Mapping Broadband Health in America is a groundbreaking data visualization platform that depicts the intersection of broadband and health data for every county in the U.S.  In order to accommodate different types of users – from the casual observer to the sophisticated researcher – the map uses filtering, color-coding, and data overlays to permit users to create customized maps highlighting the variables of interest and also to conduct visual analyses while controlling for different variables.  It is also open data and open source so that users can conduct their own analysis and also add functionality that addresses their priorities.

Broadband and Health Data

The fixed broadband data in the mapping update was released in December 2016 and covers data submissions from the FCC Form 477 program as of December 2015 (released on December 7, 2016).  The broadband data points were chosen to provide insights into what can be enabled and delivered through the broadband health ecosystem of network, devices, and applications and to identify exactly where gaps exist.  These data points include – broadband access, rural broadband access, Internet adoption, and upload and download speed.  The map also includes functional characteristics such as the number of providers in an area and the percentage of the population served at each provider tier.

The map uses data on broadband access at 25 mbps download and 3 mbps upload; it also displays higher speeds where available which are relevant to more complex telehealth applications and use cases.  Internet adoption metrics are based on data publicly released in quintiles and capturing the extent to which consumers subscribe to fixed residential connections at 200 kbps or higher. Proportions for broadband access statistics are calculated using 2014 demographic data from GeoLytics, E. Brunswick, NJ.

The health data is drawn from the 2017 release of the Robert Wood Johnson Foundation County Health Rankings & Roadmap (which reflects the most recent data on the metrics of interest from the Health Resources and Services Administration, Dartmouth Atlas Project, American Medical Association, Centers for Disease Control and Prevention and other primary sources); and additional demographic data is from the U.S. Census Bureau.  As detailed in the chart below, the metrics reflect three critical dimensions of health – health outcomes, access to care and quality of care – where broadband connectivity has been shown to enable effective and cost-saving interventions.  Population health outcomes are represented by adult obesity, diabetes prevalence, health-related quality of life (fair or poor health) scores, and reported sick days.  Quality of care is represented by preventable hospitalizations.  Access to care is represented by the number of primary care physicians per 100,000 population in a given county.  See Data Sources.

Health Dimensions Health Measures
Health Outcomes Diabetes, Obesity, Poor/Fair Health, Sick Days
Access to Care Primary Care Physician Access
Quality of Care Preventable Hospitalizations

To put the health metrics in context, the map platform also includes other demographic information and socio-economic determinants, including rurality, education and income.  We use the U.S. Census Bureau definitions of “urban” and “rural” areas, where “urbanized areas” are areas of 50,000 or more people, and urban clusters are those with at least 2,500 but less than 50,000 people.  All other areas not included within an “urban” area are considered “rural”. 

Broadband Access and Speed Tiers

The Connect2HealthFCC Task Force calculated broadband download and upload speed tiers by determining the proportion of population that has access to each tier as its maximum available offering. The proportion of population for each speed tier was determined by identifying the highest speed tier offered in each census block, attributing that census block to the speed tier, then totaling the county population proportion of all census blocks attributed to each speed tier.

States, Counties and Census Blocks

Map features are available at the state and county zoom levels.  We chose to focus on counties for several reasons:  (1) county level data is available across various health (e.g., diabetes, obesity, preventable hospitalizations) and connectivity benchmarks; (2) counties are a discrete geographic unit with community governance that can potentially drive broadband economies and local health policy (i.e. they are neither too broad such as a state level geography nor too granular such as neighborhood level geography); and (3) counties are the building blocks for publishing many types of data (e.g. economic data) and for tracking progress and regional population and economic trends.

For broadband metrics, the FCC releases data for the number of providers and maximum download and upload speeds available at the census block level. Consistent with the Commission’s methodology in other contexts, a census block was considered to have access if a provider advertised speeds of at least 25mbps upload and 3mbps download. The population of each census block considered to have broadband access was noted, and totaled across the particular county. By dividing the total population of census blocks with broadband access by the total county population, we were able to derive the proportion of the population in a county with broadband access. Rural broadband access is similarly calculated by dividing the total population in rural census blocks with broadband access by the total population of rural census blocks in the county.

Map Design

To create the data visualizations in the map, we assigned a color-coded value for each broadband variable (yellow to blue) and health metric (yellow to red) in every county and state.  In the broadband and health choropleth maps (found under the corresponding tabs), the color of each state or county represents the level of broadband (yellow to blue) or health metric (yellow to red) for that feature.

  • For broadband, the color ranges correspond to quintiles of access from 0 to 100%.
  • For health, the choropleth spectrum is centered on the national median with color progression corresponding to equal intervals from highest to lowest value for that metric.
  • In the Overview tab, blue represents those geographic features (i.e. states or counties) meeting the specified broadband metric parameters; pink represents those features meeting the specified health metric parameters; purple – a mix of blue and red – represents features that meet the specified ranges for both the selected broadband and health metrics. Areas shaded white reflect counties with no data or that do not meet the selected parameters.

In addition, the map provides supplemental visual context for each state and county in spider plots, charts and graphs.  These features were designed to help users who may be less familiar with the broadband health profile of targeted areas and will facilitate easy comparison between counties.

Health Maps Supplemental Visual Context: County StatsHealth Maps Supplemental Visual Context: Number of ProvidersHealth Maps Supplemental Visual Context: Health Behaviours

Open Data, Open Source

The map platform allows the user to conduct further analysis by downloading the data in a number of formats including CSV. It also allows developers to integrate the data into their own platforms using JSON or XML data download formats.  The code is also open source, and our "open integration" model allows users to integrate their own data to visualize its impact on the broadband health space.  We encourage developers to leverage the platform for their own use.  Please use the Community Engagement tab to share efforts in analysis and development using the platform and to identify other data or features that would be useful.

Friday, March 18, 2016