“Broadband is no longer nice-to-have; it's need-to-have for everyone, everywhere. It is not a luxury. It is a necessity.” Those were the words of Federal Communications Commission (FCC) chairwoman Jessica Rosenworcel in her comments before the National Press Club last October. Her statement reflects the growing importance of internet access in all our lives.
One particular reason broadband is a necessity is its ability to expand health care by bringing resources into the home. Unfortunately, affordable housing communities do not enjoy the same access to the internet as their market-rate counterparts.
In my 30 years of working in the field of affordable housing for older adults, I have seen firsthand the difference that reliable broadband service can make in the health and well-being of the residents. The COVID pandemic dramatically accelerated the use of the internet as the preferred (and often only) delivery mechanism for many social and health services. Physician practices now ask patients to book their appointments online. Telehealth visits are more convenient, especially for those who have mobility challenges. Obtaining test results is as simple as going into an electronic medical record. Health care from the privacy of one’s home is increasingly accessible if you have access to the internet.
For older adults, an additional benefit of access to internet in the home has been an increase in connectivity to loved ones and a significant impact on reducing loneliness and isolation, which has reached epidemic proportions, according to the U.S. Surgeon General’s 2023 Advisory on the Healing Effects of Social Connection and Community. It is for obvious reasons like these that research from the National Institutes of Health has found that broadband access is the “super social determinant of health.” Unfortunately, this super social determinant of health is not yet available to all.
Affordable housing providers understand the value to bringing internet access into the apartments of all residents, especially as a strategy to increase access to self-managed health care. However, there are significant challenges in installing broadband in affordable housing communities across our nation. First, Wi-Fi installation and management are highly capital- and labor-intensive processes, posing significant barriers to adoption for providers, particularly in affordable housing. Second, many affordable housing properties have lengthy, legacy agreements with telecom or cable providers that limit their available options for broadband service, including provisions that prevent property owners from entering into bulk billing agreements that would bring better, cheaper service to residents. Due to these and other challenges, residents are often left to enter individual agreements with broadband service providers, which can be a much more costly option for those with limited incomes.
While meaningful attempts have been made to address this inequality in internet access, these policies have faced challenges. In 2022, Congress allocated over $65 billion through the Bipartisan Infrastructure Law for various programs aimed at bridging the digital divide for those underserved or unserved, including those in affordable housing communities. However, these funds are spread across a variety of agencies and each state, creating a complex web that housing providers must navigate to access funds, thereby limiting the speed at which the program can be implemented.
Further, even direct subsidies like the recently expired Affordable Connectivity Program (ACP), which helped to accelerate broadband adoption by offering low-income households a monthly subsidy to be used toward their internet bill, came with inherent barriers for those living in multifamily settings. The time-consuming application process meant that the ACP was very hard to scale in community living such as senior affordable housing. In total, residents in affordable housing communities are far less likely to enjoy “necessary broadband” features in their home. In my experience of working with older adults in affordable housing, this equates to less agency for engaging with today’s complex health care system.
Hopefully, this historic federal investment can still accelerate the adoption of Wi-Fi access in affordable housing communities. One potential avenue to do so is to rapidly embrace strategies of bulk internet billing and managed Wi-Fi. Under bulk agreements, buildings can leverage the collective buying power of their residents to negotiate a better rate for higher-quality internet across an entire property. With managed Wi-Fi agreements, a third-party network manager monitors Wi-Fi service throughout the building and works with property managers to address service and connectivity issues as they arise. Thus, bulk internet and managed Wi-Fi can reduce the cost concerns to affordable housing providers and residents and the labor intensity of maintaining Wi-Fi networks for housing providers.
Unfortunately, owners face regulatory hurdles in implementing bulk internet billing agreements and managed Wi-Fi solutions. For example, the Department of Housing and Urban Development places restrictions on charging for Wi-Fi as a utility, which can make it difficult for housing providers to be reimbursed for bulk internet or managed Wi-Fi service. A second potential challenge comes from the FCC, which announced in March that it intends to propose new regulations that would restrict the ability of multifamily housing providers to enter into bulk billing agreements. Given the importance of internet access, the agencies should be working with housing providers to expand broadband deployment through all effective means, not limiting the options available to the market—especially ones that are inherently pro-consumer and lead to higher adoption and reduced costs for broadband service.
We now know that access to the internet is no longer a luxury for Americans, and that it provides numerous benefits for the health and well-being of American households. Community-based Wi-Fi and managed Wi-Fi solutions have proven capable of successfully accelerating broadband deployment by keeping costs down for consumers and housing providers and minimizing the burden of network upkeep. If we believe that digital connectivity is indeed a super social determinant of health, then it should be a top priority for policymakers, public agencies, and practitioners to bring this connectivity to affordable housing as soon as possible.
