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Background

Broadband is defined as high-speed internet access that is always available and faster than the traditional dial-up access. Access to broadband has been recognized as a “super-determinant” by the Federal Communications Commission (FCC), the American Public Health Association (APHA), and other organizations. Access to broadband has been shown to affect many aspects of our life, including healthcare access. As a result, the Internet Tax Freedom Act, which prevents state and local authorities from taxing Internet access, has been in effect for several years. Access to healthcare is a key determinant of health for people, especially for those living in rural areas where health services are limited. With the increasing use of telemedicine, access to broadband can play a key role in improving access to vital health services. Access to high speed internet will provide higher quality of care with lower cost through video consultation and remote patient monitoring. In many places, especially rural areas, despite increased broadband connectivity this service is currently not available at the speed required to enable innovation in the health care field.
The aim of this report is explore if there are statistically significant differences between residential fixed connections and mortality across census tracts in Washington State.

Methodology

Data on access to broadband for census tracts, ,in Washington State were gathered from the Federal Communications Commission (FCC) website. This link provides information on residential fixed high-speed connections with at least 10 Mbps downstream and at least code connections per 1,000 households 1 Mbps upstream per 1000 households. Census tracts were stratified into tracts with 600 or less residential fixed connections per 100,000 households (x<= 600), 600 to 800 residential fixed connections per 100,000 households (600 < x <= 800), and more than 800 residential fixed connections (x > 800) per 100,000 households.
We calculated age-adjusted mortality related to all-causes; cancer; heart disease; Alzheimer’s disease; unintentional injuries; chronic lower respiratory diseases; stroke; diabetes; suicide; chronic liver disease and cirrhosis; flu and pneumonia; and overdose. Mortality for years 2011-2015 came from Washington State Department of Health. The Kruskal–Wallis test was conducted to explore if there are statistically significant differences between residential fixed connections and mortality across census tracts in Washington State.

Results

The results of this report show that age-adjusted mortality related to all-causes; cancer; heart disease; unintentional injuries; chronic lower respiratory diseases; stroke; diabetes; suicide; chronic liver disease and cirrhosis; flu and pneumonia; and overdose was significantly lower in census tracts with more than 800 residential fixed connections per 1000 households compared to other census tracts. Age-adjusted mortality related to Alzheimer’s disease was significantly lower in census tracts with 600 or less residential fixed connections per 1000 households compared to other census tracts.

Select a disease to further explore the relatinship between mortality and access to Broadband
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Discussion

This report highlights the relationship between poor access to high speed internet and poor health outcomes in Washington State. Census Tracts with poor access to broadband services are experiencing significantly higher mortality rates. However, the FCC data on access to broadband is likely to overestimate access. At this point internet providers are required to submit lists of census blocks in which they can or do offer service to at least one location within the census block.
Broadband access has been shown to be a proxy for socio economic status and education level, which directly affects health outcomes. However, access to broadband has become such a basic and critical component of our daily life that improved access to this service and educating the population on how to benefit from it will likely have a direct impact on access to care and information, resulting in improved health outcomes.

References:

  • Federal Communications Commission, https://www.fcc.gov/
  • Washington State Department of Health, https://www.doh.wa.gov/DataandStatisticalReports/HealthStatistics/Death