Digital redlining-the invisible structural determinant of health

The Biden administration’s ambitious $42 billion push for universal broadband by 2030 marks a significant step toward bridging the digital divide. Simultaneously, health care systems across the US continue to intensify screening efforts for the social determinants of health (SDOH), which refer to health-related social, economic, environmental, and structural factors, such as broadband connectivity. SDOH screening efforts align with mandates and recommendations by the Joint Commission, the Centers for Medicare & Medicaid Services, and Healthy People 2020 Objectives.¹ By screening for SDOH (eg, adverse social risk factors such as food insecurity), health care professionals can gain a more comprehensive understanding of patients’ lives, allowing improved tailoring of interventions, referrals, and services to reduce health disparities and enhance care. Surprisingly absent from current SDOH screening and referral initiatives is critical consideration for the role digital redlining plays in shaping access to health care and social services.

Digital redlining refers to discriminatory disinvestment in broadband infrastructure and originates from historical redlining—a policy through which the US government intentionally segregated neighborhoods by excluding predominantly Black communities from homeownership and lending programs, leading to systemic economic and social disinvestment in these communities over time.