Studies and Data Analytics on Broadband and Health
The Connect2HealthFCC Task Force’s (C2H Task Force) Advancing Broadband Connectivity as a Social Determinant of Health Initiative is based, in part, on the Task Force’s prior and ongoing research and analytics showing a significant correlation between increasing broadband access and improved health outcomes. Internet adoption appears to have an even stronger correlation to health outcomes, even after controlling statistically for other potentially confounding factors, such as education, income, and rurality. Research in this area, however, remains scant, which may explain why broadband connectivity has not yet been recognized as a social determinant of health by relevant authoritative bodies. The Task Force has therefore continued its critical work to enhance and improve the data analytic platform - Mapping Broadband Health in America - which enables a detailed study of the intersection of connectivity and health. The platform also supports research to better understand the complex relationship between broadband and health. Current focus areas include diabetes, obesity, cancer, and drug abuse/opioids, and soon maternal health. Below is a chronological snapshot of selected Task Force work on this Initiative.
Early Data Analytics and Findings (2015-2017)
The C2H Task Force first pioneered the concept that broadband connectivity may be a new or unrecognized social determinant of health, which could have important implications in the development of policies, models, and approaches for promoting digital equity (broadband access and adoption) and health equity (community and population health outcomes).
- October 2015 — Linked the then-novel perspective of broadband as a social determinant of health directly to bridging the digital divide at the Broadband Health Tech Forum hosted by the Task Force in coordination with Wayne State University and TechTown Detroit.
- Early 2016 — C2H Task Force began studying the relationship of broadband connectivity and chronic disease using diabetes as the health variable as it is a serious, common, costly, yet manageable chronic condition. The results of that study are described below.
- August 2016 — C2H Task Force created and unveiled its Mapping Broadband Health in America platform, which allows users to visualize, overlay, and analyze broadband and health data at the national, state, and county levels. The maps are interactive and enable a detailed study of the intersection between connectivity and health for every county in the United States. Based on this framework, the Task Force coined the term “double burden counties” to identify those counties that have both low broadband connectivity status (access or adoption) and high health needs as compared to the national average.
- June 2017 — C2H Task Force updated the Mapping Broadband Health in America platform and released Key Findings. Among other things, the Task Force found the following:
- The picture of health remains notably different between connected communities and digitally isolated communities (i.e., where 60% of households lack broadband access and over 60% lack basic Internet at home). This holds true across health outcomes, access to care, and quality of care metrics.
- Outcomes: Based on December 2015 broadband data, the least connected counties generally have the highest rates of chronic disease. Obesity prevalence is 25% higher and diabetes prevalence is 41% higher (an increase of 6 percentage points since the prior year) in these counties.
- Access: Most of the counties with the worst access to primary care physicians are also the least connected (i.e., 40- 60% of consumers in these counties do not subscribe to even basic Internet at home).
- Quality: Preventable hospitalizations (i.e., hospital stays that could have been avoided with appropriate care) are 1.5 times higher in the least connected counties compared to other counties.
Diabetes and the Broadband Health Continuum (2017-2019)
Late 2017 — C2H Task Force commenced a study to explore the relationship between the level of connectivity in a community and that community’s health and whether increasing broadband connectivity in a community correlated with improved health outcomes at the community and population levels. The analysis used diabetes prevalence data and broadband data (as of December 2015). Below were some of the findings:
- There is a significant correlation between increasing broadband access and improved health outcomes. Based on December 2015 data, counties in any quintile of broadband access have on average 9.6% lower diabetes prevalence than in those counties in the next lower quintile of access. This change in diabetes prevalence remains when we control for education (8.7%) and income (8.4%) separately or together with age (6.0%).
- Internet adoption appears to have an even stronger correlation to improved health outcomes. Communities in a given quintile of Internet adoption on average have 16.5% lower diabetes prevalence compared to communities in the next lower quintile.
- Even in counties with the highest diabetes rates (the so-called “diabetes belt” counties), where one might expect it to be more difficult to see an impact, increasing quintiles of broadband access correlate to decreasing rates of diabetes prevalence – 3.8% lower diabetes (and 1.8% and 2.0% when corrected for education and income, respectively).
The data suggested that there is a significant correlation between increasing broadband access and improved health outcomes and that Internet adoption appeared to have an even greater correlation to improved health outcomes. Accordingly, the Task Force concluded that broadband connectivity is a social determinant of health and is one of the key environmental factors that can determine the health of communities. In addition, the Task Force determined that because other established social determinants of health, such as education, employment opportunities, and job training, are increasingly premised on the availability of connectivity, broadband connectivity is not only a social determinant of health, but in its role as a gateway to other social determinants of health, it can be arguably considered as a super determinant of health. Future research should investigate the role of broadband access and adoption in enhancing the effects of the established social determinants of health, e.g., education.
As detailed in the Broadband and Diabetes study, we suggested that there is a “connectivity continuum” influencing health. In this “connectivity continuum,” the most proximal relationship between connectivity and a given health outcome is tied to actual utilization of broadband connectivity for health. Distal to that is the broadband subscription (i.e., adoption) required for utilization; and further distal to that and with a smaller correlation with health outcomes is the existence of broadband infrastructure or “access,” which is a necessary pre-condition to other components.
A copy of the study is associated with GN Docket No. 16-46 and can be accessed here.
Broadband and Cancer Study (2020-2021)
The C2H Task Force conducted research focused on the relationship between broadband connectivity and cancer mortality and incidence rates in the Appalachian region, a key effort related to the L.A.U.N.C.H. Initiative.
Broadband and Opioids Study (2021)
C2H Task Force is integrating drug abuse or opioids-related data to the Mapping Broadband Health in America platform and studying the relationships between broadband access/Internet adoption and drug mortality/opioid prescription rates.