The Cultivation of Digital Health Citizenship

Abstract

Contemporary health policy discourse renders individuals responsible for managing their health by means of digital technology. Seeing the digital as productive of citizenship, rather than facilitative of it, this paper unpacks the contested role of technology in acts of digital health citizenship. Drawing on longitudinal data collected in the English healthcare context, this article shows that digital health citizenship is produced through patients' involvement in the generation of health knowledge, including 'big' health data, digital artefacts, experiential knowledge and service feedback. The paper adds to existing literature by disaggregating the contested role of technology in displays of digital health citizenship, showing that digital health technology can give rise to expressions of altruism, belonging, and demands for recognition and change in healthcare, whilst responsibilising citizens for the care of themselves and others. The discussion shows how, rather than merely facilitating the actions of a free and autonomous subject, this citizenship often becomes algorithmically produced (e.g. through nudges) and remains isolated to separate instances of engagement without a long-term orientation. Our study enriches the growing sociological literature on health citizenship by exploring how digital technology produces health citizenship at the intersection of biosociality and technosociality.

Keywords: Digital health; Health citizenship; Health knowledge production; Patienthood.