Broadband initiatives for unserved and underserved areas

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Disparity Rating  
Disparity rating: Potential to decrease disparities

Strategies with this rating have the potential to decrease or eliminate disparities between subgroups. Rating is suggested by evidence, expert opinion or strategy design.

Health Factors  
Date last updated

Broadband is high-speed internet access that is faster than dial-up and ready for use immediately. Broadband speed and bandwidth vary1 but can be measured as download/upload speed in megabits per second (Mbps)2. Broadband transmission technologies include digital subscriber line (DSL), cable modem, fiber, wireless, satellite, and broadband over powerlines (BPL)3. Comprehensive broadband initiatives consider geographic, social, and economic factors to improve broadband infrastructure and increase broadband adoption, including the cost of internet service, devices, and digital literacy skills4. There are many ways for states to increase broadband availability and adoption in unserved and underserved areas, such as grants and loans to internet service providers, nonprofit utility cooperatives, and local governments5. Definitions of unserved and underserved areas vary by state6. In the U.S., approximately 24 million people live in digital deserts without broadband access, including approximately 19 million people in rural areas and 1.4 million people living on Tribal lands7.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased broadband adoption

  • Increased labor force participation

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased access to care

  • Increased access to mental health services

  • Increased financial stability

  • Improved health outcomes

  • Improved mental health

  • Improved well-being

  • Increased social connectedness

What does the research say about effectiveness?

There is some evidence that broadband initiatives for unserved and underserved areas can have positive economic outcomes, through increased broadband adoption and labor market participation, with larger effects for people living in rural areas8, 9, 10. Additional evidence is needed to confirm effects.

A review of international studies on broadband’s impacts on rural development finds that broadband appears to have small but definite positive effects, particularly on income and employment in rural areas8. Moving to higher speed broadband (100 Mbps) may have a greater positive effect on employment rates than lower speeds9. Increased broadband access may also increase employment among women, especially those with children and who have at least some college education11.

Broadband initiatives for unserved and underserved areas are a suggested strategy to support equitable access to health-promoting services, including telemedicine, online social services, distance education, online grocery orders, ecommerce, online social support, civic engagement opportunities, the ability to search for jobs and file for unemployment benefits, and more3, 4, 7, 12, 13. Increased broadband access is associated with improved health outcomes, including reduced rates of diabetes diagnoses and smoking and increased consumption of fruits and vegetables14. One study associates broadband access with increased telemedicine use in rural counties15. For adults in urban settings, limited neighborhood broadband internet access is associated with lower likelihood of using hospitals’ patient portals16. Another study finds broadband expansion is associated with modest improvements to health outcomes, as individuals can choose higher-quality health care providers17.

Broadband access initiatives are often part of multi-component efforts to improve broadband’s functionality, affordability, and use. Such initiatives can include adding fiber, high-capacity fixed wireless to the home, and affordable high-speed mobile to improve connection options in underserved areas18. Providing access to low-cost internet is the necessary first step for increasing adoption and meaningful broadband use. Initiatives can also promote digital literacy by offering digital software and hardware training at convenient locations for community members, supporting the availability of low-cost computers and technical support, and establishing public access computing centers19.

State policy can support or inhibit affordable broadband expansion. State-level funding programs have a positive significant impact on general and fiber broadband availability while municipal or cooperative restrictions have a negative impact on availability, in urban and rural areas20. An analysis of state-level policies regulating municipally owned networks finds that such policies may erect significant barriers to entry and recommends public-private partnership in building networks and offering service21. One comparison finds municipally-owned networks offering fiber-to-the-home service had lower pricing when the service costs and fees were averaged over four years, compared to private competitors22. Another analysis focused on the economic impacts of constructing and maintaining 70 miles of new broadband infrastructure in Michigan’s upper peninsula found broad benefits across the region, state, and greater U.S., including an estimated $18 million (USD) increase in sales or outputs, a $10.4 million increase in GDP, and a $4.9 million increase in personal income23.

How could this strategy advance health equity? This strategy is rated potential to decrease disparities: supported by some evidence.

There is some evidence that broadband initiatives for unserved and underserved areas have the potential to decrease economic disparities between rural areas and other regions8. Whether increased broadband access decreases disparities between rural communities may depend on the existing conditions in communities when broadband is expanded12 and what broadband speed is made available9. Additional evidence is needed to confirm effects.

