Digital mobilities and immobilities in accessing health services: The experiences of minoritised ethnic communities in accessing and using primary care services in the UK

Systemic and racialised exclusions from accessing and using primary health care services are protracted forms of exclusions that are consistent and prevalent within the contemporary landscape of health inequalities in UK cities (NHS Race and Health Observatory, 2023; Lokugamage et al., 2021). However, these inequalities are often neglected and overlooked by policy interventions, thereby undermining the health outcomes of minoritised ethnic communities (Chouhan and Nazroo, 2020). With the massive push towards the rapid digital transformation of primary health services in recent times, which has been accelerated since the emergence of the Covid pandemic, there is a risk that racialised exclusions will increase (The Topol Review, 2019). Digital mobility – defined as a person’s access to digital technologies and their ability to interact successfully with online services and resources, wherever they may be – is becoming a vital element of daily life and increasingly it is essential for access to healthcare. Against the backdrop of the chronic and persistent poor health outcomes of some minoritised ethnic communities, which have been disproportionately impacted by the pandemic, and driven by a critical realist intersectional approach which foregrounds our research study on the lived experiences of one hundred individuals with migration heritage in four case study sites in England and Scotland, we reveal the ways in which digital mobility is mediated by a cluster of conditions which intersect with each other. We highlight a spectrum of digital mobilities among individuals from diverse ethnic groups and multiple identities in engaging with primary care services, ranging from complete digital immobility to complete mobility. Within this spectrum, others get by, assisted in some cases by a cluster of local resources, such as support from relatives or neighbours or bilingual staff within the health service, and often at the cost of loss of privacy. However, their access to health services remains conditional on the availability and suitability of these supports, leading us to propose the concept of ‘digital precarity’ to illuminate their often tenuous relationship with ever-changing digital health services.