Daily Yonder/Dartmouth Health Atlas This map shows the difference in per capita Medicare costs among 1,845 rural hospital service areas. Green areas have costs below the national average. Brown areas are above the national average. For a larger version of the map, click here.

In Whitefish, Montana, the average yearly cost of taking care of a Medicare patient over a three-year period ending in 2006 was $3,950.

Across the country in the Florida Panhandle town of Graceville, the cost of tending a Medicare patient during the same time was nearly $15,500. 

People in Graceville are poorer than people in Whitefish, it’s true. But the difference in cost of caring for a Medicare patient in these two towns is astounding — more than four times more expensive in one rural Florida hospital than in one town in rural Montana.

The map above shows the wide range of costs in caring for Medicare patients among 2,990 rural and exurban hospital service areas. The map, the first of its kind, is based on a remarkable set of data collected by researchers at the Dartmouth Medical School. Doctors and economists there take a sample of Medicare costs from every hospital. They account for differences in race, sex and age from place to place, but not income. What they have discovered are large differences in medical costs from one part of America to another.

“This map illustrates that variation in health care spending is not just about big city versus rural areas,” Dartmouth College economist Jonathan Skinner told The Daily Yonder. Skinner said this “landmark map” showed that “even within rural there is a large variation in costs.”

Tim Murphy/NPP This chart compares the recruitment rates in urban, exurban and rural counties.

Recruits joining the U.S. Army in 2008 disproportionately came from rural and exurban communities — especially from southern states.

Recruitment rates in rural and exurban counties across the United States were well above the national average. (See chart above.) In rural counties in Southern states, recruitment rates were more than 44% above the national average.

In contrast, the rate of people joining the U.S. Army from Northeastern cities was nearly 40% below the national average.

Rural Nevada counties had the highest Army recruitment rate among the rural counties in the 50 states in 2008, followed by Alabama and Florida. Rural Massachusetts had the lowest rate, followed by the rural portions of North Dakota and Utah.