Health & Wealth Desk

Wednesday mornings during Morning Edition, and Wednesday afternoon during All Things Considered

KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a short weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.

Bram Sable-Smith / KBIA/Side Effects Public Media

When Darvin Bentlage needed colon surgery in 2007, he had an expensive stay at the hospital.

“The room alone for a week was $25,000,” Bentlage says. Add in the cost of the procedure and, “it added up to about $60,000 or $70,000.”

Hope Kirwan / KBIA

TaNisha Webb points out a leak in the furnace room of an apartment in Kansas City, Mo. She explains the damp conditions are not ideal, especially right next to the system that circulates air throughout the home.

"It's going to pull in any other issues, airborne mold spores, bacteria growth potentially through the furnace and kind of distribute it in other places," Webb said.

Hope Kirwan / KBIA

Several months remain until the next open enrollment period for health insurance, but any insurance company looking to raise the cost of their plans next year had to submit their proposed increase by June 1.

In Missouri, seven insurance companies submitted rate increases for 11 different plans, with proposed raises ranging between 11 and 28 percent. Almost every company who submitted a rate increase cited the rising cost of healthcare as a reason for the change.

Bram Sable-Smith / KBIA/Side Effects Public Media

When cattle farmer Greg Fleshman joined the board of Putnam County Memorial Hospital in rural northern Missouri in 2011, the hospital was on the brink of closing.

“Things we just falling apart financially and the morale of the employees. And it just seemed to get worse and worse,” he recalls. “Those were the darkest days.”

Bram Sable-Smith / KBIA

Earlier this year, KBIA began a special reporting project highlighting the income and health disparities in the Missouri Bootheel. In May the project continued as KBIA traveled to the Bootheel town of Kennett, Mo., to host a community conversation.

The goal was to bring local residents and leaders to the same table to discuss difficulties in access to health care, the struggling rural economy and how to fix it. The following is an excerpt from that conversation. The full version may be found in an earlier post

Kristofor Husted/KBIA/Harvest Public Media

On May 20th, KBIA held a community conversation event in Kennett, Mo. The goal was to bring local residents and leaders of rural southeast Missouri to the same table to discuss difficulties in access to health care, the struggling rural economy and how to fix it. It's an event we called Health Barriers: Symptoms of a Rural Economy.

CDC NCHS, National Vital Statistics System, Mortality / The Center for Disease Control

The CDC reported in March of this year that the Midwest now sees higher rates of heroin overdose deaths than any other region of the country. The rate for heroin related deaths in the Midwest increased nearly 11-fold between 2000 and 2013.

Members of Missouri Law Enforcement said that opiates, including prescription drugs and heroin, have become more commonly abused in recent years.

According to the St. Louis County Health Department there were 113 heroin related deaths in 2014. And according to the St. Louis City Department of Health there were 123 heroin or opiate overdose deaths in the city.

Here a lawmaker, a treatment expert and families talk about the impact heroin and opiates are having in Missouri.

Dr.Farouk / Flickr

Last weekend, around 100 students graduated from the University of Missouri School of Medicine.  


But four times that many doctors will commit suicide this year in the United States.


Many believe problems with depression and anxiety in medical students is a leading cause for the mental health issues among physicians. Rep. Keith Frederick, R-Rolla, said these issues can also effect a doctor's ability to practice.


"Some doctors end up taking their own lives, but many go on practicing in a state where they're not as effective as they would be if they were completely healthy," said Frederick, who is also an orthopedic surgeon. "The healthcare provided by those physicians in training and future physicians will be much better if they aren't themselves suffering from depression.


Rebecca Smith / KBIA

A House bill that would have allowed anyone to possess and administer naloxone, a drug that reverses opiate overdoses was one of the victims of the Senate stalemate at the end of the 2015 Legislative session.

Last July, Gov. Jay Nixon signed a bill that allows law enforcement to carry naloxone in their vehicles and administer the drug at the scene of an overdose. This is much like what paramedics have done throughout the state for many years.

But some legislators, advocates and law enforcement believe that putting Narcan in the hands of friends and family of addicts would be more effective at saving lives.

alamosbasement / flickr


  When it comes to kids, physical health may be what sends them to the doctor. Scrapes and fevers may get students sent to the school nurse.

But studies from the National Institute of Mental Health show that half of all mental disorders start by age 14, and almost half of teens have a mental disorder.

