Farming was once the predominant way of life in Iowa’s Monona County, which is bordered on its western edge by the Missouri River and has just 13 people per square mile.
Although 76% of the county’s land area is devoted to farming, less than one-third of the workforce makes its living from farming. Manufacturing, transportation, and retail are other main sources of employment. Although agriculture remains important, the decline of farming, along with the aging of Iowa’s population as a whole, have led to a decrease in Monona County’s population from 11,692 in 1980 to 9,149 in 2014. Almost exclusively white, nearly 25% of the county’s population is aged 65 or older, compared with 13% for the state.
Today, Monona County residents of all ages face significant challenges to their health and well-being. A multisector community alliance and the Monona County public health department have identified key challenges, including alcohol abuse, child safety and well-being, and lack of physical activity, and have implemented targeted initiatives to address them. Their efforts have shown early signs of success, but more recent data to gauge sustained progress are unavailable. Left unanswered for now is how best to respond to Monona County’s alarming rates of heart disease and its contribution to premature death.