Believe it or not, there is a republic where obesity alone leads to the spending of $147 billion annually. The land of the free and the home of the large, where the proportion of obese citizens hovers around 35 percent. An expanse of amber waves of grain, where we eat too many carbohydrates, causing epidemics that have raged in the limelight, seemingly without opposition.

Welcome to a nation where, in rural and impoverished areas, the obesity and diabetes epidemics surge at an even higher degree – comprising about 40 percent of adults – and where, sadly, impoverished communities that fall into this category are often plagued by socioeconomic and political barriers, complicating the task of maintaining community health.

Welcome to our “Free and Reduced Lunch Nation.” Welcome to the United States of America.

It’s sometimes hard to believe, but luckily for us, there is no better sample population than that of this great state.

The fact is, the state of Alabama, and particularly its rural Black Belt, is a hotbed for preventable disease of all kinds, and, honestly, it doesn’t seem to be getting any better.

No longer does this great state face obvious and nationwide issues with diabetes and obesity, but rather, these problems seem to pale in comparison to the infant mortality and prenatal troubles plaguing the state, not to mention our absolute lack of obstetric services in rural counties.

Here’s a quick run-down.

Alabama is now maintaining the second highest death rate for children under 20 years old in the United States, and between 2010 and 2012, infant mortality was at a rate of 8.6 deaths per 1,000 births across Alabama, roughly double the national average.

That, coupled with the fact that 11 of the 18 historical Black Belt counties are now maintaining double-digit rates, paints an incredible picture about the absolute lack of availability of prenatal care in rural Alabama, an idea that can be further witnessed just by looking at the adequacy of prenatal care utilization index.

In 2005, the average percentage of women receiving inadequate prenatal care in the Alabama Black Belt stood at 20.93 percent, with 15 of the 18 Black Belt counties falling above the average 11.3 percent mark in this category. Meanwhile, in Greene County alone, 31.4 percent of women are receiving inadequate prenatal care.

But where does this problem stem from?

Easy. In 1980, 46 of the 55 counties in Alabama currently considered to be rural had hospitals providing obstetrical services. Today, that figure has dropped to 17 of the 55 counties, with Marengo County losing their Labor and Delivery unit at Bryan W. Whitfield Memorial Hospital this month.

The issue isn’t always disease; it’s access.

Our state is suffering from an absolute health education crisis, a complete lack of medical availability and an incredibly diverse set of preventative health epidemics never before seen in our time. With the Affordable Care Act on the horizon, the general maintenance of community health has never been more paramount to each individual citizen.

That’s why organizations like Bama Covered, DIET and others are absolutely necessary at this moment, and that’s why we need more.

The health disparity margin at this moment is like an emergency beacon, and I firmly believe the student body, the medical community and the administration of The University of Alabama should further respond to the distress call.

There are tangible issues we can tackle. We should do our part to increase obstetric and prenatal care access in surrounding counties – whether it be with a mobile health operation or with an open, weekly prenatal clinic – and modify and provide education on nutrition and metabolic diseases. We can make a dent in these plaguing issues, and we can make access more universal.

It’s our duty as community members, as representatives of this long-standing institution, as Alabamians and as Americans.

Maxton Thoman is a sophomore majoring in biology. His column runs weekly.