Advancing telehealth equity: Addressing barriers across social determinants of health

Abstract

Social determinants of health (SDoH), including economic stability, education, healthcare access, neighborhood environment, and community context, play a critical role in shaping health outcomes. Telehealth, defined as the use of digital and telecommunications technologies to deliver healthcare remotely, presents both opportunities and risks for equity. It can reduce barriers such as transportation costs and distance, yet it may also deepen disparities among populations with limited digital access or literacy. This review highlights lessons from selected global and U.S. telehealth programs to examine how SDoH influence adoption and outcomes. Key challenges include digital literacy gaps, privacy concerns, cultural preferences for in-person care, provider training deficits, infrastructure limitations, and reimbursement inconsistencies. Potential solutions include policy reforms, broadband expansion, digital literacy initiatives, and community-centered approaches. By framing telehealth through an SDoH lens, this review contributes to the literature by clarifying strategies that can advance more equitable and sustainable implementation.