A study published this past week from the Joint Center for Political and Economic Studies found that expanding broadband access can help boost employment, incomes, education and healthcare in the Black rural South – but many households are unable to afford it or lack the option to subscribe at all.

The study, which was authored by Director of Technology Policy Dominique Harrison, examined 152 rural counties across 10 states with populations that are at least 35% African American.  

"Access to broadband is a problem in both metropolitan and rural areas, but efforts to close the digital divide often overlook the Black Rural South," wrote Harrison in the study.   

"Too often, national broadband conversations conflate rural with 'white' and point to affordability as the reason for racial disparities in broadband adoption in metropolitan areas. The discussions rarely examine the unique plight of Black residents of rural communities," Harrison pointed out.  

WHY IT MATTERS

As telehealth usage has spiked, advocates have pointed to the importance of ensuring that any measures to continue its advancement don't widen the existing digital divide.  

Unfortunately, as Harrison points out, Black residents of the rural South face disproportionate hurdles to connectivity.  

Across the United States, about 22% of Black people report lacking home access to the internet, compared with 18% of the population as a whole.   

But in the counties Harrison examined for the study, nearly 40% of Black people lack broadband access.  

"The lack of broadband infrastructure magnifies the structural racism that African American families experience in the Black Rural South," Harrison wrote. "Broadband is essential to education, job growth, economic prosperity, healthcare, and civic engagement."  

"Systemic policy changes must address racial disparities, digital inequality, and broadband connectivity," she added.  

Overall, about a quarter of residents in the counties studied lack the option to subscribe to high-speed broadband, compared with 8.8% of non-southern rural residents and 3.8% of all Americans. Even where broadband is available, many may be unable to afford it.  

Harrison noted, too, that these percentages may be an undercount: If broadband providers can serve a single customer in a census block, the Federal Communications Commission considers the entire census block as served.   

In the study, Harrison drilled down into the ways broadband could improve healthcare, noting that many counties lack physical access to hospitals or clinics.  

"Broadband connectivity is a social determinant of health in rural counties that lack local resources and services," she wrote. "Telemedicine can connect rural patients to medical specialists and specialty care not available in their local community and can also save money by diverting patients from more expensive care settings, which is particularly important for communities in poverty.  

"Telehealth can also help healthcare systems, HBCUs, organizations, and providers expand access to and improve rural healthcare quality by eliminating transportation challenges, lowering costs, and improving the quality of care," she added.  

Harrison outlined a number of policy recommendations for addressing broadband needs in the Black rural South:  

1. Establish a permanent, meaningful broadband program for lower-income households
2. Require broadband providers that receive Universal Service Funds to provide low-income households and high-cost-area consumers with an affordable option
3. Prioritize the Black rural South in federal broadband infrastructure investments
4. Prioritize Black rural South counties in southern states' recovery fund distributions
5. Launch a task force and create rules to prevent digital redlining
6. Prioritize federal funding for broadband projects developed by Historically Black Colleges and Universities
7. Invest in research to understand challenges and to continuously improve broadband access
8. Update the federal definition of “high-speed” broadband
9. Prohibit state governments from inhibiting local broadband networks
10. Increase federal coordination and focus on the Black rural South

"Our economic recovery depends on equitable, targeted policy solutions for all Americans, including rural Black communities," wrote Harrison.  

THE LARGER TREND  

Broadband expansion has been a frequent priority for legislators when it comes to policy-making amidst COVID-19, particularly where rural communities are concerned.  

But as experts noted at HIMSS21 this summer, addressing issues of equity when it comes to technology and healthcare will require a wide-ranging, long-term effort.  

"None of us can solve it all alone," said Dr. Ivor Horn, director of health equity and product inclusion at Google. "We all have to work together to achieve this goal."  

ON THE RECORD  

"New and inclusive federal solutions must make high-speed broadband affordable and result in the build-out of high speed, quality broadband infrastructure in the Black Rural South," wrote Harrison. "If as the White House has stated, the country must 'build back better,' the Black Rural South should be a priority."

Kat Jercich is senior editor of Healthcare IT News.
Twitter: @kjercich
Email: kjercich@himss.org
Healthcare IT News is a HIMSS Media publication.