A study from France finds that expanding ultrafast broadband access has positive effects on new business startups in rural communities with favorable starting conditions, i.e., a good economic climate, natural amenities like green spaces or desirable topography (e.g., mountains), and a higher share of the population that’s younger and highly skilled or educated. However, expansions appear to have little or no impact in most rural areas without these conditions, leading experts to caution that broadband alone may increase disparities in regional economic growth12. Experts note, however, that broadband should still be expanded for its benefits to other determinants of health12.

Broadband access is considered a super determinant of health7 because disparities in access to broadband exacerbate economic, social, education, and health inequalities3, 4, 13, 56. Surveys identify significant disparities in broadband access across the U.S. by age, gender, income, and geography; as well as in overall internet access, including dial-up and cell phone access, by race and ethnicity, education, age, gender, and income57. Residential broadband access can increase labor force participation for women, with the largest increase among college-educated women with children; increased labor force participation is most likely through internet access use for telework11.

Experts suggest that broadband infrastructure development and maintenance can provide long-term jobs for individuals without college or advanced degrees. Recommendations for communities include establishing high-quality credentialing and training programs to provide a pathway for individuals to enter the broadband industry, as well as incentivizing employers to recruit, train, and hire diverse and underrepresented employees58.

A strong digital divide also exists between urban and suburban areas with high incomes and rural and urban areas with low incomes, suggesting household income may affect access more than geography3, 4, 59. Nationally, households earning less than $20,000 have a broadband adoption rate of 62%, lower than the average state broadband adoption rate of 84%. State by state broadband adoption rates vary; states with the lowest adoption also have populations with the lowest median incomes, many communities of color, and high percentages of their populations living in rural areas. In general, the average majority white neighborhood has a broadband adoption rate of almost 84%, while the average majority Black neighborhood has a broadband adoption rate of just over 67%60.

Studies disagree as to whether supply or demand explanations better account for differences in broadband adoption rates between urban and rural areas8. The digital divide appears to include a connectivity gap, where rural users experience lower speed internet connections than more urban users61. Residents of Tribal lands report predominantly using smart phones to access the internet, as well as using public Wi-Fi or by going to the home of a friend or relative18. Some rural-based occupations may also experience disparities in access. A North Carolina-based study describes disparities in broadband access for migrant and seasonal farmworkers, likely because business owners decide wired broadband infrastructure is too expensive to install, even if internet service is available; a shorter-term solution, such as providing hotspots and education on how to use them, may decrease disparities in internet access62.

In some areas, internet service may be widely available; however, the affordability of service and devices, device maintenance, and skills for older residents and those with lower incomes remain challenges to meaningful broadband adoption. Discounted internet service plans from private providers may also be underutilized by eligible community members63. In communities less well-positioned to take advantage of broadband access, experts recommend pairing broadband expansion with other efforts, such as adoption initiatives which highlight broadband’s benefits, digital literacy programs, and education initiatives to support new and existing businesses, including creating accessible and easy to use websites12, 64. Experts also suggest collaborating with university extension programs, churches, libraries, nonprofits, and other groups with strong on-the-ground networks2. Prioritizing equity and universal access in initiatives can limit the negative effects of competing political, social, and commercial priorities on implementation efforts64.

What is the relevant historical background?

The Telecommunications Act of 1996 supported some early progress in expanding access to internet services in rural and urban areas, aiming to support a competitive market of service providers offering lower prices. However, this and more recent federal initiatives (Broadband Technology Opportunities Program, or BTOP, begun in 2009) appear to benefit urban areas and near-metro rural areas more than rural areas at greater distances from cities. Challenges in reaching the most rural areas include technology (for example, weakened connection signal strength with DSL) and the influence of large service providers on laws and regulations, which has contributed to states prohibiting municipal broadband providers or cooperatives8.

As of 2022, the majority of people in the U.S. without broadband access are rural residents. Additionally, it appears that 47 million people have only one service provider option, and 33 million can only access dial-up or DSL connections.8.