Several years ago, Missouri State Representative Holly Rehder’s daughter struggled with prescription drug abuse. “She had cut her thumb at work and went and got stitches and got a prescription,” Rehder recalls. When her prescription ran out she continued using the pain killers, says Rehder, “because they were so easy to obtain.”

Now, Rehder is sponsoring a bill to make it harder for addicts to obtain drugs in Missouri.

KOMUnews / Flickr

Dr. Claudia Preuschoff is a pediatrician in Poplar Bluff. She often treats children from rural communities in her area, especially those who may need more than primary care.

“I just had a referral last week from a nurse practitioner in a much more rural area,” Preuschoff said. “The question was 'Do you think this child has autism, and if so what are we going to do about it?'”

According to a study by the CDC, the prevalence of autism spectrum disorder diagnoses in the United States more than doubled between 2000 and 2010.

In rural areas - where there are few medical specialists - the increase in identified cases of autism can be especially difficult to manage.

Provided by the University of Missouri Extension

McDonald County, Missouri, is home to many immigrant groups that have moved into the county in the last twenty years. These groups include Hispanic, Somali, Burmese, Sudanese and numerous others. And while these groups do not overlap culturally, they do share one thing - language acts as a barrier to access when it comes to their health.

Jack Howard/KBIA

Missouri is home to two of the nation’s least accessible cities - St. Louis and Springfield. A group named WalletHub gathered information to compile this list of accessible cities. And one criteria it used was how easily people with disabilities can move around. Or, in the case of these cities, can’t.

But a new accessibility app called Compeer is currently being beta tested and may soon be able to help those with disabilities navigate cities more easily.

Mothers Exchanging Breast Milk Online in Columbia

Apr 22, 2015
Micheala Sosby / KBIA

When Sarah Cranston met Danielle Geurts, she had a lot of questions. She wanted to know about Geurts’ caffeine consumption, any medications she took, and her baby’s health. Cranston wanted to be sure Geurts’ breast milk was safe for her own 6-month-old son, Ian.

Cranston and Geurts met on a Facebook page for mothers looking to either donate or receive breast milk.


Lucia Sebastian is the Language Assistant at the Head Start in Noel, Missouri. She works with the numerous immigrant children who have limited English skills and need help to communicate.

She has a four-year old daughter enrolled at Head Start, but she recounted an incident where Head Start was instrumental in helping her older son, Victor.

When her son was eleven years old, he was playing baseball with a friend in the yard and got hit in the mouth with the bat. The blow knocked out several teeth, but Sebastian was unsure she could afford the costs of taking Victor to the hospital.

Juhan Sonin / Flickr

Think about the information your doctor’s office or health insurance provider collects about you: your address, birthday and social security number. But they also have your medical history, current conditions and information about your insurance policy connected to your file.


All of this information is incredibly personal and to a hacker, it's incredibly valuable.


Jack Howard/KBIA

After the Affordable Care Act passed in 2010, electronic health records were put into effect in 2012 and were intended to reduce paperwork and increase the quality of care.


But when it came to nursing homes, the New York Times reported in August 2014 that staffing records used to rate nursing homes were mostly self-reported and possibly skewed. According to federal documents, a series of improvements including a more regulated, electronic system of staff recording, similar to that adopted under the ACA, were proposed to improve the care for nursing home patients.


DVIDSHUB / flickr

Last week, Kansas City University of Medicine and Biosciences announced it will open a medical school in Joplin, the first new medical school in Missouri in more than 40 years. The school is expecting to matriculate 150 students in its first class in 2017, and between 150 and 160 students in each subsequent year. KBIA’s Bram Sable-Smith spoke with Dr. Marc Hahn, president and CEO of the university, about the needs the new school will be filling for that region of the state. 

Bram Sable-Smith / KBIA

This story is part of our series "Shortage in Rich Land" on Missouri's Bootheel region. Click here to see all of the stories.

Anthony Smith has a spiel he will deliver many, many times today.

“I’m Anthony Smith with the Family Counseling Center," he says, "and today is identified as the 'point-in-time count' for the state of Missouri. The governor’s office does this annually. We try to conduct a winter count to identify individuals who are homeless, or at risk of being homeless in our community.”

Bram Sable-Smith / KBIA

This story is part of our series "Shortage in Rich Land" on Missouri's Bootheel region. Click here to see all of the stories.

