One in three Americans does not have a broadband connection, according to a new report from the NPD Group. This means that about 100 million people in the U.S. can’t benefit from telehealth and other digital health connections that can bolster self-care, home care, and lower cost care.

Most of these folks in the broadband-digital divide live in rural America/

“The so-called digital divide, between those that can or cannot make the best use of the Internet, can be clearly felt in rural markets where the lack of broadband impacts everything from entertainment to the educational system,” Eddie Hold, President of NPD Connected Intelligence, was quoted in NPD’s discussion of the statistic.

The map from NPD’s research on Rural America and Technology shows the greatest-broadband deficits are in the “greener” states: these include North Dakota and Michigan’s Upper Peninsula where less than 30% of the states’ citizens have broadband; followed by South Dakota, Mississippi and Alabama, with 30-39% of people having broadband; and then states with 40-49% broadband penetration including Maine, New Hampshire, West Virginia, Kentucky, Tennessee, and Arkansas.

Greatest broadband connectivity is found in Washington State, California, New York, New Jersey, and Delaware.

Health Populi’s Hot Points:  Without broadband, a person cannot seek employment, access education, connect to people in an emergency, quickly find a ride, or access telehealth at home, at work, or when out-of-town.

Increasingly, “home care” is being re-invented through the internet cloud, using digital health apps and tools integrating data to populate our electronic medical records and personal data files that we want to curate for our own health and wellness.

The first five layers of the triangle, from the tip southward, illustrate Maslow’s Hierarchy of Needs — from the bottom up, physical needs like food, shelter and water, on up through our safety, loving connections, self-esteem, and personal actualization and aspiration.

Below our physical needs are two to add to the social determinants of health — Wi-Fi connectivity (broadband), and battery power.

I came to understand this concept personally and viscerally when on an airplane grounded at the Los Angeles Airport a few years ago. The plane was stuck on the ground, with myself and fellow passengers on-board, due to a shooter in the airport.

I had brought on-board my mobile phone, fully powered up and housed in a Mophie battery case (which had about eight hours of power charged), a large bottle of water, and portable protein.

While sitting on the tarmac on the plane, I was able to access my Twitter app @HealthyThinker and communicate with people — first, loved ones and my social network communities, and then a reporter from the LA Times who found me on my twitter feed and hashtag #LAAirport and we had a twitter-enabled conversation about what was happening from my point-of-view on the air strip.

Bolstering my assertion that Wi-Fi (and battery power) are social determinants, here’s another view on security, phone’s battery life and Wi-Fi baked into Maslow’s Hierarchy published last week in The Guardian on how these factors play into life in Nigeria these days.

I also discuss this in my book, HealthConsuming, in the chapter, “ZIP Codes, Genetic Codes, Food and Health.” For more on broadband as an SDoH, here’s additional evidence.

Finally, AMIA, the medical informatics advocacy group, has endorsed broadband as an SDoH and attested that to the FCC.

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