Equity Considerations
  • Is high-speed broadband available in your community? Have assessments been done to determine if households are subscribed? Can households afford the broadband or other internet services available to them?
  • What policies exist in your community or state that support or prohibit expanding broadband or other internet service provider options and affordable subscriptions?
  • If broadband is accessible and affordable, are there other barriers to individuals’ meaningful use? What initiatives might pair well with expanding broadband and internet access, to ensure groups often left out, such as older individuals and those with less education, can benefit from access?
  • What types of jobs might broadband development provide in your community, particularly for individuals without college or advanced degrees? Are credentialing and training programs available, to serve as pathways to those jobs? What might incentivize employers to hire locally?
Implementation Examples

At the federal level, the Affordable Connectivity Program reduces the cost of broadband services and devices, like laptops, for eligible households, with greater discounts for households on Tribal lands24. The program was authorized for over $14 billion USD as part of the Infrastructure Investment and Jobs Act in 202224 and appears to be a success25, 26 with over 19 million households subscribed as of June 2023 and substantial increases in household wireline broadband between 2019 and 2021. However, many eligible households are still not aware of the program27 and funding is expected to run out in 202428, which could endanger broadband access for subscribed households if the program is not continued. The Broadband Equity Access and Deployment (BEAD) Program is another multi-billion dollar source of federal funding for broadband planning, infrastructure, and adoption efforts in all 50 states, Washington D.C., and U.S. territories29. The Digital Equity Act (DEA) also provides $2.75 billion USD across three grant programs promoting digital equity and inclusion, to ensure communities have the skills, technology, and capacity to use broadband meaningfully30.

As of 2023, more than half of states have an active task force, commission, or other authority to support broadband development and use. These authorities can provide input on state frameworks or plans, promote public-private sector participation, create maps to determine which areas are unserved or underserved for broadband access, administer or assisting with funding programs, and support digital literacy and adoption efforts31. The Purdue Center for Regional Development describes models for broadband expansion, including municipally owned broadband, public-private partnerships, private sector efforts, and co-operative models, each with different costs and benefits2. As of 2022, 44 percent of states have preemption laws or other barriers to municipal broadband; though some states have repealed their laws, such as Colorado in 202332, 33. The National Association of Counties (NACo) supports the Community Broadband Act which was re-introduced in Congress in 2023. The act would override state-level preemptions and allow counties or other public providers in any state to provide broadband services, while also preventing discrimination against private sector providers34.

Many states use broadband service maps from the Federal Communications Commission (FCC) to inform broadband expansion efforts35, though additional data is often considered. The FCC National Broadband Map tool shows residential coverage for fixed and mobile broadband36. In addition, the FCC’s Mapping Broadband Health in America tool allows users to easily generate maps to explore possible relationships between broadband and health at the county, state, and national level37. For example, a sample data visualization shows the intersection between rural fixed broadband access and maternal mortality38. The federal Broadband Data Task Force maintains and updates the FCC broadband data and mapping tools39. The FCC also maintains the Lifeline Program for Low-Income Consumers, which offers eligible households a monthly discount on broadband service and support for first-time connection charges40. Additional funding is available to households on specific Tribal lands40, 41.

Several states also have cooperatives or networks to promote middle- and last-mile broadband expansion, with a focus on expanding service to underserved or unserved areas and providing service to community anchor institutions like libraries. These include the Illinois Century Network, Northwest Open Access Network (Washington), Mid-Atlantic Broadband Cooperative (Virginia), Tidal Network (Southeast Alaska)42, and Project THOR in Colorado, which is owned by local governments and operated by a local broadband provider43, 44. Some cities have developed community broadband networks. Chattanooga has a high-speed, community-wide fiber optic network that provides high speed internet access to residents throughout the city45. A study of the network finds its value exceeds the project cost by more than $2.2 billion dollars in terms of economic development, job creation, reduced carbon emissions and more46.

Non-profit organizations can support efforts to increase broadband access in underserved areas around the country. For example, in the Greater Cleveland area, DigitalC is working to increase broadband infrastructure in underserved residential areas, provide affordable services and devices, and improve digital literacy among residents addressing basic to intermediate skills for both hardware and software47. As of 2023, the Cleveland City Council had secured $20 million in America Rescue Plan Act (ARPA) funding for Digital C to serve as vendor in development of a citywide broadband network47.

