The Invisible Dimensions of Digital Health

Digital health continues to expand, offering remote monitoring, electronic records, and data-driven insight. Yet systems still measure people primarily through biological and behavioral indicators. Emotional well-being, belonging, and creative expression are neglected. This gap is especially evident among older adults, for whom companionship and recognition often matter as much as clinical stability. In this thesis, participatory art facilitators working with older adults in Taiwan and Europe were interviewed for insights into how creative engagement functions as relational care . Their input coincides with related literature. According to Sutherland et al. (2024) online arts participation significantly enhances emotional connection and reduces isolation. As digital health frameworks evolve, integrating participatory arts is not optional; it is essential for representing the full reality of human well-being.

The art facilitators interviewed for this thesis note that older adults found comfort not in the artistic product but in the predictable presence and shared rituals of each session. This echoes Murthy’s (2020) concept of high-quality human connection as a determinant of health, and Bradfield’s (2021) view of participatory arts as relational practices that prioritize emotional presence and co-creation. Creative sessions allow participants to process memories, express feelings otherwise left unspoken and rebuild interpersonal trust. These relational outcomes are often overlooked by medical systems. Loneliness, disconnection, and loss of identity, highlighted by Shapira et al. (2021) as major risks for older adults, often go undetected in digital health platforms.

Methods Used: A Qualitative Exploration of Facilitator Perspectives

In this thesis, the author uses qualitative research, where in-depth interviews with participatory art facilitators were analyzed through an inductive thematic analysis, following Braun and Clarke (2006) and complemented by constructivist grounded theory sensibility (Charmaz, 2014). Rather than applying predefined categories, themes emerged through engagement and interactions with facilitators’ narratives, emphasizing the co-constructed nature of meaning and relationality in their work. This methodological ensured that the findings reflected authentic, lived experiences of adapting participatory arts for older adults in both physical and digital environments.

What Conventional Metrics Fail to Capture

Current digital frameworks favor indicators that are easy to quantify: activity levels, biometric readings, appointment attendance. Yet they rarely measure joy, purpose, companionship, or creative involvement. Dadswell et al. (2017) describe participatory arts as “social glue,” showing that shared creative experiences foster belonging and support. Likewise, Groot et al. (2021) emphasize that arts engagement strengthens emotional resilience and agency. These findings reveal what conventional metrics are missing. Through storytelling, drawing, movement, and dialogue, older adults reconnect to identity and community.

What the Results Tell Us: When Care Moves Online and Human Connection Must Lead

Although the transition to digital formats proved possible, in Lin’s thesis the findings make clear that meaningful online engagement depends not on technology alone but on deep relational sensitivity. Facilitators emphasized that older adults remained engaged only when they felt emotionally held, seen, and accompanied even through a screen. This placed new and continuous demands on facilitators’ skills: reading subtle cues without physical presence, slowing the pace, translating warmth into voice and gesture including digital confidence with patience and improvisation. Such work cannot rely solely on individual goodwill; it requires system-supported professional development in digital facilitation, relational communication, hybrid design, social emotional sensitivity and competence.

These insights lead to a broader reimagining of digital health. If biological and behavioral metrics—steps, heart rate, sleep cycles—can be monitored and analyzed, then the patterns of participatory arts engagement should also be recognized as meaningful indicators of well-being. Frequency of art participation, signs of joy, emotional energy, narrative expression, and continuity of involvement all reflect psychosocial stability in ways that clinical metrics cannot capture. Digital health systems that integrate these relational and creative signals could move beyond monitoring illness to understanding the quality, texture, and purposefulness of daily life. Participatory arts thus point to a future where digital health is not only clinically informed but humanly informed, grounded in the rhythms of connection, meaning, and shared creativity.

Aligning with Finland’s Digital Health Strategy

These issues are especially resonant when examined in relation to Finland’s Strategy for Digitalization and Information Management in Healthcare and Social Welfare (2023–2035). Finland’s strategy emphasizes information-based foresight, citizen capability, and the integration of behavioral, emotional, and social data to strengthen preventive care. Reading this policy helps situate participatory arts within a broader systemic framework. If Finland aims to include emotional and social dimensions in digital well-being data, then creative participation could serve as a legitimate psychosocial indicator. This perspective aligns with White’s (2010) framing of participatory arts as socially rooted practices that enhance collective meaning-making. The more this idea is explored, the clearer it becomes that participatory arts are not leisure, but relational health infrastructure aligned with Finland’s vision of person-centered, data-enabled well-being.

