Curry County is the unhealthiest county in the state, with the highest mortality, suicide and alcohol and drug use rates.

And, said Annette Klinefelter of the county public health department, establishing a free-standing emergency department could be key to improving those problems.

Klinefelter, the planning and development manager for Curry Healthy Communities, presented her findings at a special meeting of the Brookings City Council on behalf of the Brookings Vision Council.

The findings weren't exactly uplifting.

Curry County has the highest mortality rate in Oregon andndash; not surprising to many, as the area boasts an higher number of retired and elderly people.

"You could say we have a lot of old people; that of course they're going to die earlier," Klinefelter said "But that's not how it's calculated, in premature death. The elderly people here do quite well. It's the people aged 40 to 60 who are dying. We're losing a disproportionate number of people in that bracket."

An array of diseases andndash; cancer, heart disease, strokes, respiratory diseases and diabetes among them andndash; are killing people here at a rate about twice that of the state average. So is alcohol and drug abuse. And the number of people who have considered committing suicide andndash; 35 per 100,00 residents in Curry County versus 15.3 per 100,000 residents statewide andndash; is unprecedented, Klinefelter said.

Extrapolated to Curry County's population of about 22,000 residents, that means about eight suicides a year.

Some of the blame can be put on a "dearth of living wage jobs, a dearth of affordable housing" and the difficulty in obtaining health insurance. Much can also be blamed on the lack of emergency infrastructure, Klinefelter said.

Free-standing emergency rooms started as a way to serve the needs of people in rural areas, and are gaining in popularity across the nation. As opposed to urgent care clinics, such facilities seek to duplicate procedures offered by hospital emergency departments. And unlike most urgent care centers, they usually accept ambulance traffic.

People aged 60 to 102 are most likely to call 911 andndash; the most common complaints are back pain and shortness of breath andndash; and transported via ambulance to Sutter Coast Hospital in Crescent City.

Three times as many patients are transported to Sutter Coast Hospital in California than Curry General Hospital in Gold Beach andndash; ambulance rides that result in about $400,000 crossing the state line each year. Add that to the cost of care patients receive there, and that tab totals about $21 million leaving the area each year, Klinefelter said.

"Healthwise?" she said. "I'd give Curry County a C-. Considering we live in such a beautiful area, I think that's unfortunate."

The prognosis isn't too good, either.

"Brookings did have a master plan 20 years ago," said Klinefelter, a Brookings native. "They wanted a golf course, a water treatment plant, a community college. They were able to make all those things happen."

Now, she said, a free-standing emergency department needs to be on the horizon to provide such services to those who already live here, to attract others who are hesitating about relocating because of it andndash; and keep millions of dollars in the county.

Oregon, however, is one of two states that doesn't offer certification for such facilities.

Brookings, the largest city in the county, needs a voice on the Curry Health District's board, Klinefelter said. The city isn't included in the network's service area because years ago, Brookings had its own medical network. When that disbanded, however, the south end of the county was not absorbed into the health system up north, leaving the city's populace in limbo.

If the city can't get a voice on the hospital board in Gold Beach, she said, it should bend the ears of those at the state level to establish protocol for the development of such emergency department facilities. Annexing Harbor could carry some weight there, as well.

"Until that changes, or they (the hospital board) expand the parameters andndash; they could shut down that building tomorrow," Klinefelter said. "The hospital in Gold Beach is 60 years old. It's falling apart. And it's in a tsunami zone."