Academic Journal
Interface design failure as a social determinant of health.
| Τίτλος: | Interface design failure as a social determinant of health. |
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| Συγγραφείς: | Cohrs FM; Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., de Mello MAF; Departamento de Geriatria, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil., Ramos LR; Departamento de Medicina Preventiva, Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil. |
| Πηγή: | The Gerontologist [Gerontologist] 2026 Jun 09; Vol. 66 (7). |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Oxford University Press Country of Publication: United States NLM ID: 0375327 Publication Model: Print Cited Medium: Internet ISSN: 1758-5341 (Electronic) Linking ISSN: 00169013 NLM ISO Abbreviation: Gerontologist Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2009- : Cary, NC : Oxford University Press Original Publication: St. Louis, Gerontological Society. |
| Ιατρικοί όροι (MeSH): | Social Determinants of Health* , Telemedicine* , User-Computer Interface*, Humans ; Digital Health ; Aged |
| Περίληψη: | Digital exclusion from essential services is conventionally framed as a user deficiency requiring digital literacy training. We challenge this perspective, arguing that exclusion results from structural interface design failures rather than individual incapacity. This analysis positions interface design as a social determinant of health, examining how design decisions create systematic barriers to healthcare, social services, and civic participation. We synthesize evidence from multiple global contexts examining the persistence of the Windows, Icons, Menus, Pointer (WIMP) paradigm developed in the 1970s, structural bias in contemporary design processes, and health consequences of compulsory digitization. The WIMP paradigm persists despite five decades of demographic change, embedding assumptions about visual acuity, motor control, and technical literacy that systematically exclude older adults and other populations. Homogeneous design workforces reproduce these exclusionary patterns. Compulsory digitization transforms design failures into barriers to fundamental rights: 38% of U.S. adults aged 65+ were unprepared for telehealth during COVID-19; digital-only healthcare scheduling excludes patients lacking smartphone proficiency; interface complexity correlates with functional dependence and accelerated cognitive decline in older populations. Addressing interface design as a social determinant of health requires comprehensive intervention: regulatory frameworks mandating accessibility across essential services, genuine co-design with excluded populations, cultural adaptation, workforce diversification, exploration of post-WIMP paradigms, and policy commitments recognizing accessible design as a fundamental right rather than accommodation. (© The Author(s) 2026. Published by Oxford University Press on behalf of the Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.) |
| Contributed Indexing: | Keywords: Compulsory digitization; Digital exclusion; Interface design; Older adults; Social determinants of health; WIMP paradigm |
| Entry Date(s): | Date Created: 20260429 Date Completed: 20260612 Latest Revision: 20260707 |
| Update Code: | 20260708 |
| DOI: | 10.1093/geront/gnag074 |
| PMID: | 42054587 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1758-5341 |
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| DOI: | 10.1093/geront/gnag074 |