ArticleInternational journal for equity in health2026
Excluded by design: a qualitative study of inequalities in health and social care innovation.
Article in International journal for equity in health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Co-creating care: Involving children, young people, and families in paediatric medical device innovation.Frontiers in medicine · 2026Article
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInnovations, especially those involving digital technologies, are expanding rapidly in health and social care in many countries around the world, but the extent to which the needs of underserved populations are considered is unclear. The aim of this study was to explore if and how socioeconomic health inequalities are considered in the design and delivery of health and social care innovations in the United Kingdom.
methodsA qualitative study using 23 semi-structured interviews with a range of stakeholders involved in the development and delivery of innovations in health and social care in England and Scotland exploring 20 areas of innovation. Data were analysed thematically.
resultsOf 20 innovation areas, only one explicitly focused on reducing health inequalities for people living in deprived areas. The remaining broadly fell into three groups: (1) ‘Aspirational intent’ where stakeholders hoped their work would benefit people living in deprived areas but active planning was not involved; (2) ‘Stymied intent’ where stakeholders were aware of health inequalities but faced systemic and structural constraints that limited their opportunities to tailor innovations to the needs of deprived populations; and (3) ‘No intent’ where stakeholders (over half of those interviewed) were apparently unaware or indifferent to health inequalities. The lack of consideration for innovations utilising digital technologies holds particular risks for widening health inequalities. Two additional cross-cutting themes - ‘The influence of funding’, and ‘The role of the third sector’ - were identified. Stakeholders reported including a focus on health inequalities when funders explicitly prioritised it. Conversely, a lack of funding significantly hindered stakeholders’ abilities to address health inequalities. The involvement and contribution of the third sector in tackling or mitigating the effects of health inequalities was commonly reported as an under-utilised and under-funded resource.
conclusionsOur study suggests that socioeconomic health inequalities are seldom explicitly considered in the funding, design, delivery, policy translation and implementation of service innovations. Present innovation trajectories therefore risk widening rather than narrowing health inequalities, especially for digitally-based innovations.
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