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SPAGHETTI FEEDS EMPHASIZE BROKEN SYSTEM IN RURAL AMERICA
November 24, 2009



(NATIONAL) -- When Secretary of Agriculture Tom Vilsack spoke at the Community Food Security Coalition conference in Des Moines, Iowa last month, one of the things he spoke about was the sense of community one gets from living in a small town.

Rural blogger Steph Larsen says an example he used was the phenomenon of holding a fundraiser such as spaghetti feed for someone who gets sick and has high medical bills to pay.

Larsen writes that in some rural communities such fundraisers happen far too often and, while they represent a good example of how people come together in a crisis, it is also glaring evidence of how broken our rural health care system is.

“If we had affordable, accessible, and equitable health care in rural areas, no one would have to ask their community to hold a fundraiser so they could pay for medical treatments,” notes Larsen

She says the spaghetti feed phenomena might become an even more common occurrence out in the country as time goes by as there is evidence to suggest that mortality is more common in rural America compared to urban areas.

According to the Economic Research Service, the rate of death has been decreasing for both urban and rural residents, but around 1989 the rate for rural areas decreased less than urban areas, and the trend has continued since then.

”The most startling thing is that no one can put a finger on exactly why,” says Larsen.

“Nobody has determined why the difference in mortality rates is widening. A possible explanation for the emergence of the nonmetropolitan mortality penalty is based on the observation, says one researcher, that access to health care is the most pervasive health disparity in the nonmetropolitan United States. *

Researcher Arthur Cosby wrote in 2008. “If healthcare is becoming significantly more effective in prolonging life, then limited access to healthcare is becoming profoundly harmful to the nonmetropolitan US population, hence, the nonmetropolitan mortality penalty.”

“What is the health care access like in your community?” asks Larsen. “If something minor were to happen to you or your family, how far would you have to travel? What about something major?”



* The difference between the death rates in rural and urban America has been increasing since 1990. Mortality rates have declined in both the cities and the countryside, but since 1990 urban death rates have improved at twice the rate of rural.

As a consequence of the changing rates of mortality, hundreds of thousands of rural residents have died since 1990 who would have been expected to live had the gap not appeared, according to researchers who first discovered this shift in rural health last year.

If the gap between rural and urban mortality rates had remained constant, there would have been more than 389,000 fewer deaths in rural communities between 1990 and 2004. Researchers call this the “nonmetropolitan mortality penalty.”

The high rural mortality rates is another example of a health penalty paid by rural residents. Last year, researchers at Harvard University found that life expectancy for women living in nearly 1,000 mostly rural counties had declined from 1983 to 1999.

And in September, another group of researchers reported that the rate of suicides in rural counties jumped some time in the 1980s or 1990s. In the 1970s, rural and urban places had similar rates of suicide and attempted suicide. By the late 1990s, rates of suicide were 54% higher in rural areas than in U.S. cities.

In 1989, rural communities, on average, had six more deaths for each 100,000 residents than urban communities.

By 2005, however, there were 82 more deaths for each 100,000 rural residents than for a similar number of people living in urban areas.

“These excess deaths are equivalent to approximately 9% of the total mortality in the nonmetropolitan (rural) United States,” according to Arthur Cosby and other researchers writing in the August 2008 issue American Journal of Public Health. Cosby is a sociologist at Mississippi State University.






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