Broadband access within Medically Underserved Areas and its implication for telehealth utilization

PurposeThere is little information as to how America's broadband infrastructure might impact recent efforts to expand access to virtual care for underserved communities. ObjectiveTo examine potential and realized access to broadband internet services within Medically Underserved Areas (MUAs) that rely on community health care service providers for primary care. MethodsThis cross-sectional study included 214,946 US Census Block Group estimates from the 2017 and 2019 American Community Survey and the corresponding Federal Communications Commission database. Changes in household broadband subscription rates and Healthy People 2020 access thresholds within MUAs were assessed. FindingsIn 2019, 24,304 MUA households (31.9%) met Healthy People 2020 targets for broadband subscription rates, compared to 64.4% of non-MUA households (n = 89,285). On average, 74.7% of MUA households had a broadband internet subscription compared to 85.2% of non-MUA households, whereas 61.1% (n = 46,635) of MUA households had access to broadband speeds of at least 25.0 Mbps, compared to 75.6% (n = 104,696) of non-MUA households. Within urban households, there was a 0.8 to 1.3 to 1.6 annual percentage point convergence in MUA versus non-MUA broadband disparities between across quintiles (P < .05). Rural MUA households showed little improvement in broadband access between 2017 and 2019. ConclusionsThere has been an overall convergence of broadband access disparities between MUA and non-MUA households over time, but less improvements in access among the most rural households. Reimbursement for audio-only telehealth visits by state Medicaid agencies would help drive down barriers to virtual health care options for populations residing in MUAs.

Automated summary

This study aimed to examine the impact of America's broadband infrastructure on expanding access to virtual care for underserved communities. The findings showed that only 31.9% of households in medically underserved areas met the Healthy People 2020 targets for broadband subscription rates, compared to 64.4% of non-MUA households. Although there was some convergence in broadband disparities between MUA and non-MUA households in urban areas over time, rural MUA households showed little improvement in broadband access.