"The Problem Will Solve Itself": Concepts of Age and Ageing at a Digital Health Industry Meeting – Focused Ethnographic Study (Preprint)

Résumé fourni par la source

BACKGROUND Digital health technologies are considered a key response to demographic ageing. However, older adults, who have the highest need for healthcare, remain among those least likely to access and benefit from digital health. While barriers to technology use among older adults are well documented, little is known about how the digital health industry itself addresses age and ageing. OBJECTIVE The objective of this study was to explore the digital health industry's approach to the inclusion of older people by investigating the discourse on age and ageing at a digital health industry meeting. METHODS A focused ethnographic study was conducted at DMEA (Digital Medicine Expertise & Applications), Europe's largest digital health industry meeting, held from April 25 to 27, 2023, in Berlin, Germany (>700 exhibitors, >16,000 visitors). A multidisciplinary 10-person research team collected data through participant observations across all meeting areas, semistructured interviews with 10 representatives of 9 digital health companies, incidental conversations, and a virtual ethnography of the meeting's website, YouTube, and Twitter/X presence (April to October 2023). Fieldnotes and interview protocols were analyzed as one corpus using Kuckartz's structured qualitative content analysis in MAXQDA, with the data source retained for comparison across sources, followed by consistency checks and team validation. RESULTS Four themes were identified: (1) the near-absence of age and ageing – older people were largely invisible in exhibits, imagery, and the conference program, and most company representatives could not specify whether or how older users had been involved in product development; (2) conceptions of age and ageing in the digital health industry were predominantly deficit-oriented, framing ageing as a management problem or associating older age with helplessness, while marketing imagery showed idealized, healthy older adults; (3) several companies recognized the exclusion of older, non-digitally proficient people as an ethical dilemma, particularly where analog alternatives are disappearing; and (4) attitudes toward the inclusion of older people diverged. A few companies involved older users directly in development, testing, and training, and in some cases older users coped better with digital products than younger users. More often, responsibility for inclusion was attributed to policy makers, the problem was expected to resolve itself as digitally experienced cohorts age, or proxy support by relatives and health professionals was described as the way to reach older people, which carries the risk of bypassing older users themselves. CONCLUSIONS Age and ageing played a minor role at the digital health industry meeting in 2023. Where the topic was addressed, deficit-oriented stereotypes or idealized representations of ageing were dominant. The findings indicate that older people are underrepresented in the digital health industry. Participatory development involving older adults, age-inclusive representation, training and support structures, and clear responsibilities, including regulatory incentives, are needed to prevent a widening of the digital divide in healthcare.

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