In the post-COVID-19 pandemic era, a ‘digital-first’ agenda is being adopted in health/social care services, while digital exclusion has not been fully addressed. People with severe mental illness face profound inequalities at many levels (i.e. social, financial and health). Digital exclusion may further exacerbate some of these inequalities.

Digital inclusion is becoming more important as many consumer products and engineered systems adopt increasingly digital interfaces. The designers of such services often assume that users have a certain level of digital interface competence, but this is not the case for many users. In this paper, we present a set of personas that could help designers to better understand and consider the range of digital expertise across the population. The personas are based on survey data from 338 people across England and Wales in 2019. The survey examined various factors that affect ability to use digital interfaces, including technology experience, attitudes towards technology and competence with basic interface operations. Twelve clusters were identified using K-means cluster analysis, and twelve personas were developed based on these. The personas help to bring to life the range of digital expertise and highlight people at risk of digital exclusion. In addition, the cluster sizes indicate the proportion of the population represented by each persona and thus the scale of potential digital exclusion.

During COVID-19, health provision and information resources have been increasingly provided via digital means (e.g. websites, apps) and this will become a standard practice beyond the pandemic. People with severe mental illness face profound health inequalities (e.g. a >20-year mortality gap). Digital exclusion puts this population at risk of heightened or compounded inequalities. This has been referred to as the ‘digital divide’. For any new digital means introduced in clinical practice to augment healthcare service provision, issues of accessibility, acceptability and usability should be addressed by researchers and developers early in the design phase, and prior to full implementation, to prevent digital exclusion.

Having access and skills to use social technology, i.e. social internet use, social media and social applications, are considered as being vital to online social connection. Whilst evidence exists around facilitators and barriers to general technology use, evidence is limited with regards to the motivators, skills and tangible offline benefits older technology users experience with social technology. Therefore, this study used a qualitative, exploratory method to understand older adults’ experiences of using social technology to connect with others. Semi-structured interviews were conducted with 20 older adults (65+ years) across England, Scotland and Wales. Despite having access to social technology for social connection, and using this technology regularly, multiple barriers impacted motivators and skills for use, namely perceived self-efficacy and fear, the culture of online communication, absence of social capital and physical functioning. Some of these barriers of social technology use are reminiscent of barriers of wider technology use and emphasise the importance of addressing these barriers for digital exclusion, as well as social connection. However, some of these barriers were specific to social technology use and should be considered when providing guidance or interventions to increase older adults’ online social connection. Social connection was a clear tangible outcome to social technology use, and individuals discussed the benefits of using social technology, particularly visual communication tools, for online connection.

Amid rapid population ageing and the high-speed progress of information and communications technology, use of smart electronics can improve older people's quality of life by helping them to stay connected, active and independent, which may, in turn, increase their overall happiness and sense of social belonging. Taking a gender perspective, this paper aims to understand variations in digital exclusion among older people. Using data from the 2016 China Longitudinal Ageing Social Survey, it finds that digital exclusion seems to vary by gender, with rural female older people being most excluded, possibly because they have the lowest capital endowment. The gender difference in the digital divide is even more salient with all other things being equal. Digital exclusion in the information era may further exacerbate gender inequality, particularly for those who are already most vulnerable. Since digital inclusion is somewhat inherent in the concept of intelligent old-age support, it should be considered an urgent necessity to help older people, especially rural women, become familiar with smart electronic products.

The ability to use the internet frequently is likely to provide a useful means of engaging with society and using services in later life, yet older people are the most likely to suffer digital exclusion, with those of the oldest ages at the greatest risk. Using six waves (2002–2012) of the English Longitudinal Study of Ageing, we model cohort-specific patterns of frequent internet use for people aged 50 and over. Multi-level growth models are used to observe trajectories of internet use over the ten-year period. Firstly, analyses are stratified by gender and wealth, and secondly we additionally test for health effects. The study finds cohort-specific differences in patterns of internet use. Rates of internet use increase faster among younger cohorts yet, despite initially increasing, begin to decline among older cohorts. Poor health is shown to be a key factor in shaping the trajectory of internet use over time. Rates of internet use are consistently lower for women than men and for those in poorer financial circumstances, independently of age cohort. The findings demonstrate the importance of ensuring older people can remain digitally included throughout later life, including after the onset of poorer health, especially as some of these individuals might benefit the most from some of the services the internet can provide.