Columns for The Lufkin News

DETCOG, Broadband and Health

Posted Mar 08, 2020 by Sidney C. Roberts, MD, FACR

Can you hear me now? That phrase, made popular by Verizon Wireless in the early 2000s, epitomizes the frustration of rural America over lack of reliable cell phone coverage. To this day – despite what cell phone carriers like AT&T, Sprint, and Verizon advertise – coverage in many areas (including at my house inside the Lufkin, Texas city limits) is suboptimal. AT&T’s answer? Just use WiFi calling! That may work for me; I have adequate internet access. But what about the majority of deep East Texans? More than just being an inconvenience, poor cell phone coverage and inadequate broadband access are harming our health.

Broadband is the infrastructure and information technology network that delivers high speed connectivity to the internet. Think of broadband as a pipeline of information. As with any pipeline, the rate of flow (water, gas, data, etc.) can depend on the number of users, time of day, and reliability of service. But you have to be able to connect to the pipeline.

In the early days, the internet was accessed through slow, often expensive dial-up connections. Today, high speed or broadband internet access is via DSL (or Digital Subscriber Line), fiber-optic, wireless, cable, and satellite services, often bundled with phone and TV subscriptions.

Broadband access is about more than faster access to Facebook and Instagram. Increasingly, reliable and high-speed internet access is important for community health. The Federal Communications Commission (FCC), which is responsible for regulating the radio, television and phone industries, established a Connect2HealthFCC Task Force to raise consumer awareness about the value of broadband in the health and care sectors.[1] You may know about heart-healthy diet and recipe apps and wearable fitness trackers, but did you know that we now have medical devices like pacemakers, defibrillators, glucose monitors, insulin pumps, and neuro-monitoring systems that can utilize wireless technology to control or program a medical device remotely and monitor and transmit patient data from the medical device to the healthcare team? Those without internet access can get delayed and inadequate care.

Maps showing lack of broadband coverage look just like maps of poor, rural America where healthcare is also lacking. In Kentucky, for example, the same areas where higher rates of lung cancer are seen are those with limited broadband access.[2] These county-by-county maps are similar to what we see in deep East Texas with cancer deaths and health outcomes.[3][4][5] This does not mean that lack of broadband access causes lung cancer, obviously! But the social determinants of health (such as education level and income) that are associated with smoking, lung cancer, heart disease, obesity, and overall health outcomes, are more pronounced in areas with limited broadband access.

So how could access to broadband increase the health of a community? The FCC believes that “broadband-enabled technology solutions can help us meet the health and care challenges of today and tomorrow by connection people to the people, services and information they need to get well and stay healthy.”[6] Possible solutions that are especially important in deep East Texas include telehealth and telemedicine for improved access to physicians and specialists (including mental health services), health information technology and access, fall detectors, pharmacy connectivity, personal health data upload capability, and connectivity to hospitals and emergency rooms. With a growing and aging population compounded by a shortage of primary care physicians nationwide estimated in the tens of thousands –especially pronounced in rural areas – remote connectivity options for healthcare become even more important.

The Deep East Texas Council of Governments (DETCOG), under the leadership of Executive Director Lonnie Hunt, recently received a report titled Deep East Texas Broadband Growth Strategy, which detailed the potential economic growth (10,300 new jobs and $1.4 billion in GDP growth over 10 years) and growth in median household income associated with near complete broadband access, a loft goal. In IT, education, and telehealth alone, investments have the potential to impact the region with 2,500 jobs and $300 million in GDP over the next ten years.

DETCOG’s goal is to support development of a regional fiber optic-based broadband network throughout its twelve-county region. They hope to do this through creation of a non-profit or other entity that would manage the project, bring the necessary partners together to accomplish the goals, and oversee planning, financing, and implementation of the regional broadband network.[7] Full implementation realistically will cost hundreds of millions of dollars. But it doesn’t have to all come at once.

In February, with support from the TLL Temple Foundation, DETCOG started the process to contract with a major law firm with offices in Washington, DC, to create an entity to manage broadband in East Texas.[8] Funding such an entity and project will not be easy. Other COGs have tapped into grants like the FCC’s Rural Health Care Program, which provides funding to eligible health care providers for telecommunications and broadband services necessary for the provision of health care.[9] Electric and telephone cooperatives, public utilities, internet providers, local, state, and federal entities, and foundations can and should play a role.[10][11]

Do you hear me now? We must support DETCOG’s vision for a fiber optic network for all of deep East Texas. This will be a long term project requiring many players, both public and private, to accomplish. We need – we must have – high-speed broadband access in our entire region for jobs, for the economy, and for our health.

[1] https://www.fcc.gov/general/stay-heart-healthy-broadband-technologies-and-apps

[2] https://www.fcc.gov/sites/default/files/launch-broadband-and-lung-cancer-sample-maps.pdf

[3] https://broadbandmap.fcc.gov/#/

[4] https://statecancerprofiles.cancer.gov/map/map.noimage.php

[5] https://glasshousepolicy.org/wp-content/uploads/2019/02/GHP_Broadband-Report_86th-Legislature.pdf

[6] https://www.fcc.gov/health/broadbandhealthimperative

[7] https://0d24fbc8-d5de-4683-8267-6b36f8555656.filesusr.com/ugd/a7f184_d49edda7a40741ec8b07c9cbd14f76d4.pdf Accessed February 15, 2020.

[8] http://lufkindailynews.com/news/local/article_f90467e6-a10a-5cc7-aa29-17029c31200c.html

[9] https://www.fcc.gov/general/rural-health-care-program

[10] https://www.ltgov.state.tx.us/wp-content/uploads/2019/10/2019-Interim-Legislative-Charges.pdf

[11] Hunt, L and Ghoshal, K, DETCOG Briefing: Deep East Texas Broadband Growth Survey

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