A year and a half ago I wrote about Blue Zones, areas of the world where people outlive most others. The Kaiser Family Foundation coined a new term: Dead Zones. Those are areas where care is sparse, people tend to be poor and chronically ill. They also lack access to care.
Millions of Americans live in areas without a readily available source of medical care that also lack Internet coverage with sufficient bandwidth to make telemedicine feasible. These areas, which tend to be poor and rural, face other obstacles that render residents sicker than average.
Nearly 3 million people live sicker and die earlier on average in more than 200 counties nationwide, according to a KFF Health News analysis. These “dead zone” counties have three things in common: They lack access to high-speed and reliable internet, primary care providers, and behavioral health specialists.
An interactive map of U.S. counties is available here. Hover over counties to explore local data. More from KFF Health News:
High rates of chronic illness and historical inequities are hallmarks of many of the more than 200 U.S. counties with poor services that KFF Health News identified. Dozens of doctors, academics, and advocates interviewed for this article unanimously agreed that limited internet service hinders medical care and access.
Without fast, reliable broadband, “all we’re going to do is widen health care disparities within telemedicine,” said Rashmi Mullur, an endocrinologist and chief of telehealth at VA Greater Los Angeles. Patients with diabetes who also use telemedicine are more likely to get care and control their blood sugar, Mullur found.
Some diseases common among poor, rural residents include diabetes, hypertension, heart disease, among others.
Diabetes requires constant management. Left untreated, uncontrolled blood sugar can cause blindness, kidney failure, nerve damage, and eventually death.
Reliable transportation can also be a problem for poor, older people with chronic health problems who must travel great distances to seek care. Telemedicine is often not an option.
Connectivity dead zones persist in American life despite at least $115 billion lawmakers have thrown toward fixing the inequities. Federal broadband efforts are fragmented and overlapping, with more than 133 funding programs administered by 15 agencies, according to a 2023 federal report.
The subject of the article was Barbara Williams, a 72-year-old black woman who moved back home to Greene County, Alabama after retiring as a cook in Cleveland, Ohio. One of nine children, all the surviving siblings have diabetes. Indeed, about one-quarter of the residents in Greene County have diabetes, double the national average.
Nineteen of Alabama counties have areas where broadband Internet deserts over medical care provider shortage areas. Most regions of the United States that lack broadband and medical providers are rural, sparsely populated and many of them poor with older residents on Medicare or Medicaid. There is no easy solution. Furthermore, broadband Internet may not solve the problem of reduced access to care. As Ms. Williams told KFF Health News, she does not want to engage in video calls or telemedicine. In that regard, she is probably not unlike many poor seniors who are not comfortable with technology.
Read more at KFF Health News: Millions in US Live in Places Where Doctors Don’t Practice and Telehealth Doesn’t Reach