Health literacy, media literacy, and the digital divide: A conceptual framework for public health

The increasing digitalization of health systems has transformed the ways in which individuals and communities interact with information, health services, and decisions related to their wellbeing. In this context, health literacy, media health literacy, and the digital divide in health have emerged as critical determinants of informed and equitable participation in digital environments. The aim of this conceptual review is to examine the interconnections between health literacy, media health literacy, and the digital divide, and to propose an integrated conceptual framework to inform equitable public health practice, policy, and research in the digital era. The article provides a critical and integrated analysis of these constructs, highlighting their conceptual relationships, key methodological challenges, and implications for clinical practice, health policy development, and public health research. The findings indicate that approaches focused exclusively on individual skill development are insufficient to address digital health inequities. Without attention to structural and organizational determinants, the expansion of health technologies may reproduce or exacerbate pre-existing social and health inequalities. Accordingly, the review underscores the need for multilevel approaches that align literacy development, digital inclusion, and health system design to strengthen equity in the digital era.