Broadband penetration rates are considerably lower in the most rural counties, especially where access to primary care physicians and psychiatrists is inadequate, according to a study published in the Annals of Internal Medicine.

Coleman Drake, Ph.D., from the University of Pittsburgh, and colleagues examined broadband internet access among Americans with inadequate access to primary care physicians and psychiatrists. Broadband internet access was measured as the county-level fixed broadband penetration rate, defined as the percentage of the county's population with internet access at a download speed of at least 2 MB per second, sufficient to support video-based telehealth visits.

The researchers found that as counties became more rural, broadband penetration rates decreased, ranging from 96.0 percent in urban to 82.7 percent in rural to 59.9 percent in Counties with Extreme Access Considerations (CEAC). Relative to rural counties, in CEAC, there were decreases in adequate access to primary care physicians and psychiatrists. Counties with inadequate access to primary care physicians or psychiatrists generally had poorer broadband penetration rates within rurality categories. For example, the broadband penetration rate in CEAC was 62.4 and 38.6 percent if primary care physician access was adequate and inadequate, respectively. Likewise, the broadband penetration rate was 62.4 and 49.1 percent, respectively, in CEAC with adequate and inadequate psychiatrist access.

"Our findings suggest that inadequacies in broadband infrastructure have broader consequences than limited internet access," the authors write.

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