Spirit of Keokuk County

By Dr. James A. Merchant

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Recent traumatic fatalities in Keokuk County resulted in two communitywide funerals held at the Sigourney High School, the only venue in the county large enough to accommodate the thousands who came to mourn these deaths and to lend support to families and friends. This is what rural communities do in the face of tragedy and disasters, a public display of communal sharing and support - respect for your neighbor and community we have observed among these families for many years.

In 1990, the University of Iowa won a planning grant for a countywide health study of 1,000 families over a period of 20 years. We are in the final four months of this study designed to prospectively observe injuries, respiratory disease, mental health outcomes, hearing and vision acuity, and agricultural and other rural and environmental risk factors that may be associated with these health outcomes.

We considered several rural counties close to Iowa City, but chose Keokuk County largely because community leaders expressed a very strong interest in hosting and collaborating on this study - by assisting in finding a study facility, forming a countywide advisory committee and, most important, assuring the participation of whole families over three rounds of study.

As we now enroll the final households, those who encouraged us to choose Keokuk County clearly were right - more than 20 percent of all households in this county of about 10,500 people have participated. The Keokuk County Rural Health Study has involved nearly 6,000 three-to-four-hour clinic visits for lengthy questionnaires and medical tests (most families coming two or three times,) and nearly 3,000 home and farm visits to observe and measure farm and home environmental exposures.

These data have resulted in more than 50 scientific publications, with many more to come, that serve as science-based guides for similar agricultural communities nationally and globally.

The spirit of Keokuk County existed long before the Keokuk County Rural Health Study and will continue long after this study is completed and the lessons learned passed on to improve the lives of those living and working in other rural communities.

Residents' generosity of their time, personal space and life experiences was observed daily by our staff, who were made to feel welcome in their homes.

This is the Keokuk County we know.

Dr. James A. Merchant is principal investigator, Keokuk County Rural Health Study, and professor/founding dean, University of Iowa College of Public Health. Comments: james-a-merchant@uiowa.edu