Minnesota is one of the states at the forefront of innovative broadband development. The Minnesota Office of Broadband Development contracts with an independent organization, Connected Nation48, to develop broadband service maps, including for Tribal areas49. The office also offers resources for digital inclusion, to help with the cost of broadband services and devices50. The state is on track to meet broadband speed goals exceeding the federal standard, and 88% of Minnesotans already have access to 100/20 Mbps51. To further support these efforts, the Minnesota Office of Broadband Development conducts crowd-sourced speed tests52. A recent digital equity community needs assessment for the Minnesota Department of Education recommends funding a digital navigator program at community-based organizations, libraries, and other trusted organizations to provide community members with one-on-one digital literacy instruction53.

The annual Indigenous Connectivity Summit brings together community network managers and operators, Indigenous-owned internet service providers, community members, researchers, policy makers, and leaders to address the need for affordable, high-quality, and sustainable internet access for Alaska Native, American Indian, Inuit, Native Hawaiian, First Nations, and Métis communities54. The National Telecommunications and Information Administration operates the Tribal Broadband Connectivity Program, a $1 billion program to increase broadband access on Tribal lands that supports telehealth, distance learning, broadband affordability, and digital inclusion55.

Implementation Resources

Resources with a focus on equity.

FCC-Mapping 2023 - Federal Communications Commission (FCC). Mapping broadband health in America. Updated October 24, 2023.

BroadbandUSA-SBLN - BroadbandUSA, National Telecommunications and Information Administration. State Broadband Leaders Network (SBLN) and state broadband programs.

BroadbandUSA-TBCP - BroadbandUSA, National Telecommunications and Information Administration. Tribal Broadband Connectivity Program (TBCP).

Pew-Broadband policy map 2021 - The Pew Charitable Trusts (Pew). State broadband policy explorer: Laws governing high-speed internet access. 2021.

NACo-Broadband 2021 - National Association of Counties (NACo). Broadband Task Force: High-speed internet is essential for all counties. July 2021.

NDIA-Digital navigators - National Digital Inclusion Alliance (NDIA). The digital navigator model.

FCC-Lifeline Consumers - Federal Communications Commission (FCC). Consumer Guides. Lifeline support for affordable communications. Last updated/reviewed June 29, 2021.

Purdue-Gallardo 2019 - Gallardo R, St. Germain B. Southeastern Indiana Regional Planning Commission: State of broadband. Purdue Center for Regional Development. 2019.

Footnotes

* Journal subscription may be required for access.

1 FCC-Speed - Federal Communications Commission (FCC). Consumer Guides. Broadband speed guide.

2 Purdue-Gallardo 2019 - Gallardo R, St. Germain B. Southeastern Indiana Regional Planning Commission: State of broadband. Purdue Center for Regional Development. 2019.

3 CRS-Rachfal 2020 - Rachfal CL. State broadband initiatives: Selected state and local approaches as potential models for federal initiatives to address the digital divide. Congressional Research Service (CRS) R46307; 2020.

4 CRS-Kruger 2019 - Kruger LG, Gilroy AA. Broadband internet access and the digital divide: Federal assistance programs. Congressional Research Service (CRS) RL30719; 2019.

5 Pew-Broadband 2019 - Pew Research Center (Pew). How states support broadband projects: Lawmakers use a variety of funding sources and mechanisms to meet expansion goals. 2019:1-6.

6 Pew-Urahn 2020 - Urahn SK, Irwin M, Stauffer A, et al. How states are expanding broadband access. The Pew Charitable Trusts (Pew); 2020.

7 Bauerly 2019 - Bauerly BC, McCord RF, Hulkower R, Pepin D. Broadband access as a public health issue: The role of law in expanding broadband access and connecting underserved communities for better health outcomes. Journal of Law, Medicine and Ethics. 2019;47(2S):39-42.

8 Mack 2023 - Mack EA, Loveridge S, Keene T, Mann J. A review of the literature about broadband internet connections and rural development (1995-2022). International Regional Science Review. 2023:1-62.

9 Lobo 2020a - Lobo BJ, Alam MR, Whitacre BE. Broadband speed and unemployment rates: Data and measurement issues. Telecommunications Policy. 2020;44(1):101829.

10 Atasoy 2013 - Atasoy H. The effects of broadband internet expansion on labor market outcomes. Industrial and Labor Relations Review. 2013;66(2):315-345.

11 Dettling 2017 - Dettling LJ. Broadband in the labor market: The impact of residential high-speed internet on married women’s labor force participation. Industrial and Labor Relations Review. 2017;70(2):451-482.

