Bram Sable-Smith

Health Reporter

A curious Columbia, Mo. native, Bram Sable-Smith has documented mbira musicians in Zimbabwe, mining protests in Chile, and the St. Louis airport's tumultuous relationship with the Chinese cargo business. His reporting from Ferguson, Mo. was part of a KBIA documentary honored by the Missouri Broadcasters Association and winner of a national Edward R. Murrow Award. He comes to KBIA most recently from the Salt Institute for Documentary Studies in Portland, Maine.

Ways to Connect

It’s a familiar story in rural America. Four years ago the Pemiscot County hospital, the lone public hospital in Missouri’s poorest county, nearly closed. What’s keeping it in business today has also become increasingly common in rural healthcare: relationships with a handful of local pharmacies.


No one at the hospital in Fulton, Missouri (population 12,790) had ever heard of a management consultant named Jorge Perez until he showed up at its potluck in September.


When Sarah Scantling went into labor this summer, she had to drive 30 miles and across state lines.

Three years earlier, the only maternity ward where she lives in Pemiscot County, Missouri closed down. Scantling had to choose between a handful of other hospitals in the region between 20 and 70 miles away. She chose to give birth in the hospital in Dyersburg, Tennessee.


Fencing surrounds a patch of grass that used to be a neighborhood in the center of Herculaneum, Missouri. A sign in the grass reads, "No Trespassing. Lead Contamination."
Bram Sable-Smith / KBIA/Side Effects Public Media

Bill Haggard is the mayor of Herculaneum, Missouri, a town of 4,000 about a 30 minute drive south of St. Louis. He’s also the fire chief, president of the historical society and a retired teacher, among other distinctions, although he identifies first as a “lifelong resident.”

For more than a century this town was built up around the lead smelter that sat along the Mississippi River. Today, though, most of the houses remaining in the hollowed out center of town are marked in spray paint with a bright orange ‘X.’

“If they have an ‘X’ on them they’re coming down,” Haggard says while driving by houses slated for demolition.

For five years now, the Missouri legislature has considered legislation to create a prescription drug monitoring database that would allow pharmacists and physicians to look at their patient's prescription history for signs of misuse of narcotics. And for five years, Missouri pharmacists like Erica Hopkins have watched those efforts fail with disappointment.


$1.25 million.

That’s the size of the bill that could have shuttered the only public hospital in rural Pemiscot County, Missouri in August 2013.

Bram Sable-Smith / KBIA

University of Missouri System faculty, staff and community members gathered in Columbia Friday to hear system president Mun Choi outline the University of Missouri System’s budget for fiscal year 2018.

Current decreases in state funding, uncertainty about future state funding and enrollment declines at the system’s flagship campus in Columbia have forced officials to look for both short- and long-term solutions to significant budget shortfalls.


For the hundreds of rural hospitals struggling to stay in business, health policy decisions made in Washington D.C. this summer could make survival a lot tougher.

Blue Cross Blue Shield of Kansas City announced on Wednesday that it will not offer individual plans on the Affordable Care Act insurance exchanges next year The move will affect about 67,000 people across 30 counties in Missouri and two counties in Kansas

“Through 2016 we have lost more than  $100 million [on ACA plans],” the company’s CEO Danette Wilson said in a release. “This is unsustainable for our company.”


Bram Sable-Smith / KBIA/Side Effects Public Media

Two-year-old Ryan Lennon Fines is sitting on his family’s couch flipping through a picture book of emergency vehicles. He’s looking for the motorcycle, but first he stops on the page with an airplane.

“That’s an air ambulance,” his father Scott Fines tells him, “you’ve been on one of those.”

When Ryan was born on Christmas day 2014, his mouth wasn’t connected to his stomach. It’s a condition known as esophageal atresia. After three months in a NICU in St. Louis the family flew to Boston, where Ryan had surgery.

In the current debates over health care, one topic rarely gets mentioned: dental health benefits. That’s because dental health has historically been separated from the rest of medicine. But today, that separation leaves many Americans with no way to prevent or treat debilitating dental health problems.

Author Mary Otto tells the story of the rampant disparities in dental health in the United States and how those play into other disparities of race, class and income in her new book, Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America.


Bram Sable-Smith / KBIA

The Boone County Hospital Board of Trustees announced Thursday it’s considering five operating proposals for the hospital’s future.

The Hospital is currently in a lease agreement through the year 2020 with St. Louis-based BJC Health Care. A new operating agreement with BJC is one of five options Boone Hospital’s Board of Trustees is considering for its future.

Six years ago, 53-year-old Corla Morgan noticed blisters forming on her neck and back.

“I couldn’t sleep because when I took my shirt off, if my shirt touched my skin, the skin just peeled off,” Morgan says. “I was in really horrible pain.”

The University of Missouri's interim chancellor says he'll be leaving for new work as president at the New York Institute of Technology after May 3.  

In 2016 nearly 600 Missouri babies were born addicted to drugs. The condition, know as neonatal abstinence syndrome, has spiked in the state increasing by 538 percent between 2006 and 2016.  

 

The KBIA Health & Wealth Desk will be exploring those numbers throughout the year, along with work being done to address the issue. Reporter Bram Sable-Smith recently spoke with one organization, Project WIN, that provides behavioral health services including addiction counseling to pregnant and postpartum women in the Missouri Bootheel. Brooke Burlison is the project manager. 

 

 


Darvin Bentlage says his health insurance plan used to be the same as all the other cattle farmers in Barton County, Mo.: stay healthy until he turned 65, then get on Medicare. But when he turned 50, things did not go according to plan.

“Well, I had a couple issues,” he says.

He’s putting it mildly.


