TY - JOUR
T1 - Digital infrastructure as a determinant of health equity
T2 - an Australian case study of the implementation of the National Broadband Network
AU - Schram, Ashley
AU - Friel, Sharon
AU - Freeman, Toby
AU - Fisher, Matthew
AU - Baum, Fran
AU - Harris, Patrick
PY - 2018/12
Y1 - 2018/12
N2 - Inequities in access to fast and reliable internet connections, essential for digital access to services and information that are important for health, can exacerbate social inequalities in health. We evaluated the social equity of the rollout of the National Broadband Network (NBN) in Australia based on the type of digital infrastructure delivered to areas of varying socioeconomic status. We found that areas of greater socioeconomic disadvantage were significantly less likely to receive the highest quality infrastructure, controlling for level of remoteness. These social inequities in provision of quality infrastructure will shape and possibly exacerbate inequities in health. In our discussion we consider how political decisions have obstructed equitable implementation of the policy. Lessons from the Australian case study may be valuable for other countries investing in public digital infrastructure who want to ensure equity of provision and can also inform Australian policy in the NBN's remaining rollout.
AB - Inequities in access to fast and reliable internet connections, essential for digital access to services and information that are important for health, can exacerbate social inequalities in health. We evaluated the social equity of the rollout of the National Broadband Network (NBN) in Australia based on the type of digital infrastructure delivered to areas of varying socioeconomic status. We found that areas of greater socioeconomic disadvantage were significantly less likely to receive the highest quality infrastructure, controlling for level of remoteness. These social inequities in provision of quality infrastructure will shape and possibly exacerbate inequities in health. In our discussion we consider how political decisions have obstructed equitable implementation of the policy. Lessons from the Australian case study may be valuable for other countries investing in public digital infrastructure who want to ensure equity of provision and can also inform Australian policy in the NBN's remaining rollout.
KW - Health inequity
KW - social inequality
KW - social determinants of health
KW - digital infrastructure
KW - policy implementation
KW - health inequalities
KW - social inequity
UR - http://purl.org/au-research/grants/NHMRC/1078046
UR - http://www.scopus.com/inward/record.url?scp=85057543872&partnerID=8YFLogxK
U2 - 10.1111/1467-8500.12323
DO - 10.1111/1467-8500.12323
M3 - Article
VL - 77
SP - 829
EP - 842
JO - Australian Journal of Public Administration
JF - Australian Journal of Public Administration
SN - 0313-6647
IS - 4
ER -