12 Duvivier 2022 - Duvivier C, Bussière C. The contingent nature of broadband as an engine for business startups in rural areas. Journal of Regional Science. 2022;62(5):1329-1357.

13 Benda 2020 - Benda NC, Veinot TC, Sieck CJ, Ancker JS. Broadband internet access is a social determinant of health! American Journal of Public Health. 2020;110(8):1123-1125.

14 Whitacre 2014 - Whitacre B, Brooks L. Do broadband adoption rates impact a community’s health? Behaviour and Information Technology. 2014;33(7):767-779.

15 Wilcock 2019 - Wilcock AD, Rose S, Busch AB, et al. Association between broadband internet availability and telemedicine use. JAMA Internal Medicine. 2019;179(11):1580-1582.

16 Perzynski 2017 - Perzynski AT, Roach MJ, Shick S, et al. Patient portals and broadband internet inequality. Journal of the American Medical Informatics Association. 2017;24(5):927-932.

17 NBER-Parys 2023 - Parys JV, Brown ZY. Broadband internet access and health outcomes: Patient and provider responses in Medicare. National Bureau of Economic Research (NBER). 2023: Working Paper 31579.

18 AIPI-Howard 2019 - Howard B, Morris T. Tribal technology assessment: The state of internet service on Tribal lands. American Indian Policy Institute, Arizona State University; 2019.

19 Benton-Rhinesmith 2016 - Rhinesmith C, Barton A. Digital inclusion and meaningful broadband adoption initiatives. Wilmette, IL: Benton Institute for Broadband & Society; 2016.

20 Whitacre 2020 - Whitacre B, Gallardo R. State broadband policy: Impacts on availability. Telecommunications Policy. 2020;44(9):102025.

21 Landgraf 2020 - Landgraf SW. Entry threats from municipal broadband Internet and impacts on private provider quality. Information Economics and Policy. 2020;52.

22 Talbot 2018 - Talbot D, Hessekiel K, Kehl D. Community-owned fiber networks: Value leaders in America. Cambridge: Berkman Klein Center for Internet & Society Research Publication; 2018.

23 Upjohn-Robey 2021 - Robey J. Construction of broadband in the eastern Upper Peninsula of Michigan. Kalamazoo, MI: W.E. Upjohn Institute for Employment Research; 2021.

24 FCC-ACP - Federal Communications Commission (FCC). Affordable Connectivity Program.

25 BB-Layton 2023 - Layton R. Benefits of ACP extend beyond people who subscribe to broadband. Broadband Breakfast (BB). 2023.

26 Benton-Horrigan 2022 - Horrigan JB. Broadband benefit programs are helping to close the digital divide. Wilmette, IL: Benton Institute for Broadband & Society; 2022.

27 SRDC-Whitacre 2023 - Whitacre B, Gallardo R. Broadband availability vs. adoption: Which matters more for economic development? Mississippi State: Southern Rural Development Center (SRDC); 2023.

28 ILR-ACP Dashboard - Institute for Local Self-Reliance. Affordable Connectivity Program Dashboard.

29 BroadbandUSA-BEAD - BroadbandUSA, National Telecommunications and Information Administration. Broadband Equity Access and Deployment (BEAD) Program.

30 BroadbandUSA-DEA - BroadbandUSA, National Telecommunications and Information Administration. Digital Equity Act Programs.

31 NCSL-State broadband - National Conference of State Legislatures (NCSL). State broadband task forces, commissions or authorities and other broadband resources. Updated June 2020.

32 LawAtlas-State preemption - LawAtlas. State preemption laws in 12 domains.

33 NLC-Bauer 2023 - Bauer J, Rochford P. Understanding opportunities for local broadband authority. National League of Cities (NLC).

34 NACo-Community broadband - National Association of Counties (NACo). Support Community Broadband Act. May 2023.

35 FCC-Maps - Federal Communications Commission (FCC). Reports and Research: Maps.

36 FCC-National Map - Federal Communications Commission (FCC). FCC National Broadband Map.

37 FCC-Mapping 2023 - Federal Communications Commission (FCC). Mapping broadband health in America. Updated October 24, 2023.

38 FCC-Broadband health - Federal Communications Commission (FCC). FCC Initiatives: Connect2HealthFCC. Mapping Broadband Health in America platform.

