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Volume 16, Number 10
In May 2017, the American Medical Informatics Association urged the Federal Communications Commission (FCC) to consider broadband internet access (BIA) to be a social determinant of health in any future FCC policies and programs. The basis for this argument was that BIA has become a core component of life in the developed world, including in many ways that impact health.
This argument made just three years ago has become crystal clear in the face of the coronavirus pandemic. An editorial published in the August 2020 issue of the American Journal of Public Health highlights how BIA needs to be regarded as an important social determinant of health because of its influence on other established social determinants of health. Following are several examples that substantiate this position.
Almost instantaneously, the COVID-19 pandemic moved telehealth from an emerging development in healthcare to an overnight reality. Given that a substantial proportion of ambulatory care services are now provided through video visits, persons lacking BIA face an important obstacle in having access to healthcare.
Online grocery ordering has become routine for many, and is especially important for persons whose health status makes them particularly vulnerable in the pandemic. BIA is essential for utilizing this service.
Educational attainment and socioeconomic status have well-established connections to health status. While online education had become increasingly prevalent prior to the pandemic, during the pandemic BIA has become vital for engagement in education from elementary school through all levels of higher education. Similarly, BIA is critical for obtaining information about job openings, and is increasingly necessary for completing employment applications and virtual interviews.
Social distancing, more accurately described as physical distancing, is a crucial aspect of mitigation efforts to reduce the spread of COVID-19. Given that social relationships and interactions have important health benefits, and loneliness is an important risk factor for morbidity and mortality, BIA is a lifeline for many persons who otherwise would be more isolated from important individuals in their lives.
Access to electricity and clean water are commonly considered necessary utilities, whereas broadband internet access has typically been considered a useful but not vital resource. The pandemic has certainly highlighted frustrations associated with poor network connections among those who have some form of internet access, but the absence of BIA has become another important contributor to health disparities in our country. It is therefore appropriate that broadband internet access be recognized as a public health priority.
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