When Secretary of Agriculture Tom Vilsack spoke at the Community Food Security Coalition conference in Des Moines on Tuesday, one of the things he spoke about was the sense of community one gets from living in a small town. An example he used was the phenomenon of holding a fundraiser such as a spaghetti feed for someone who gets sick and has high medical bills to pay.

It's true, in some communities this is a regular occurrrence. In the year I've lived in Lyons, I can think of several such events both here and in neighboring communities. One was for a newborn with a large number of birth defects, another was for a man with cancer.

While it is a good example of how people come together in a crisis, it is the blaring 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.

Unfortunately, this might become an even more common occurrence - there is evidence to suggest that mortality is more common 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:

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 that access to health care is the most pervasive health disparity in the nonmetropolitan United States,” 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? If something minor were to happen to you or your family, how far would you have to travel? What about something major?