Tribal lands need broadband to improve health care access, but progress is slow

Shoshone-Bannock tribal lands are vast with a rocky terrain, which poses a challenge in building fiber-optic cable lines for high-speed internet to homes. (Photo by Sarah Jane Tribble, KFF Health News)

The lands of the Shoshone-Bannock Tribes in Idaho span seemingly endless miles. But the beauty of this vast tribal expanse comes with a cost: Profound broadband gaps that limit health care for Native Americans throughout the region. "Tribal members are historically underserved and, on average, live with the highest rates of chronic illnesses and die 6.5 years earlier than the average U.S. resident," reports Sarah Jane Tribble of KFF Health News.

Accessing medical treatment without broadband connectivity presents a range of challenges. Tribal members have to drive to medical appointments because telehealth isn't an option. "Tribal field nurses update charts in paper notebooks at patients’ homes, then drive back to the clinic to pull up records, send orders, or check prescriptions," Tribble writes. Getting care and medicine all takes longer.

All the while, millions in federal dollars have been set aside to address tribal broadband infrastructure. "Three years ago, the Shoshone-Bannock Tribes were awarded more than $22 million during the first round of the federal Tribal Broadband Connectivity Program," Tribble explains. "But tribes that were awarded millions in a second round of funding saw their payments held up under the Trump administration."

Shoshone-Bannock Tribes Broadband Infrastructure Deployment project
(Map by Lydia Zuraw and Sarah Jane Tribble, KFF Health News)

For some tribal members, waiting for fiber isn't an option. Instead, they pay for Starlink, which uses low-earth-orbit satellites and costs between $80 and $120 a month. "For 53-year-old Carol Cervantes Osborne, who lives with constant pain from severe rheumatoid arthritis, having internet is a necessity," Tribble explains. "She signed up for Starlink so that she can connect with doctors remotely through telehealth appointments." 

Despite the wait for broadband and the current lack of care access on their lands, tribal leaders say Starlink is too expensive for most of their members.

This year, the Shoshone-Bannock Tribes started work on their high-speed internet installation, but progress will be slow. "To build fiber-optic cables underground, the tribes must navigate lava rock and work with the Bureau of Indian Affairs to get permits," Tribble explains. "Eventually, the old radio station will be central to operations, with fiber-optic cable lines that web out over about 800 square miles to reach the reservation’s five district lodges."