Study: Broadband internet access as a social determinant of health in the early COVID-19 pandemic in U.S. counties (DOI: 10.1016/j.ssmph.2025.101747)
The mortality rate from COVID-19 was about 50% lower in U.S. counties with higher internet access in the summer and early fall of 2020.
A new University of Michigan study found that broadband connection was a key factor in reducing mortality and incidence during the early months of the pandemic. The average county with high internet access had 48%-53% fewer new COVID-19 deaths and 19%-34% fewer new COVID deaths per 100,000 residents than the average county with low internet access.
The research, published in SSM-Population Health, also showed that residents of counties with high internet access reported slightly higher rates of mask-wearing in July 2020 and fewer new COVID-19 cases were reported in counties with higher internet access in July-October of that year.
"I was struck by the magnitude of the difference that internet access made in reducing rates of COVID-19 cases and deaths," said study author Spencer Allen, U-M doctoral student in sociology. "Very few studies have looked at the relationship between internet access and COVID-19 outcomes in the U.S. To my knowledge, this is the first paper to focus on that relationship in the early pandemic when we still knew relatively little about COVID-19."
The study adds to growing evidence that internet access is a critical "social determinant of health," especially during public health crises. In 2020, broadband served as a lifeline, enabling access to up-to-date information on protective measures like masking, social distancing and recognizing symptoms.
Despite the internet's reputation for spreading misinformation, Allen's study highlights its overall positive impact during the pandemic-linking it to lower COVID-19 cases and death rates. The internet facilitated remote work, reduced exposure to crowded spaces and enabled timely medical care. It also allowed millions to adapt quickly to online work, education, telehealth and social connections.
"Like many Americans, I first learned about COVID-19 and how to protect myself from the virus online," said Allen, also a graduate trainee in the Population Studies Center at the Institute for Social Research. "However, I also knew that not everyone could access the internet. This tension made me wonder: When so much information about the pandemic was shared online, did parts of the country with higher internet access fare better during the pandemic than parts with lower internet access?"
Impact on policy and communities
The research underscores the urgent need to address disparities in internet access. Nearly 20% of U.S. adults lacked broadband in 2020, according to the Pew Research Center, with rural and low-income areas disproportionately affected. These gaps contributed to unequal health outcomes during the pandemic, Allen says.
"Internet access is not a commodity: It is a lifesaving resource that can help people access information about health conditions, connect with their medical teams and maintain beneficial social connections," he said. "While I am encouraged by recent federal efforts to improve internet access through the Broadband Equity, Access, and Deployment Program and the Digital Equity Act, both funding streams are vulnerable to shifting political winds, leaving millions of disconnected Americans in the dust."
A recent decision from the U.S. Court of Appeals for the Sixth Circuit strips the ability of the Federal Communications Commission to enforce net neutrality across the country. Net neutrality is the principle that an internet service provider can't reduce speeds for certain websites or charge consumers more to access specific services.
"While my research suggests that internet access can be beneficial for health in the pandemic, just having an internet connection means very little if someone can't access the entire internet," Allen said. "Congress must act to enshrine internet access in the law to guarantee that every American has free and equal access to the internet."
For the researcher, very few studies examine the relationship between internet access and health outcomes, not just COVID-19. To explore this relationship further, Allen is developing a project using U.S. mortality data from before the COVID-19 pandemic.
"I want to determine whether the link between internet access and mortality is unique to the pandemic or has existed over a longer period," he said.
