Glossary on Core Terms for the LeibnizScience Campus Digital Public Health

Health is a capability beyond the absence of diseases or infirmities or bio-physical parameters. It is an ongoing, dynamic process, which is potentially achievable for everybody in all circumstances. Health includes malaise and well-being as it is a spectrum and not binary (full health or no health). This understanding of health allows one to be healthy even when one is coping with negative events. For older people or those affected by chronic illness, health can be understood only as the ability to live with restrictions, to accept physical deficits, and to find an arrangement with these

Public health comprises the entirety of all social, political and organizational efforts aimed at improving the health situation, reducing the likelihood of illness and death and increasing the life expectancy of groups [of individuals] or entire populations. Public health includes all organized, multidisciplinary and multi-professional approaches in disease prevention, health promotion, disease control, disease management, rehabilitation and care [and therefore includes all three levels of prevention].

Sources

Leonardi F (2018). The Definition of Health: Towards New Perspectives. International Journal of Health Services; 48(4): 735-748. doi: 10.1177/0020731418782653.

Franzkowiak P & BzGA (2015). Gesundheitswissenschaften / Public Health. Available from: https://leitbegriffe.bzga.de/alphabetisches-verzeichnis/gesundheitswissenschaften-public-health/ [24/09/2021].

Digital health is a broad umbrella term encompassing eHealth (which includes mHealth), as well as emerging areas using information and communication technologies (ICT). Examples are advanced computing sciences in ‘big data’, genomics, and artificial intelligence to address the needs of health and healthcare systems.

Digital public health is a tool to fulfill the aims and mission of public health, but not a discipline itself. The health system goals of quality, accessibility, efficiency and equity of healthcare, embraced by public health professionals are unaltered by the process of digitalization.

Electronic health (eHealth) is the use of information and communication technologies (ICT) in support of health and health-related fields, including health-care services, health surveillance, health literature, and health education, knowledge and research.

Mobile health (mHealth) is a component of eHealth. It is the medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, personal digital assistants (PDAs), and other wireless devices.

A distinction between medical apps and health apps is based on the consideration of three central perspectives: the user perspective, the technological perspective and the regulatory perspective.

Health apps are primarily aimed at health-conscious users and offer support in the areas of prevention, education and health promotion. They are generally not aimed at healthcare professionals. From a technological perspective, their focus is on the collection, recording, processing and visualization of users' health-related data. A not insignificant proportion of apps focus purely on imparting knowledge. From a regulatory perspective, it is worth noting that, unlike medical apps or DiGA, health apps are not generally subject to any specific, binding regulation.

Medical apps address representatives of the health care professions. Medical apps focus on medical and nursing functions and often relate to the areas of diagnostics and therapy; they are regulated by the Medical Devices Act.

Sources

Bundesamt für IT-Sicherheit, IT-Sicherheit auf dem digitalen Verbrauchermarkt: Fokus Gesundheits-App, 2021 

Digital Health Equity is the absence of avoidable and/or unjustified differences, variations and disparities in access and use of digital health technologies, services and interventions and the absence of avoidable and/or unjustified differences, variations and disparities in the health achievements among the population resulting from the use of digital health technologies, services and interventions

Digital Health Equality is absence of differences, variations and disparities in access and use of digital health technologies, services and interventions and the absence of differences, variations and disparities in the health achievements among the population resulting from the use of digital health technologies, services and interventions

Sources:

Followed the definition of health equity and healthy equality as below and added digital aspect in a meaningful way

Whitehead, Margaret. "The concepts and principles of equity and health." Health promotion international 6.3 (1991): 217-228

Kawachi, I., Subramanian, S. V., & Almeida-Filho, N. (2002). A glossary for health inequalities. Journal of Epidemiology & Community Health, 56(9), 647-652.

A Digital Public Health Intervention addresses at least one essential Public Health function through digital means. Applying a framework for functional classification and stratification categorizes its interaction level with the user. The developmental process of a DiPH Intervention includes the user perspective by applying participatory methods to support its effectiveness and implementation with the goal to achieve a population health impact."

Sources:

Wienert J, Jahnel T, Maaß L. What are Digital Public Health Interventions? First Steps Toward a Definition and an Intervention Classification Framework. Journal of Medical Internet Research. 04/01/2022:31921 (forthcoming/in press)

The first step involved identifying terms deemed suitable for inclusion in the glossary for Digital Public Health. An interdisciplinary group of seven researchers from various fields, e.g. public health, HCI, participatory science, law, were involved. Each researcher independently identified potential terms based on their own previous experience on Digital Public Health. A draft list of terms was assembled in a single document. Each term was assigned with the name of the researcher who had provided it. 

The second step involved gathering descriptions for each of the listed terms. Each researcher was assigned the responsibility to provide definitions for the terms they had proposed. If two or more researchers provided the same term, they were asked to either agree with the proposed definition provided by another researcher or provide another definition for the term. It was decided to collect definitions for the terms based on the researchers’ understanding who provided the term. Therefore, rather than collecting descriptions and discussing possible interpretations of each of the terms, simple definitions were collected. 

In this stage, the researchers discussed each term individually. Since some of the terms were discussed as being generic, therefore, it was decided to leave them in the list but without definitions. Some of the terms were considered stand-alone whereas some were grouped together to make it meaningful (e.g. (in)equity/(in)equality). 

In this stage, the Early Career Research Academy researchers were invited to vote the collected terms as per the relevance of importance to LeibnizScience Campus Digital Public Health. The voting result was followed by a discussion among the researchers that led to selecting of the core terms presented below. Discussion and revision of these definitions continued further in two workshops with other researchers from various disciplines in the LeibnizScience Campus.