Two million rural Americans live in 'dead zones' that lack health care providers and reliable internet service

'Dead zone' counties have three things in common: They lack access to high-speed and reliable internet, primary care providers, and behavioral health specialists. (KFF Health News graphic)

In U.S. communities that lack both medical care providers and dependable internet service, residents tend to "live sicker and die younger than others in America," report Sarah Jane Tribble and Holly K. Hacker for KFF Health News. KFF Health News calls regions that lack both services “dead zones.” Roughly 2.7 million Americans live in dead zones, and the vast majority of those zones are rural.

"In 2023, 83% of residents in non-metropolitan, or rural, counties had access to broadband, compared to over 90% of metropolitan residents," reports Sarah Melotte of The Daily Yonder. Out of the 2.7 million Americans who live in dead zones, "two million, or 70% of them, are from rural counties. That means the rate at which rural residents live in these shortage areas is five times higher than the urban rate."

In some cases, communities leverage broadband service and telehealth care to fill in for a lack of providers; but the absence of both options leaves millions disadvantaged. "Compared with those in other regions, patients across the rural South, Appalachia, and remote West are most often unable to make a video call to their doctor or log into their patient portals," KFF reports. "Both are essential ways to participate in the U.S. medical system."

Without reliable high-speed internet, it's hard to attract and keep medical providers in more remote parts of the country. At the same time, poor connectivity means telehealth care isn't an option. "Connectivity dead zones persist in American life despite at least $115 billion lawmakers have thrown toward fixing the inequities," Tribble and Hacker explain. "Federal broadband efforts are fragmented and overlapping, with more than 133 funding programs administered by 15 agencies, according to a 2023 federal report."

The contrast between "the digital haves and have-nots" is stark. "The KFF Health News analysis found that counties with the highest rates of internet access and health care providers correlated with higher life expectancy, less chronic disease, and key lifestyle factors such as higher incomes and education levels," KFF reports. In many rural counties, the lack of reliable high-speed internet access leads to the opposite, where residents tend to live unhealthier, poorer and shorter lives."