Treffer: Census-tract broadband connectivity and the risk of diabetes, hypertension and obesity/overweight in California.

Background: In the digital age, a growing literature suggests that broadband coverage and high-speed internet access are social determinants of health. However, there is little research on regional broadband connectivity and its relationship to the prevalence of common health conditions such as type 2 diabetes, hypertension, and obesity/overweight. Using the California Health Interview Survey (CHIS) and US Census data, we aimed to assess if local broadband connectivity at the census tract level was related to prevalence of cardiometabolic dysfunction (diabetes, hypertension, and obesity/overweight) in these census tracts. METHODS : Using a cross-sectional design, we analyzed data from 2019 California Health Interview Survey (CHIS) respondents aged 18 years or older (n = 21,905). Broadband connectivity and population density at the census tract level was determined from 2010 US Census data. Health information, secondary predictors, and covariates were self-reported by California Health Interview Survey CHIS respondents.
Results: The prevalence of type 2 diabetes was greater in broadband connectivity areas with less than 40% high-speed connectivity (OR 2.4, 95% CI 1.6-3.7, p < 0.001) as compared with broadband connectivity areas with greater than 80% high-speed connectivity. As compared to areas with greater than 80% high-speed connectivity, we did not find differences in diabetes prevalence for areas with 40-60% high-speed connectivity (OR 1.2, 95% CI 0.8-1.7) or areas with 60-80% high-speed connectivity (OR 1.2, 95% CI 0.97-1.4). There were trends toward greater hypertension prevalence in areas with lower high-speed broadband connectivity as compared to higher broadband connectivity, but none of the differences reached statistical significance (all p values between 0.05 and 0.1). We did not find statistically differences in the prevalence of obesity/overweight for areas with different penetration of high-speed broadband connectivity.
Conclusions: In California, the prevalence of cardiometabolic conditions, particularly type 2 diabetes, is highest in areas with lowest broadband connectivity. More research is needed to better understand the direct relationship between broadband connectivity, the usage of online health resources and the management or prevention of cardiometabolic dysfunction.
(© 2025. The Author(s).)

Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board at the University of California, Los Angeles (IRB# 20–000583). The research was conducted in accordance with the NIH Guiding Principles of Ethical Research. Consent for publication: Not applicable. Competing interests: Dr. O. Duru is a consultant for ExactCare Pharmacy, Inc and Boehringer Ingelheim. There are no other potential conflicts reported by study authors.