If physical geography is considered, "most" areas don't have cable alternatives and won't for years (hopefully, population growth slows). This is why a couple of companies took the risk of spending big bucks on satellites.
I couldn't get dsl in rural georgia until a couple of years ago since it was a relatively large capital outlay for the phone company and there was no guarantee that they would get customers since they have to share their physical lines with other phone companies. In fact, we still wouldn't have it if not for a new, wealthy neighbor who 'knew' someone in atlanta.