It’s a cold afternoon in Kennett, Mo. The lawns in this low-income housing neighborhood are still wet from yesterday’s rain. And just inside the door of her mother’s brick home, 27-year-old Marylouisa Cantu sits on a couch, pregnant and draped in a blanket.

Her mother beckons, through the storm door.

“Come in, come in.”

Hope Kirwan / KBIA

Representative Jay Barnes of Jefferson City is sponsoring a bill this legislative session that would help develop health clinics at underserved Missouri schools.

House Bill 320 is still in committee, but this is the second year that Valley Middle School in House Springs, Mo. has served students in their in-school health clinic

Bram Sable-Smith / KBIA

This story is part of our series "Shortage in Rich Land" on Missouri's Bootheel region. Click here to see all of the stories.

It’s early morning. The sun is shining brightly on the corrugated metal siding of the Otto Bean Medical Center in Kennett, Mo., and inside the building, Judith Haggard is pricking the soles of her patient’s feet with a pin.

Otto Bean is part of the SEMO Health Network, a Federally Qualified Health Center which operates several clinics across southeast Missouri.

Haggard is a nurse practitioner and one of the ranking medical providers here at the clinic, which has no full-time doctor. She has just 15 minutes to spend with her patient, a 71-year-old diabetic on Medicaid.

A Growing Number of Births Happen Outside Hospitals

Mar 11, 2015

A growing number of births in the United States are happening outside of hospitals, according to the National Center for Health Statistics. The Missouri Department of Health and Senior Services reported two percent of births in Missouri took place in homes, birth centers, and in family practices in 2013. The number of out-of-hospital births has been on the rise since 2006 in Missouri because it’s becoming an attractive alternative for some families.

If you’re in the market for fluorescent light bulbs, you might talk to Chris Smiley. In the past few weeks, she’s been trying to sell off what’s left of Sac-Osage Hospital.

“Casework, lighting, plumping, sinks, toilets. Anything you want,” Smiley says.

That’s not in her job description. She’s actually the CEO of Sac-Osage, a hospital in Osceola, Mo., that closed in September.

Rebecca Smith / KBIA

Pippa Hull sits on her mother’s lap across the kitchen table in their Parkville home. She is an outgoing and talkative seven-year-old girl, who just happens to have a rare and severe form of epilepsy called Lennox-Gastaut syndrome. Pippa’s mother, Megan, said this form of epilepsy is characterized by its lack of response to treatments.

Hull said they have tried different medications, they have had a VNS or Vagus Nerve Stimulation device implanted in Pippa’s chest, and they have even tried a special diet to try and reduce the number of seizures Pippa experiences.

Alex / Flickr

It’s generally known that women tend to live longer than men. But what’s less known is how the same longevity can be a  financial burden for women.

Last month, the Women’s Foundation of Greater Kansas City and the MU Institute of Public Policy released a report called Status of Women in Missouri. According to the report, women make up two-thirds of the Missourians aged 65 and older who are living in poverty.

“Their lives are much longer but then you couple that with the pay gap,” said Wendy Doyle, President and CEO of the Women's Foundation.

Courtesy of Aaron Banks

Aaron Banks, a Columbia native, spent more than a year investigating crimes by listening to phone calls from prison inmates to their friends, family and children. He said the conversations with children really struck a nerve with him. 

“They would be asking when am I going to see you again? why aren’t you at home? And that kind of stuff. It was just heartbreaking to hear that sort of thing," he said.

Banks said these overheard conversations began to affect his relationship with own children, so he began to spend more time at home and this made his craft beer hobby more difficult.

Andy Lamb / Flickr

Hepatitis C is a virus that affects the liver, often causing liver cancer or cirrhosis. Although they share a name, it is completely different from hepatitis A or B so current hepatitis vaccines don’t guard against hep C.

The Centers for Disease Control and Prevention estimates that about 3.2 million people in the United States have hepatitis C. But Bruce Burkett, Founder and Director of the Hep C Alliance, said the disease often goes untreated simply because people don’t know they are infected.


Dan Ox / Flickr

Megan Oberg had a rough time after her first two deliveries. One moment she'd be happy, in another, not really. And she said that's pretty typical.


“Most women who have given birth can tell you some time during the first two weeks you tend to have some ups and downs as far as mood swings, as the hormones leave the system,” Oberg said.


For her third pregnancy she decided she wanted to try something new.