Governing the digital determinants of health for children and young people: a global public health imperative.

The digital determinants of health are the structural conditions through which digital infrastructures, business models, and design choices shape health outcomes. Yet these determinants remain largely outside public health policy and remain fragmented across regulatory sectors. Rather than regulating individual technologies in isolation, governance should ensure that digital systems and environments advance population health and reduce inequities. A public health approach shifts attention from individual responsibility-and the tendency to blame users-towards the governance of the structural features that produce health risks and inequities. We identify four governance domains for the digital determinants of health: infrastructure and access, platform design and commercial practices, data governance and surveillance, and institutional accountability and rights. Effectively governing these domains requires intersectoral strategies that tackle problematic concentrations of political and economic power. We argue that the governance of the digital determinants of health should be recognised as a core public health function, with the health of children and young people as a priority and entry point and precaution as a guiding governance principle.