Dr.Farouk / Flickr

This week on Intersection, we talk with KBIA health reporter Bram Sable-Smith about possible changes to healthcare in Missouri. One change could come this Thursday, when the U.S. House is scheduled to vote on the American Health Care Act. This bill is the GOP’s proposed replacement for the Affordable Care Act, also known as Obamacare. We discuss what the changes proposed in the GOP replacement bill could mean for Missouri, especially for people in rural parts of our state. 

Listen to the full episode here: 


In a letter sent to Congress Wednesday, the American Medical Association said it could not support the American Health Care Act "as drafted." The bill was released Monday evening as congressional Republicans' replacement for the Affordable Care Act, also known as Obamacare. 

Ahead of the association's decision, KBIA sat down to talk healthcare reform with Dr. David Barbe, president-elect of the American Medical Association and a practicing physician in rural Mountain Grove, Mo. 


This story has been updated on March 7, 2017.

Missouri State Senator David Sater is looking for ways to reduce the amount of money his state spends on Medicaid, because, as he sees it, “the Medicaid program is eating out lunch right now.”

His idea? To voluntarily cap the amount of Medicaid funding coming from the federal government. 


Courtesy of Dr. Nabil Al-Khalisi

How hard is it for an Iraqi to get a visa to the United States? Ask Dr. Nabil Al-Khalisi, a French-born Iraqi doctor with a track record of working with Americans and British in Baghdad.

Al-Khalisi says he spent over a year trying to get a visa to leave Iraq and had even arranged to be smuggled out of the country in a pickled-cabbage barrel before receiving a Fulbright scholarship to study in the U.S. in 2010. He requested political asylum, which he received after a two-year vetting process. Today he's a diagnostic radiology resident at the University of Missouri — Kansas City. 


Monash Univeristy / flickr

Health care policy has come back into public discussion in a big way, and we want to add your voice to the conversation. Over the coming months, we’ll be featuring interviews with health care providers, experts and everyday Missourians about their health hopes, needs and concerns moving forward.


Bram Sable-Smith / KBIA

A lunchtime rally brought about 50 people to U.S. Senator Roy Blunt’s Columbia, Missouri office Friday, voicing their support for the Affordable Care Act to his local staff. The demonstrators called for the health care law to be fixed rather than repealed completely.


Who Didn't Watch The Election Last Night?

Nov 9, 2016

We've spent most of the morning hearing from people who followed last night's election returns intently. But how about the people who actively avoided them? KBIA sent reporters Carter Woodiel, Hannah Haynes and Bram Sable-Smith out to find them.

Every morning Pat Wilson walks down the hall from her office in the Julia Goldstein Early Childhood Education Center through the gym and into a part of the building not typically associated with a school nurse: the kitchen.

There, she checks a list—posted on the side of the stainless steel refrigerator—of all the students in the school with a food allergy.

“It’s constantly being updated,” Wilson says.


Deana Kilpatrick smoked crack for the first time when she was 13 years old. “From there,” she says, “I really just spiraled down hill.”

For the next 30 years, drugs and alcohol were part of her life. Then last November, at the age of 43, she moved to Branson, Missouri looking for a new start. It was going pretty well until loneliness drove her to relapse a few months ago. She got a fourth DWI and faced up to four years in jail.


Emma Brown / for KBIA

When the first busload of campers arrived at Camp Sabra in Missouri’s Lake of the Ozarks this summer, they were greeted by more than one hundred cheering, dancing and hugging counselors.

For the first time in four years, Sydney Aaranson was not one of those counselors.


Univeristy of Missouri System / flickr

Wren Baker was officially announced as the new Athletic Director of the University of North Texas today, Baker had been serving as Interim Athletic Director at the University of Missouri.

The announcement was widely anticipated and comes less than a month after Mack Rhoades left the Athletic Director post at Mizzou to take a similar job at Baylor University.

In an email to the University of Missouri community, Interim MU Chancellor Hank Foley called the search for a permanent Athletic Director "a top priority" and said he would serve in the role in the meantime. 

Eric Peters / U.S. Department of Agriculture

There's been a national spike in the number of deaths from opioid drug overdoses over the past 15 years and some of the biggest increases have come in the Midwest. Missouri is no exception and also holds the distinction of being the only state without a prescription drug monitoring database—a common tool for preventing abuse.

U.S. Agriculture Secretary Tom Vilsack head's the nation's initiative on rural opioid addiction. On Friday, Vilsack and U.S. Senator Claire McCaskill will host a town hall meeting in Columbia to discuss the epidemic with media and invited guests. 

KBIA spoke with Secretary Vilsack earlier this week. 

Promotional Video / MU Health

Every year, the US Census Bureau and the Centers for Disease Control and Prevention administer the National Health Interview Survey to help track the health of the various demographic groups that make up the county's population. But it wasn’t until 2013 that the survey included questions about sexual orientation.

One finding that emerged was that lesbian and bisexual women are more likely to be obese than their heterosexual counterparts. Jane McElroy, associate professor of Family and Community Medicine at the University of Missouri-Columbia, is the first to publish research on interventions to specifically address the issue. Her study was published in the current issue of Women’s Health Issues, and she came by the KBIA studios to discuss her findings.


On a rainy Tuesday morning in May, social worker Meghan Bragers drove up to Ferguson, Mo. to visit a 23-year-old expectant mother named Marie Anderson.

Anderson, who was 33 weeks pregnant at the time, was having a particularly difficult pregnancy.

“She’s been in a car accident, her car has been totaled, she’s having back issues, she’s having increased depressive symptoms,” Bragers said en route to the visit. “Things have gotten pretty difficult.”

Difficult, or as Anderson herself called it, “a tornado.”


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