social determinants of health

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The Last Train - Episode 564 of the Community Broadband Bits Podcast

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We're more than 15 years and a hundred billion dollars into the alphabet soup of federal broadband infrastructure subsidy programs, and millions upon millions of households are stuck on deteriorating connections and capacity-constrained technologies. This week on the podcast, Christopher is joined by Jonathan Chambers, partner at Conexon, to talk about how the BEAD program is our last chance. And to make sure we get it right, we have to grapple with the array of long-standing failures - purposeful and not - that have gotten us to this point: the regulatory capture of the FCC, the willful ignorance of bad data collection and mapping, the acceptance of disingenuous "technology neutral" arguments, turning a blind eye to the imbalance in service and cost between our cities and rural expanses, and pretending that not every households in the country can have a first-class, affordable, reliable Internet connection.

This show is 40 minutes long and can be played on this page or via Apple Podcasts or the tool of your choice using this feed. 

Transcript below.

We want your feedback and suggestions for the show-please e-mail us or leave a comment below.

Listen to other episodes here or view all episodes in our index. See other podcasts from the Institute for Local Self-Reliance here.

Thanks to Arne Huseby for the music. The song is Warm Duck Shuffle and is licensed under a Creative Commons Attribution (3.0) license.

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Increased Wellness and Economic Return of Universal Broadband Infrastructure: A Telehealth Case Study of Ten Southern Rural Counties

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In a new report, published in partnership with the Southern Rural Black Women’s Initiative (SRBWI), the Institute for Local Self-Reliance (ILSR) Community Broadband Networks Initiative examines the link between high-speed Internet infrastructure, access to healthcare, and the economic implications involved.

The report –“Increased Wellness and Economic Return of Universal Broadband Infrastructure: A Telehealth Case Study of Ten Southern Rural Counties” has particular relevance for those living in rural broadband deserts as it details how universal, affordable, broadband infrastructure would return $43 million per year using telehealth across 10 counties in the Black Belt of Alabama, Georgia, and Mississippi. Read Increased Wellness and Economic Return of Universal Broadband Infrastructure: A Telehealth Case Study of Ten Southern Rural Counties [pdf].

It explains how robust broadband infrastructure could pay for itself in short order and open up untold access to healthcare, educational opportunities, economic development, community engagement, and other benefits along the way. This issue is particularly relevant today, because the BEAD program represents a once-in-a-generation investment in broadband infrastructure, larger than any other federal grant program many times over. While it will solve the issue of access to infrastructure for most rural households, we have significant concerns about affordability - BEAD will lead to new connections, but states have wide latitude as to which ISPs get those funds to build new connections. The national monopolies have a long history of charging more to exactly the communities that can’t pay as much, leaving many households out. The report argues that electric cooperatives offer better and more locally accountable paths to universal, affordable service.

Drawing on academic scholarship and existing telehealth programs at hospitals around the country, the report focuses on an assortment of chronic health ailments plaguing those counties, such as diabetes, chronic respiratory disease (including asthma, chronic obstructive pulmonary disease, emphysema, heart disease, heart failure, cancer, obesity, and mental health and then demonstrates the benefits that could come from effective telehealth interventions for each.

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Chattanooga Coalition Tackling Internet Access, Devices, and Healthcare in Neighborhood Project

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A recently announced $610,000 grant award from the Tennessee Valley Authority to a partnership in Chattanooga, Tennessee will fund a pilot project to fund a set of holistic interventions in the Orchard Knob neighborhood to create healthier, more cost-efficient, better-connected homes for 1,000 residents.

The initiative, driven by a coalition made up of the Enterprise Center, EPB Fiber, Parkridge Health System, Habitat for Humanity, Tech Goes Home, and the Orchard Knob Neighborhood Association, aims to tackling an array of social determinants of health all at once. From The Chattanoogan:

Together, the partners plan to simultaneously invest in infrastructure and test new strategies for improving social determinants of health and quality of life of residents within a historically underserved neighborhood. Ultimately, the program in Orchard Knob will serve as a model for other communities across the Tennessee Valley.

It's happening as a result of funds contributed by the TVA's Connected Communities initiative, which aims to help "communities within the Valley leverage tech- and data-driven solutions to improve residents’ lives, deliver environmental benefits and scale economic opportunities." So far, these include projects like outfitting the Cheatham County School District with a solar array and battery backup, technology upgrades at more than a dozen Knoxville Recreation Centers, and improved connectivity at public housing sites in Murfreesboro.

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Study: Lack of Internet Access Leads to Increased Covid-19 Mortality Rates in Rural, Suburban, and Urban Communities

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Two decades into the twenty-first century, it still feels a little strange to justify all of the obvious ways that Internet access serves as a key pillar among the social determinants of health (SDOH) that govern our individual and collective wellbeing. The concept itself is at least two hundred years old: a German pathologist named Rudolph Virchow is often quoted as saying in the late 1840s, in response to the privation he saw in the run-up to the 1848 revolutions, that “medicine is a social science and politics is nothing else but medicine on a large scale.” 

Our modern framing of the problem comes in large part from the World Health Organization, which in the preamble to its 1946 constitution wrote that “health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” In 2020, the FCC has called broadband access a “super social determinant of health” in 2020, precisely because it serves as a gateway to all of the other elements of life that foster healthiness and wellbeing, from access to education, information, better food, economic opportunity, and socialization. 

But a recent study published to the JAMA Open Network makes the connection even more explicit. In it, a team of researchers at The Center for Spatial Data Science at the University of Chicago show that a lack of Internet access has been strongly correlated with higher Covid-19 mortality rates across every type of household and in rural, suburban, and urban areas alike. 

Internet Access Most Strongly Correlated with Covid-19 Mortality Rates

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