Broadband internet access as a social determinant of health in the early COVID-19 pandemic in U.S. counties

Abstract

Recent work suggests that internet access was key in delivering life-saving health information about the COVID-19 pandemic. This paper expands on these findings by focusing on the early pandemic in the United States to examine the role of internet access on masking and COVID-19 incidence and mortality. Using county-level data from the American Community Survey, The New York Times, and other sources, weighted OLS regression models with state fixed-effects were used to predict the association of internet access on self-reported masking in July 2020 and COVID-19 incidence and mortality during multiple periods from July–October 2020. Results suggest that internet access is associated with a substantial decrease in a county's COVID-19 incidence and mortality. Most strikingly, models predict that counties with the highest internet access had less than 50% of the COVID-19 mortality as counties with the lowest internet access from July–October 2020. Meanwhile, though the association between internet access and masking is positive and significant, the effect size net of control variables is small. In sum, this paper finds that internet access is associated with COVID-19 outcomes in ways beyond information about masking alone.