Participatory arts offer unique value to digital ecosystems. Creative expression helps older adults regulate emotion and rediscover purpose. Co-creation strengthens social connection, supporting the emotional stability emphasized by Gawande (2014), who argues that human flourishing in later life depends on meaning rather than mere safety. Most importantly, the consistency of participation itself is a powerful signal: motivation, emotional energy, cognitive presence, and relational trust are all reflected in how an individual engages creatively. These patterns can illuminate early signs of withdrawal or distress long before clinical symptoms emerge.

Future digital health frameworks could gradually incorporate indicators that reflect relational and creative life, such as participation frequency or the evolution of emotional expression. Such metrics would shift digital systems from symptom-focused monitoring to holistic well-being insight, enabling earlier and more humane intervention.

Art facilitators play an essential role in this transition. They are not instructors delivering content, but relational anchors who cultivate emotional safety, guide expression, and adapt sensitively to group dynamics. Their importance becomes even more pronounced online, where warmth must be conveyed through a screen and digital literacy varies widely. As Wexler et al. (2019) note, facilitators sustain trust through responsiveness, improvisation, and attuned presence. These are skills that require continuous training in art facilitation, hybrid session design, and digital inclusion. Without sustained professional development in these areas, digital participatory art risks remaining at a leisure-based level rather than becoming a transformative, relationally meaningful, and data-informed component of digital health.

Conclusion: Rehumanizing Digital Health Through Creative Participation

Digital health must move beyond diagnosis-centered thinking toward an ecosystem that values creativity, belonging, and emotional flow. Participatory arts expose what traditional frameworks fail to measure. When paired with clinical data, creative engagement enables digital health systems to understand not only life expectancy but life quality. In line with strategies like Finland’s, participatory arts provide a foundation for preventive, early-detection, emotionally intelligent, and truly human-centered digital health—where older adults are not just monitored but meaningfully connected.

https://www.theseus.fi/handle/10024/900387

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Writers:

Li-Ting Lin, student in Master’s Degree Programme in Digital Health, Savonia University of Applied Sciences

Bryn Lane, lecturer, Savonia University of Applied Sciences, Master School, Kuopio, Finland

Elisa Snicker, lecturer, Savonia University of Applied Sciences, Master School, Kuopio, Finland

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References:

Dadswell, A., Miller, K., Moriarty, J., & Moffatt, S. (2017). Art and belonging: A systematic review of how participatory arts support wellbeing in older adults. Journal of Aging & Social Policy, 29(5), 1–26.

Finland Ministry of Social Affairs and Health. (2023). Strategy for Digitalization and Information Management in Healthcare and Social Welfare 2023–2035. Helsinki: STM Publications.

Gawande, A. (2014). Being Mortal: Medicine and What Matters in the End. New York: Metropolitan Books.

Groot, B., de Kock, L., te Hennepe, D., van der Graaf, E., & Abma, T. (2021). Meaningful arts engagement and resilience in later life. The Gerontologist, 61(4), 675–685.

Murthy, V. (2020). Together: The Healing Power of Human Connection in a Sometimes Lonely World. Harper Wave.

Shapira, N., Yeshua-Katz, D., & Cohn-Schwartz, E. (2021). Loneliness and social isolation in older adulthood: Risks, predictors, and interventions. The Journals of Gerontology, Series B, 76(3), 503–512.

Sutherland, R., Reeves, N., Blackburn, D., & Wilson, J. (2024). Digital participation in the arts: Impacts on social connection and emotional wellbeing among older adults. International Journal of Digital Culture & Society, 5(1), 33–52.

Wexler, L., Gubrium, A., & Griffin, M. (2019). Facilitating trust and improvisation in participatory arts: Lessons from digital storytelling. Arts & Health, 11(2), 142–158.

White, G. (2010). Participatory arts and the social world: Meaning-making and collective imagination. Cultural Sociology, 4(1), 65–82.