By Erica Vandervort

Do you have a point you’d like to make or an issue you feel strongly about? Submit a letter to the editor or a guest column.

I grew up in Central Oregon. I was born at St. Charles in Bend, and spent the next 18 years living in La Pine. I graduated from La Pine High School in 2010. The majority of my family has worked in health care in one capacity or another, so I have seen first hand the struggles of working in rural medicine. In 2016, I moved to Portland and started working for a large, multistate health care organization. This experience showed me just how shockingly different urban and rural healthcare are. In 2018, I completed my Master in Health Administration. I spent most of my graduate school program targeting my research toward issues of rural health care, hoping that at some point in my career I could help to improve health outcomes for communities like La Pine.

I was excited to see Markian Hawryluk’s article in The Bulletin addressing the disparities and social determinants of health that impact La Pine and rural communities nationwide. However, I watched the La Pine community Facebook page blow up with disparaging comments, community members refusing to believe cold, hard statistical fact — rural areas have worse health outcomes than the general population because they tend to be lower income, sicker and older. The public health crisis that is the opioid epidemic has hit rural communities the hardest, as there is a lack of other pain management options when there are fewer medical resources within a reasonable distance. Naloxone treatment for opioid addiction is also limited, as very few doctors are authorized to prescribe it. Rural Americans are more likely to die from heart disease, cancer, accidental injuries, chronic respiratory illness and stroke; they also tend to be more obese, use tobacco and commit suicide at rates higher than the general population. Transportation and accessibility are major issues; many specialists, diagnostic imaging centers, mental health care and other providers may require traveling more than an hour away. Additionally, more than a quarter of U.S. veterans who returned from active military careers chose to settle in rural communities. Many of these men and women may have more complex health care needs than the typical rural American, due to combat-­related injuries or psychological conditions. Rural communities face many unique issues, and all the rural areas in the U.S. have their own cultures and idiosyncrasies, making any legislation or nationwide initiative substantially more difficult to design.

These are well-researched, evidence-based statistics. There is nothing to disagree with here, there is only the option to decide how to improve. The benefit of small towns is that they are close knit and willing to help out a neighbor. More than any piece of legislation, this is exactly the thing that will improve outcomes — but that is only possible by acknowledging the facts.

The fact that La Pine residents have to understand is that this article is not a personal attack. There are several health initiatives spearheaded by community members, and it’s understandable to be a bit frustrated that those things went unnoticed. It’s frustrating that, traditionally, Deschutes County has forgotten about “South County” in legislation and funding. However, by believing that The Bulletin is simply trying to ridicule and insult La Pine, by refusing to acknowledge the evidence, residents of La Pine are only hurting themselves. Data has no opinions, feelings or bias. It is not fake news. It doesn’t lie.

I saw many commenters citing their own experiences to condemn the statements made in Hawryluk’s piece. My educational background tells me to deal in peer-reviewed research, not the opinion of one person. … But I, too, have anecdotal evidence. By the time I was 25, eight of my La Pine High classmates had died from some of the issues cited in this article — things like opioid addiction, lack of health care access, alcohol abuse and mental illness. It’s not fair to them to ignore the disparities La Pine faces because the evidence hurts to look at.

— Erica Vandervort lives in Portland.