Broadband deserts hinder telehealth access, especially in rural areas

Telehealth can significantly improve access to healthcare for those in underserved communities, but new research reveals that broadband access gaps are hindering telehealth.

Published in JAMA Health Forum, the study showed that rural residents are more likely to live in broadband deserts. These areas lack adequate access to broadband internet, which constrains their access to telehealth services. Lack of broadband access has long been a significant social determinant of health that hinders digital healthcare services, like telehealth.

Of 249.1 million people living in the 41 states included in the study, 11.9 million (4.8%) lived in broadband deserts. The majority (88.1%) of those living in a broadband desert were rural residents.

However, only 946,278 rural residents living in areas lacking ambulance and healthcare access had enough broadband to support telehealth services. This means that most rural residents lacked adequate broadband to overcome their healthcare access challenges.  

For the study, the researchers analyzed data from various sources, including data for ambulance and healthcare deserts for the period between September 2021 and February 2022, compiled from previous studies; broadband service areas from the Federal Communications Commission's 2024 Broadband Data Collection project; and the 2020 U.S. Census Demographic and Housing Characteristics.

In March 2024, the FCC increased the threshold for sufficient broadband speed from a minimum of 25/3 megabits per second to 100/20 Mbps. In the study, researchers defined broadband deserts as areas where broadband speeds were slower than 100/20 Mbps. They also defined ambulance deserts as areas where folks lived more than a 25-minute drive from an ambulance station, and healthcare deserts as areas that are more than a 30-minute drive from a healthcare facility.

Among U.S. regions, the West and the South had the highest proportions of rural residents living at the intersection of broadband, ambulance and healthcare deserts.

The study also found gaps between device ownership and broadband subscriptions. Most households (96.7%) owned a computing device, but a slightly lower proportion (91.7%) had a broadband subscription.

Further, households in rural areas were less likely to have a computing device, like a computer or mobile device, and a broadband subscription compared with those in urban areas. While about 96% of rural households had a computing device, only 88% had a device with broadband. This compares with approximately 98% of households in urban areas having a device and 93% having a device with broadband.

"While broadband availability and subscriptions are prerequisites for telehealth, its presence does not inherently guarantee use," the study authors wrote.  

"These findings suggest that while telehealth has the potential to mitigate gaps in accessing care, its actual impact remains contingent on overcoming a complex set of socioeconomic, health care practitioner and health system offerings, and behavioral barriers beyond mere physical connectivity."

Study authors suggest that federal and state initiatives are required to ensure that telehealth can close care access gaps. These could include targeted infrastructure investments and expanded reimbursement policies, and they should focus on areas with broadband, ambulance and healthcare deserts.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers healthcare IT and innovation, including artificial intelligence, digital healthcare, EHRs and interoperability.