Standing in the rain on the lawn of her ranch-style home, Lisa Huntsman strained to hear her pulmonologist during a recent telemedicine call. “I was so nervous, it was hard to focus on what my doctor was saying,” says Hunstman, 49, who lives in Fleming, a rural community in southeastern Ohio.
In better circumstances she would have engaged with her doctor on a computer via a videoconference in which they could see each other and calmly discuss her condition and treatments. But wired broadband internet lines haven't come to her neighborhood, so she and her family must make do with spotty cellular service for phone calls and low-grade internet service via a hot spot device with a hefty price tag of $360 per month. “It's our most expensive bill,” Huntsman says. “Our house payment was never even that high."
Countless older Americans who live outside cities and suburbs have shared Huntsman's frustration, before and during the pandemic. Because it is expensive and sometimes physically unwieldy to run fiber-optic lines and coaxial cables to rural homes, many residents along the countless back roads of America lack the technology to access the full range of digital services available to the rest of us—from video chats with grandchildren to connecting to the servers at work to streaming the latest Netflix series.
How many Americans are on the wrong side of this “digital divide"? Estimates range from the Federal Communication Commission's 21 million to more than 40 million, according to the service-comparison site BroadbandNow. This lack of quality internet makes it hard for people in sparsely populated areas to keep up with the rest of the nation, says Tom Ferree, the chairman and CEO of Connected Nation, a nonprofit advocate that develops public-private programs to expand access to technology. “Saying ‘Just work from home’ in a crisis ignores the reality for many Americans,” he observes.
A surgical nurse whose work was reduced when COVID-19 shut down elective procedures, Huntsman was offered alternative telecommuting tasks by her employer. “But I had to turn that down because our internet is so poor,” she says. Her husband and teen daughter have had to take turns using the internet to juggle work and school demands; the hot spot can't reliably serve multiple users. “There were many days our daughter came to us in tears,” Huntsman recalls. “With the libraries closed, we've been known to sit outside the McDonald's just to get homework done” using the restaurant's free Wi-Fi. Even fun online activities, like streaming movies at home, are pretty much out of the question.
One particularly big downside for older Americans without good internet access is the difficulty of conducting home health consultations with doctors and therapists. Spurred by the coronavirus pandemic, health care systems nationwide have begun shifting routine visits from the clinic to the computer.
"Everyone is having connectivity issues,” says Rebecca Street, 32, a licensed marriage and family therapist in Louisville, Kentucky, who often serves rural patients via teleconference- — or tries to. “Some of my clients simply can't afford technology and the internet. We've tried to keep in touch by phone, but it's difficult to deliver quality counseling that way.”