39 FCC-Broadband Task Force - Federal Communications Commission (FCC). Broadband Data Task Force.

40 FCC-Lifeline Consumers - Federal Communications Commission (FCC). Consumer Guides. Lifeline support for affordable communications. Last updated/reviewed June 29, 2021.

41 USAC-Tribal lands - Universal Service Administrative Co (USAC). Lifeline support: Additional support for Tribal lands.

42 Tidal Net - Tidal Network. Connectivity solutions for Southeast Alaska’s remote communities.

43 Benton-Arnold 2020 - Arnold J, Sallet J. If we build it, will they come? Lessons from open-access, middle-mile networks. Evanston, IL: Benton Institute for Broadband & Society; 2020.

44 NWCCOG-Project THOR - Northwest Colorado Council of Governments (NWCCOG). Project THOR.

45 CN-Gonsalves 2021 - Gonsalves S. Study finds Chattanooga fiber networks 10-year ROI: $2.69 billion. Community Networks (CN). February 1, 2021.

46 Lobo 2020b - Lobo BJ. Ten years of fiber optic and smart grid infrastructure in Hamilton County, Tennessee. 2020.

47 DigitalC - DigitalC. DigitalC, a non-profit empowering Greater Cleveland to achieve success through technology, innovation, and connected community.

48 Connected Nation-Mapping - Connected Nation. What we do for you: Mapping & analysis.

49 MN OBD-Maps - Minnesota Office of Broadband Development (MN OBD). Maps and data.

50 MN OBD-Inclusion - Minnesota Office of Broadband Development (MN OBD). Digital inclusion.

51 MN Broadband Task Force 2020 - Minnesota (MN) Broadband Task Force. Annual report of the Governor’s Task Force on Broadband. 2020.

52 MN OBD-Speed - Minnesota Department of Employment and Economic Development, Office of Broadband Development (OBD). Broadband speed tests.

53 Literacy MN-Digital equity 2020 - Literacy Minnesota (MN). Digital equity community needs assessment report. 2020.

54 IS-Connectivity summit - Internet Society (IS). Indigenous Connectivity Summit 2020.

55 BroadbandUSA-TBCP - BroadbandUSA, National Telecommunications and Information Administration. Tribal Broadband Connectivity Program (TBCP).

56 McCall 2022 - McCall T, Asuzu K, Oladele CR, Leung TI, Wang KH. A socio-ecological approach to addressing digital redlining in the United States: A call to action for health equity. Frontiers in Digital Health. 2022;4:897250.

57 Greenberg-Worisek 2019 - Greenberg-Worisek AJ, Kurani S, Finney Rutten LJ, et al. Tracking Healthy People 2020 internet, broadband, and mobile device access goals: An update using data from the Health Information National Trends Survey. Journal of Medical Internet Research. 2019;21(6):1-10.

58 Brookings-Lee 2022 - Lee NT, Tavernier B. Reimagining the broadband technology workforce. Washington, D.C.: Brookings Institution; 2022.

59 UW Ext-Conroy 2021 - Conroy T, Deller S, Kures M, et al. Broadband and the Wisconsin economy. University of Wisconsin-Madison Extension. Study Series No. 7. 2021.

60 Brookings-Tomer 2020 - Tomer A, Fishbane L, Siefer A, Ballahan B. Digital prosperity: How broadband can deliver health and equity to all communities. Washington, D.C.: Metropolitan Policy Program, Brookings Institution; 2020.

61 Whitacre 2017 - Whitacre BE, Wheeler D, Landgraf C. What can the national broadband map tell us about the health care connectivity gap? Journal of Rural Health. 2017;33(3):284-289.

62 Cofie 2022 - Cofie LE, Rivera ND, Santillán-Deras JR, Knox G, Lee JGL. Digital inclusion for farmworkers in a pandemic: The North Carolina Farmworker Health Program internet connectivity project, 2020-2021. American Journal of Public Health. 2022;112:1551-1555.

63 CTC-Cambridge 2021 - Columbia Telecommunications Corporation (CTC). Digital equity in Cambridge: Data and strategic recommendations. Kensington, MD: CTC Technology & Energy, for the City of Cambridge, MA; March 2021.

64 Freeman 2019 - Freeman T, Fisher M, Baum F, Friel S. Healthy infrastructure: Australian National Broadband Network policy implementation and its importance to health equity. Information Communication and Society. 2019;22(10):1414-1431.