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85 Geographic landscape of US broadband availability from 2017 to 2020

Published online by Cambridge University Press:  11 April 2025

Jenna Rajczyk
Affiliation:
The Ohio State University
Jeffrey Wing
Affiliation:
The Ohio State University
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Abstract

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Objectives/Goals: Telehealth is a key solution to improving access to healthcare and disease detection, especially in rural areas. Telehealth access relies on the presence of broadband in an area, which has shifted with the growing importance of internet. We aim to assess the distribution of US county-level broadband availability from 2017 to 2020 overall and by rurality. Methods/Study Population: We employed an ecologic study design to examine the distributions of two measures of broadband availability across all US counties from 2017 to 2020. Broadband presence was defined as counties meeting the Federal Communications Commission (FCC) definition of broadband with at least one high-speed internet provider and an average download/upload speed of at least 25/3 megabits per second using 2017–2020 FCC Broadband Deployment Data. Broadband access, or county-year proportion of households with broadband, was defined using 2017–2020 data from the American Community Survey. We used log-binomial and linear regression models and a difference-in-difference analytical approach to estimate the difference in the change in broadband presence and access from 2017 to 2020 between rural and urban counties. Results/Anticipated Results: Overall, broadband presence increased across the study period, where 66.82% of counties had broadband present in 2017 versus 92.57% in 2020. A major jump occurred from 2018 to 2019, where 64.96% of counties had broadband present in 2018 compared to 91.09% in 2019. Broadband access also rose, where the average proportion of households with broadband was 69.43% in 2017 and 78.24% in 2020. The increase in both broadband presence and access from 2017 to 2020 was larger in rural counties compared to urban counties. Specifically, the increase in the probability of having broadband present from 2017 to 2020 was 30% higher in rural compared to urban counties (95% CI: 1.24, 1.38). The increase in the proportion of households with broadband was 1.21% higher from 2017 to 2020 in rural compared to urban counties (95% CI: 0.004, 0.021). Discussion/Significance of Impact: While broadband presence and access both increased from 2017 to 2020, the observed increases were larger in rural compared to urban counties. Improvements in broadband access in the US are continuously needed to increase the use of telehealth and, subsequently, lessen rural/urban disparities in healthcare access and disease detection.

Type
Biostatistics, Epidemiology, and Research Design
Creative Commons
Creative Common License - CCCreative Common License - BYCreative Common License - NCCreative Common License - ND
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
Copyright
© The Author(s), 2025. The Association for Clinical and Translational Science