The importance of digital inclusion in accessing care and support in our increasingly digitised world

The helping professions are increasingly using digital technologies like automated decision making, artificial intelligence and video or telehealth to meet the needs of their clients (Carney, 2020; Henman 2019). This trend was accelerated by the pandemic, as we relied more on digital connections and service models to ensure continuity and care during periods of lockdown and in accordance with social distancing guidelines (Meijer, & Webster, 2020). Consultations over real-time video (e.g. Zoom), once the topic of futuristic, speculative fiction have become commonplace, even mundane. Automated, digital solutions are also becoming increasingly commonplace across different human service contexts. For instance, the use of chat bots by Services Australia that use artificial intelligence to understand your questions, and answer them, have been rolled out over recent years as the number of people accessing online support during the pandemic escalated. Even facial recognition technology was trialled in Australia for the first time in a social services context, during the 2020 bushfires, allowing speedy identification and assessment of people in need after their documentation had been destroyed in the fires (Hendry, 2020). The phasing out of cash and rise of digital currencies and service platforms are further evidence that our world is rapidly becoming more digitised. Concordantly, the receipt of care and support is increasingly becoming dependent on access to digital technologies. This presents a new challenge – i.e. digital inclusion. Digital inclusion is about ensuring all can access and use digital technology and services (Australian Digital Inclusion Index, 2021; United Nations, 2021). If we aim to avoid a growing divide based on digital inclusion/exclusion, it is vital that attention to inequalities are at the forefront of our minds if the embrace of all things digital continues unabated (Crawford, 2021). 
 


The papers on this edition of JOSI focus on the digital divide in the context of Australia, the United Kingdom (UK) and the Netherlands demonstrating the need to pay attention to differences within and between countries.Key themes highlighted in this issue relate to navigating digital and online environments and the exclusion from health services evident during the COVID pandemic, how digital or online systems can be used to foster connections and reduce social isolation, for instance, for older people; and the application of systems to map and identify social inclusion opportunities through inclusive land use planning mechanisms.However, along with the promised benefits of the digital in social services, come some challenges.Noble (2018) shows how the data that is used to make decisions, even a simple google search, is inherently racist, and Eubanks (2018) shows how predictive child protection technologies in the United States are punitive and reinforce inequalities and disadvantage.The importance of human, relational and collaborative ways of working remain a cornerstone of inclusive practices.As is highlighted in our final paper in this issue, this needs to be kept front of mind to balance and manage any exclusionary risks that may arise from our digital embrace.
We nevertheless, begin JoSI 12(2) with a discussion of the problem of digital exclusion and the 'digital divide' as identified in the context of addressing health inequalities in the UK.In 'The sickening truth of the digital divide: Digital health reforms and digital inequality', Stephen and Mankee-Williams discuss the inadvertent link between digital inequalities and health inequalities, in the context of some well-intentioned universal service commitments in the UK.The impact of access to connectivity and healthcare, affordability/lower incomes, and rurality is illustrated in a brief discussion of Cornwall in England.The authors note the importance of not only understanding the digital divide, but moreover to address the determinants of digital inequalities, and health inequalities, by extension.
The new opportunities and social benefits that digital solutions can provide is highlighted in our second paper, by Fuss, Dorstyn and Ward.Indeed, the utility of digital communication platforms are demonstrated in "Belonging in the Online World: Older Adults' Use of Internet for Community" the utility of digital communication platforms.The results of this small Australian qualitative study suggest that the benefits of older Australians' use of computerised communications extend to a greater sense of belonging and support.The ability of these platforms to reduce social isolation and promote increased engagement and opportunities to build new interests and connections is discussed, and underscores the importance of building digital literacy in older people, and the need for further research to increase engagement across different social spheres, build on older people's sense of belonging and further reduce social isolation.
The ability of digital platforms to connect individuals is matched by an ability to collate large data sets and inform decision-making at macro levels, as demonstrated in our next paper which illustrates the value of geographic information systems in informing inclusive local planning.In "Assessing Land-use Suitability of Existing Inclusionary Zoning Projects in the Australian Capital Territory", Zheng and Sigler examine the application of 'inclusionary zoning' (IZ), a land-use planning initiative of local government, in the context of the Australian Capital Territory.Although the identification of socio-economic integration, access to jobs, access to public transport, access to green space and compliance with zoning requirements are central, the authors note that IZ is market dependent and relies on more effective engagement and collaboration across government and private sectors.Nevertheless, the power of digital information systems in providing visual clarity of what are complex social phenomena, perhaps stands in contrast to how complex systems can be navigate by some in society.
However, digital systems are only as good as the data that feeds them and the programming that propels them.They are not infallible.This is demonstrated by the Robodebt scandal in Australia where hundreds of thousands of social security recipients were given false debts based on an error in the way the Department's algorithm calculated income, causing significant distress and hardship (Carney, 2019).When working with people who are historically excluded, like social security recipients, and in, "Mother of a problem!Are the needs of mothers with intellectual disability being addressed in the NDIS Era?", mothers with intellectual disability, the risk of decision-making causing further harm and exclusion is great, with significant impact on lives and access to services.Transparency in decision-making is a vital safeguard for preventing these harms (Australian Human Rights Commission, 2021).Wedgwood, Collings, Spencer and Hindmarsh point out that the NDIS promised rights-based entitlement support for all Australians, but the result for mothers with an intellectual disability has been reduced access to parenting support which they are entitled to under the Convention on the Rights of Persons with a Disability.They call for transparency on how the Australia's National Disability Insurance Scheme (NDIS) identifies and addresses the support needs of mothers with a disability, as well as the need to build national capacity on evidence based parenting education and support for these women.
The need to make sure the unique and contextual requirements of individuals are not left behind is reinforced in the final paper in this edition of JOSI.In "From us to them and them to you -fostering inclusion in daily care practice in terms of equal partnership", Cardol, Hermsen, Van Asselt-Goerts and Hilberink critically appraise the concept of inclusion to show the importance of user involvement, especially real partnerships with service users in particular, service provision contexts with people with disabilities.They discuss some of the difficulties in realising real partnerships in everyday care practices and the implications for this in the context of inclusion.The authors remind us that issues around inclusion and exclusion in relation to the caring professions, are not new, but nevertheless need constant vigilance and reflexivity for practitioners working in direct practice as well as all those working towards greater social inclusion in increasingly digitised environments.

Paul Harris, PhD
Lyndal Sleep, PhD Co-Editor Co-Editor