Article Text

Original research
Impact of COVID-19 on the digital divide: a rapid review
  1. Ian Litchfield1,
  2. David Shukla1,2,3,
  3. Sheila Greenfield1
  1. 1Institute of Applied Health Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
  2. 2West Midlands Clinical Research Network, Birmingham, UK
  3. 3Eve Hill Medical Practice, Dudley, UK
  1. Correspondence to Dr Ian Litchfield; i.litchfield{at}


Objective The increased reliance on digital technologies to deliver healthcare as a result of the COVID-19 pandemic has meant pre-existing disparities in digital access and utilisation of healthcare might be exacerbated in disadvantaged patient populations. The aim of this rapid review was to identify how this ‘digital divide’ was manifest during the first wave of the pandemic and highlight any areas which might be usefully addressed for the remainder of the pandemic and beyond.

Design Rapid review and narrative synthesis.

Data sources The major medical databases including PubMed and Embase and Google Scholar were searched alongside a hand search of bibliographies.

Eligibility criteria Original research papers available in English which described studies conducted during wave 1 of the COVID pandemic and reported between 1 March 2020 and 31 July 2021.

Results The search was described using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and identified nine studies. The results are presented within a refined framework describing the three key domains of the digital divide: (1) digital access, within which one study described continuing issues with internet connectivity among vulnerable patients in the UK; (2) digital literacy, where seven studies described how ethnic minorities and the elderly were less likely to use digital technologies in accessing care; (3) digital assimilation, where one study described how video technologies can reduce feelings of isolation and another how elderly black males were the most likely group to share information about COVID-19 on social media platforms.

Conclusions During the early phase of the pandemic in the developed world, familiar difficulties in utilisation of digital healthcare among the elderly and ethnic minorities continued to be observed. This is a further reminder that the digital divide is a persistent challenge that needs to be urgently addressed when considering the likelihood that in many instances these digital technologies are likely to remain at the centre of healthcare delivery.

  • COVID-19
  • organisation of health services
  • quality in health care

Data availability statement

No data are available. This is a review article and all material has been previously published.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Data availability statement

No data are available. This is a review article and all material has been previously published.

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  • Contributors IL was responsible for the conception of the work and the design of the review. IL and SG reviewed the article and IL led the drafting of the article with input from SG and DS. Both SG and DS provided critical revisions. The final version was approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.