Skip to main content

Health for all through “Internet for All”

The pandemic revealed the crucial role of digital connectivity for employment, education, healthcare and a range of essential services. High-speed internet is now widely recognized as a “super determinant of health.” Yet, according to the Census Bureau’s American Community Survey (ACS), about one in four households in the United States do not have high-speed internet service at home, and about one in 10 have only a mobile service plan.

Overcoming the digital divide

To address crucial gaps in connectivity, Congress passed the Bipartisan Infrastructure Law in 2021, which included $42 billion for the Broadband, Equity, Access and Deployment (BEAD) Program, $14 billion for the Affordable Connectivity Program (ACP), and $2.75 billion for the Digital Equity Act (DEA). Collectively, these programs are now known as “Internet for All,” with the bulk of their funds intended to close gaps in broadband availability across the country, especially in rural areas.

But lack of affordable service, digital literacy skills and devices are very real barriers keeping a large fraction of Americans from using the internet. The 22 million households enrolled in the ACP represent just 43% of eligible households.

The digital divide recognizes that some populations face greater barriers to broadband adoption and use than others. When those barriers are removed, it advances digital equity, which the National Digital Inclusion Alliance defines as “a condition in which all individuals and communities have the information technology capacity needed for full participation in society, democracy, and the economy.” 

Community health improvement processes as a model

Public health and health organizations have been coming together for over a decade to conduct needs assessments and create health improvement plans. These plans use data to identify populations and geographic areas where residents experience worse health and face adverse social determinants of health. Time-tested methods of community outreach are used to engage stakeholders to identify community assets and needs, then develop plans to tackle community priorities related to health.

The Internet for All program asks states to use processes very similar to those described above to create BEAD and Digital Equity plans. The plans are expected to include a needs assessment for “covered populations” that have the greatest barriers to Internet adoption — older adults, communities of color, individuals with a language barrier, veterans, individuals with a disability, incarcerated individuals, households affected by poverty and those residing on tribal lands or in rural locales.

The program also stipulates that outreach strategies and stakeholder engagement must be described, along with methods of documenting how plans “will impact and interact with the state’s economic and workforce development goals, plans and outcomes; education outcomes, health outcomes; civic and social engagement; and delivery of other essential services.” 

States are currently finalizing Five-year BEAD Action Plans and Digital Equity Plans that describe how each intends to spend its BEAD and DE awards. Officials from the National Telecommunications and Information Administration (NTIA) will review the plans before releasing allocations — which, for state BEAD awards, range from $107.7 million (Delaware) to $3.3 billion (Texas).

How can state coalitions and federal funders ensure new investments in broadband reach covered populations?

1. Maximize impact through Intersectional data

Programs to improve digital equity should be guided by data to:

  • Identify community priorities regarding digital literacy, broadband adoption and impact
  • Create baseline metrics for covered populations
  • Create shared improvement goals that benefit all communities

Visualization of data at the neighborhood level has proven invaluable for seeing sharp geographic disparities in health outcomes such as life expectancy. It also reveals the close association between health outcomes, the social and demographic characteristics of people living in those neighborhoods, and internet subscription and device ownership patterns. Historical data on economic redlining has been linked to contemporary conditions, leading to insights about how discriminatory lending practices also impact health and broadband adoption.

Understanding these underlying factors can be key to crafting approaches that improve digital equity. Successful digital equity programs will be community-centric, community-led and equipped with an understanding of needs at the neighborhood level. This requires linking granular data from multiple sources, which is made easier through universal geographic identifiers and transparency to ensure efforts to close the digital divide are effective and synergistic.

Policymakers should consider resource needs based on the social vulnerabilities of residents in specific geographies. Vulnerabilities common to many resource or policy needs include race, ethnicity, income, age, disability status and language barriers. Readily available data at the census tract or zip code level is invaluable for creating and evaluating programs and policies. Geographically granular data on health, educational, and economic outcomes are especially useful for demonstrating intersections with broadband access.

2. Harness the experience and expertise of community-based organizations

Ongoing stakeholder engagement is a requirement of the Internet for All grant program and essential for building out the infrastructure and programs to promote digital equity — especially for communities experiencing the most inequities. As organizations collaborate across sectors to direct grant programs, granular data coupled with tools and methods developed for community health improvement can greatly optimize impact.

The success of the country’s historic Internet for All investments hinge on seeking and demonstrating change in specific metrics and having deep engagement of a broad coalition of stakeholders that includes organizations deeply familiar with the lived experience of residents. Because of trust earned over decades of service, community-based organizations are uniquely suited to facilitate broadband adoption among those who have been excluded from digital opportunities. Yet these organizations often get bypassed for funding because resources supporting their vital programs are often inadequate for conducting evaluations needed to demonstrate effectiveness.

3. Accelerate advancement through strategic partnership with independent experts

Data reflecting broadband need and impact is now widely available at the neighborhood level and can be parsed to show changes over a short period of time for population subgroups served by community organizations. Having access to such metrics opens the door to greater engagement by community-based organizations with Internet for All programs. But having specialized tools and expertise can make all the difference in how quickly states are able to advance digital equity.

The State Digital Equity Planning Grant Program represents a significant investment to address major barriers to social, economic and civic opportunities. To make best use of the program’s resources, ensure an efficient and effective process, and accelerate advancement toward digital equity, states are wise to partner with independent experts such as Conduent’s Healthy Communities Institute.

A partner with specialized community health expertise, robust technology and a depth of experience can make a pivotal difference for states:

  • Ensuring the most effective use of program resources
  • Facilitating transparent multi-sector collaboration
  • Consolidating, analyzing and presenting data coming from multiple sources
  • Strategically using data to define measurable objectives and evaluate strategies around shared goals

Today, health equity hinges on digital equity. A holistic approach that embraces the use of intersectional data, community-driven strategies and collaborative partnerships with experts will accelerate and broaden the impact of Internet for All programs and grow pathways to health that include everyone.

A condensed version of this article also appears in Nonprofit World - Nonprofit Briefs, Q4, 2023.

About Conduent Healthy Communities Institute (HCI)

Conduent Healthy Communities Institute provides an end-to-end solution for community health that links health and social determinants of health with technology and expertise. The HCI platform brings stakeholders together with a centralized dashboard of more than 150 health, social, and economic indicators, high value analytics, tools for storytelling, and evidence-based practices at the user’s fingertips.  HCI’s Consulting Services team provides expert guidance for assessing community needs, developing strategies, and implementing evaluation and monitoring processes. Contact Conduent Healthy Communities Institute at

About the Authors

Amy Sheon, PhD, MPH, is a Digital Health Equity consultant and principal of Public Health Innovators, LLC of Rocky River, OH. As a user and champion of Conduent HCI services for over a decade, Amy is now proud to provide digital inclusion subject matter expertise consultations to Conduent and its clients. She has more than three decades’ experience addressing health equity and social determinants of health, with a focus on data and data visualization. Amy has worked closely with the National Digital Inclusion Alliance nearly since its inception, helping government, health sector, academic, community and philanthropic organizations, as well as industry and professional associations link digital and health equity strategies. Jen Thompson, MPH, is the Director of Conduent Healthy Communities Institute (HCI) and plays a key leadership role at HCI working with communities across the U.S. to improve health and advance health equity . She applies her training in epidemiology to support HCI clients in using data to make evidence-based decisions and develop effective plans for community health improvement. Her career as a public health leader and researcher goes back nearly 15 years and includes prior positions with the California Department of Public Health as well as the Centers for Disease Control and Prevention.

Profile Photo of Amy Sheon, PhD, MPH and Jen Thompson, MPH