publication
Maaß, L., Dockweiler, C., Hocke-Bolte, Z. et al. Digital Public Health in Deutschland: Status quo, Herausforderungen und Zukunftsperspektiven. Bundesgesundheitsbl (2024). https://doi.org/10.1007/s00103-024-03989-0
