This article, titled “State of science: New frontiers in inclusive design and digital health intervention,” presents a state-of-the-art synthesis of how inclusive design has evolved in response to two simultaneous global transformations: demographic ageing and the digitalisation of healthcare systems. The study situates inclusive design not merely as a technical or ergonomic concern but as a socio-technical paradigm that must address layered inequalities embedded in access to, and engagement with, digital health interventions. By adopting an intersectional analytical lens, the authors argue that ageing cannot be treated as a homogeneous biological trajectory; rather, it is shaped by cumulative disadvantages such as disability, poverty, education level, and digital literacy. These structural determinants influence how individuals interact with digital health systems and whether they benefit from them equitably .
The article develops its argument by critically examining the assumption that digital connectivity automatically translates into digital competence. Through empirical illustrations and narrative vignettes, it demonstrates how older adults may possess devices yet lack the operational, cognitive, or confidence-based skills required to navigate digital interfaces. This distinction becomes crucial as healthcare delivery increasingly shifts toward telehealth platforms, mobile health applications, and web-based service portals. The authors warn that such transitions, while expanding efficiency and reach, risk reproducing or even intensifying health inequalities if inclusive design principles are not embedded from the outset .
A major contribution of the paper lies in linking inclusive design to digital health interventions (DHIs). DHIs are conceptualised as technology-mediated systems used to prevent, monitor, and manage health conditions. These include telemedicine services, wearable monitoring devices, mobile applications, and remote consultation infrastructures. While these tools can enhance access, patient engagement, and continuity of care, their effectiveness depends heavily on users’ digital skills, interface accessibility, and socio-economic context. The study therefore positions inclusive design as a mediating framework that ensures technological innovation does not outpace human capability .
The discussion extends to the transformative yet ambivalent role of artificial intelligence in future health ecosystems. AI is presented as a double-edged development. On one hand, adaptive interfaces, predictive analytics, and personalised health communication systems could simplify complex information and support independent living among older adults. On the other hand, algorithmic bias, data exclusion, and technologically complex interaction environments could deepen marginalisation if design processes fail to represent diverse ageing populations. The authors thus call for inclusive AI training datasets, participatory design methods, and equity-driven governance structures .
The article concludes by proposing a forward-looking roadmap for inclusive digital health design. This roadmap emphasises four strategic directions: integrating intersectionality into user research, diversifying modes of technological interaction, developing non-digital or hybrid service alternatives, and embedding inclusive design principles into emerging AI-driven systems. Collectively, the paper reframes inclusive design as a policy, research, and practice agenda essential for safeguarding dignity, autonomy, and equitable healthcare access in ageing digital societies .
Reference: Zitkus, E., Clarkson, J. P., & Duarte, Y. A. (2025). State of science: New frontiers in inclusive design and digital health intervention. Ergonomics. https://doi.org/10.1080/00140139.2025.2548007
Mini dictionary of key concepts
Inclusive Design refers to a human-centred design philosophy that seeks to create products, services, and systems accessible to the widest possible range of users, particularly those experiencing functional, cognitive, or socio-economic disadvantages.
Digital Health Interventions (DHIs) are technology-based tools and platforms, such as telemedicine, mobile health applications, and wearable devices, developed to prevent, manage, or treat health conditions and enhance healthcare delivery.
Intersectionality denotes an analytical framework that examines how overlapping social determinants, including age, disability, income, gender, and education, collectively shape individuals’ access to technology and health services.
Digital Exclusion describes the condition in which individuals lack the skills, access, confidence, or resources required to effectively use digital technologies and online services.
Human Factors and Ergonomics (HFE) is a multidisciplinary field focused on understanding human capabilities and limitations to optimise the design of systems, interfaces, and environments.
Artificial Intelligence in Health Design refers to the integration of machine learning and adaptive algorithms into healthcare systems to personalise care, automate monitoring, and enhance user interaction.
Cumulative Disadvantage captures the compounding effect of lifelong inequalities, such as poverty, low education, and disability, which intensify barriers to digital health access in later life.