The digital native fallacy: how age-based assumptions exclude young adults with chronic disease from digital health innovations

Digital health interventions often rely on a “digital native” assumption of inherent user competence and stable access. Drawing on US-based evidence, we challenge this: social media fluency does not equate to health literacy 1 , digital access is structurally unstable 2 , and insurance gaps exacerbate chronic disease risks 3 . While transferability depends on local conditions, these unstated prerequisites exclude those at greatest need. We propose five equity-first design principles to address these systemic failures.