Empowering sustainable futures: The role of digital citizenship for health in healthcare and environmental resilience

Digital Citizenship for Health (DC4H) [1] (Table 1) is not merely an emerging concept but an urgent necessity in a world where health systems are becoming increasingly digitalized. It encompasses digital health, and civic literacy, equipping citizens with the agency to engage with digital health systems, advocate for their rights, and co-create ethical governance structures. However, without deliberate investment and citizen-centered approaches, digital transformations risk deepening existing health inequities instead of addressing them. As climate change and environmental degradation accelerate, integrating sustainability into digital health governance is no longer optional—it’s imperative. This commentary explores the key role of DC4H in promoting sustainable healthcare and environmental resilience, calling for bold, multi-stakeholder action and systemic investments in literacy and governance.

The triple planetary crisis—climate change, pollution, and biodiversity loss—poses an existential threat to global health and is worsening respiratory diseases, vector-borne illnesses, and food and water insecurity [2]. Climate change is already undermining key environmental and social determinants of health and is projected to cause 21 million deaths by 2050 [3]. Healthcare systems contribute to approximately 5% of carbon emissions through energy use, medical waste, and unsustainable supply chain operations [4]. Failure to adopt greener practices deepens the environmental and public health crisis, disproportionately impacting marginalized regions. Integrating sustainability into healthcare is crucial to mitigating climate-related health risks and strengthening system resilience. Digital health innovations, including telemedicine, mobile applications, AI-powered diagnostics, and electronic health records, offer tangible opportunities to optimize resource use and fortify healthcare systems against the challenges posed by the triple planetary crisis [5]. However, their deployment must be consciously aligned with sustainability principles. DC4H plays a transformational role by equipping individuals and communities with the knowledge and tools necessary to demand and drive green healthcare policies.

DC4H extends traditional citizenship concepts into the digital health sphere, centering on individuals’ active and informed participation in digital health governance. It goes beyond digital literacy, thereby framing health engagement as a civic responsibility and enabling individuals to navigate digital health systems, critically analyze technologies, combat misinformation, and influence health policies. By managing their health data and advocating for equitable digital policies, engaged citizens actively participate in addressing health disparities and prioritizing the needs of the most vulnerable.

Citizens can better champion DC4H through system-wide transformations—from advocating for climate-resilient healthcare facilities to promoting renewable energy adoption in medical infrastructure. Despite the escalating risks caused by climate change, healthcare systems worldwide remain unprepared for the impending crisis. Prioritizing both climate adaptation and mitigation strategies saves lives in the short term and also strengthens long-term resilience and reduces inequities. Supporting country-led plans to develop climate-responsive, resilient, and low-carbon health systems and harnessing the collective power of all stakeholders through networks like the Alliance for Transformative Action on Climate and Health (ATACH) is an ethical and strategic necessity for ensuring preparedness against emerging threats [6].

Amongst all stakeholders, youth have a critical role to play in this transformation. As the generation that will inherit the consequences of today’s climate decisions, young people are not passive beneficiaries. They are active stakeholders in shaping sustainable digital health solutions [7]. As digital natives, their involvement in policy dialogs, digital health literacy initiatives, and the co-creation of technological innovations is non-negotiable. Failing to integrate youth perspectives into digital health governance and give them agency in policy processes weakens our ability to build an equitable, climate-resilient future. Instead of relying on unscalable innovations in the name of “youth engagement,” we must prioritize meaningful inclusion [7].

A major roadblock to sustainable healthcare is the phenomenon of “health-washing,” where organizations make superficial or misleading claims about their sustainability efforts while engaging in business-as-usual activities. At major events such as the UNFCCC Conference of Parties (COP) 28, countries have engaged in healthwashing by incorporating health-related language into climate negotiations, making “pro-health” commitments while continuing to support harmful practices, such as the fossil fuel industry, that undermine public health [8]. When corporations exaggerate eco-friendly commitments, citizens may be misled about actual health benefits of certain digital platforms or technologies, affecting informed decisions—an essential DC4H component. Health-washing leads to public disengagement from digital health platforms and can disproportionately affect vulnerable populations who rely on accurate information to access equitable care.

Addressing health-washing requires robust accountability frameworks. Policymakers must enforce transparent reporting mechanisms and legally binding sustainability benchmarks to ensure that environmental commitments are not a marketing gimmick. Addressing health-washing and promoting collaboration among healthcare providers, youth, researchers, and civil society are essential to building public trust. These efforts encourage meaningful engagement in digital health citizenship, helping us push for digital transformations that prioritize both public health and the planet.