Evidence map›Paper›PMID 42490560›Full record

ArticlePLOS digital health2026

Healthcare unplugged: Disparities in broadband internet and health facility access among US counties.

Khushi Kohli, Stephanie Wang, Cody Chou, Bhav Jain, Kavya M Shah, Mahi Kohli, Edward C Dee, Sandeep Palakodeti

Abstract read
In one paragraph

Article in PLOS digital health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Khushi KohliHarvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0001-6411-5729
Stephanie WangColumbia University Vagelos College of Physicians and Surgeons, Manhattan, New York, United States of America.
Cody ChouHarvard Medical School, Boston, Massachusetts, United States of America.
Bhav JainStanford University School of Medicine, Stanford, California, United States of America.
Kavya M ShahHarvard Medical School, Boston, Massachusetts, United States of America.ORCID https://orcid.org/0000-0002-8722-4095
Mahi KohliDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America.
Edward C DeeDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America.ORCID https://orcid.org/0000-0001-6119-0889
Sandeep PalakodetiDSP Health, Granville, Ohio, United States of America.ORCID https://orcid.org/0000-0003-2588-268X

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

Amid the COVID-19 pandemic, telemedicine emerged as a promising solution for early disease detection. However, access may remain limited in communities with reduced access to outpatient health facilities key for timely screening. Here, we correspond broadband internet access with access to health facilities and elucidate rural-urban disparities. For 3,133 US counties, we extracted data on the population density of outpatient care centers, diagnostic labs, and nursing/residential care (2017 National Neighborhood Data Archive), broadband access stratified based on the median percentage (9.8%) of households without broadband (2022 FCC Mapping Broadband Health in America), urbanicity level, and sociodemographic covariates (2022 American Community Survey). Two-sample t-tests substantiated the association between broadband access and facility densities. Multivariable linear regressions quantified the association between broadband access and facility densities, adjusting for sociodemographic covariates, and geographical heatmaps visualized trends in broadband access, urbanicity level, poverty rate, and facility densities. Heatmaps revealed that regions with limited healthcare facilities-particularly the Great Plains and Southwest-overlap with areas of low broadband coverage. Compared to counties with high broadband access, those with low access had fewer outpatient care centers (mean 10.46 vs. 11.91 per 100,000 residents, P < 0.001) and diagnostic labs (mean 1.91 vs. 3.95 per 100,000 residents, P < 0.001). They also demonstrated higher poverty rates, older populations, increased rurality, and lower educational attainment, employment, and insurance (all P < 0.001). Multivariable regression confirmed that declining broadband access corresponds with lower densities of outpatient care centers (β = -0.045), diagnostic laboratories (β = -0.024), and nursing/residential care facilities (β = -0.089; all P < 0.001). Ultimately, US communities with the fewest physical health resources-particularly in rural, low-income counties-are also less likely to have broadband access. Addressing this inequity necessitates coordinated investment in broadband expansion and targeted health services deployment.

Identifiers

PMID42490560
PMCPMC13395355

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.