Abstract
<title>Abstract</title> <p>Methods Data were obtained from 2019 versions of the American Community Survey, Area Health Resources File, Small Area Income and Poverty Estimates Program, and National Center for Health Statistics. The relationship between broadband access and dermatologist density was assessed using simple linear regression. Multiple linear regression was performed to adjust for potential confounding variables and to investigate the relationship between household broadband access and county demographics. Results: Data from 3,220/3,230 (99.7%) counties were included. In the most urban areas, 72.2% of households had broadband access and there were 6.5 dermatologists per 100,000 people. In the most rural areas, 49.1% of households had broadband access and there were 0.21 dermatologists per 100,000 people. Before and after adjusting for potential confounding variables, lower broadband access was significantly (p < 0.5) associated with lower dermatologist density. Lower broadband access was significantly associated with higher rurality, lower educational attainment, higher unemployment, lower median household income, higher proportion of adults aged ≥ 65 years, higher proportion of Black residents, and higher proportion of uninsured individuals. Conclusions: The potential of teledermatology to improve dermatological care access is limited by its broadband internet requirement. Poor broadband access is significantly associated with poor access to local dermatologists, rural communities, and communities with more Black, uninsured, unemployed, older, lower income, and less educated residents. Our study identifies limitations and inequities inherent in the use of teledermatology to address dermatologic care needs.</p>