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.

This is the third story in a series from the Health & Wealth desk on Healthy Nevada

Dr. Kristi Crymes is a family medicine doctor at the Nevada Medical Clinic. Crymes came up from Springfield three years ago to work in Vernon County, which has some of the state’s poorest health rankings. In 2010 the obesity rate in Vernon County was 30 percent. The incidence of adult diabetes has hung around 11 percent for the past 3 years. 

This is the second story in a series from the Health & Wealth desk on Healthy Nevada

The town of Nevada, in southwest Missouri, is changing in very subtle ways. To see it you really need to know where to look. For example, Walton Park, on Atlantic Street, used to be one of the town’s less popular parks for kids – just a small slide, a merry-go-round, and two swings. But today Walton Park is where all the cool six-year-olds go, thanks to one new piece of playground equipment.  

This is the first story in a series from the Health & Wealth desk on Healthy Nevada

Pookie Decocq is the healthy living coordinator for the YMCA in Nevada, Missouri. She’s also the town’s official Pickleball Ambassador, which is a team sport played with two wooden paddles, a whiffleball and a low net, like ping pong or badminton.

Pookie’s dream is to hold a pickleball tournament here in this rural town in southwest Missouri. But the average Nevada resident isn’t exactly the picture of health. Like a lot of small rural towns in the state, Nevada has very high rates of obesity and heart disease. Its diabetes rates are some of the highest in the country at 11 percent.

Hope Kirwan / KBIA

  Mizzou student Alex Talleur volunteers at the Community Garden at Kilgore’s Medical Pharmacy in Columbia.

As Talleur pulled green, prickly cucumbers from the yellowing vines, he said he’s envious of the kids who will be munching on the fresh produce in a few days.

"When I think of schools or anything like that, I always think of the greasy cafeteria food," Talleur said. "Having an opportunity to have really healthy, homegrown food is really great."

COD Newsroom / Flickr


Primary health care is no longer limited to the family doctor. With the growing popularity of clinics like the new Mizzou Quick Care, nurse practitioners are becoming more involved in providing primary care.

Jonny Williams / Flickr

Of the numerous items Missouri legislators will consider during this veto session, Senate Bill 841 has state health advocates paying attention. The bill's main purpose was to ban the sale of e-cigarettes to minors. But these good intentions may have led lawmakers astray.

Austin Federa / KBIA

In the wake of the Michael Brown shooting, residents of Ferguson are still dealing with the emotional effects of the conflict.

Bianca Huff and her three-year-old son live in Canfield Green, the apartment complex where Michael Brown was shot and killed on August 9. Five days after Brown’s death, KBIA producer Bram Sable-Smith talked with Huff about how she has been helping her son understand everything that has happened.

“He’s seen the police before, so he was like ‘Did the police do this?’ and ‘How did the boy pass?’ and just different questions,” Huff said. “And he be like ‘So he gone?’ And I said ‘Yeah, he gone but he in a better place’ And he just say ‘Ok’ and keep going about the day. So as long as he don’t get too distraught, I just let him do that.”

Fortunately, there are people already on the ground in Ferguson helping people like Huff and her family cope with the recent tragedy in their community.

Billion dollar day care

Aug 27, 2014
Nori / Flickr


Zsanay Duran lives at the end of a cul-de-sac in her neighborhood in Springfield, Mo. Inside her house looks less like a home and more like a daycare center.

Duran began providing unlicensed home daycare sort of by accident. Last fall when she was looking for work for her teenage son, she came across a posting on Craigslist from a mother who was desperate for childcare. The woman had an 8 month old baby and worked the 5am shift at a local fast-food chain. She could only afford $12 a day for childcare. Duran said her story really hit home.

“I was a single mom and I needed help in order to get on my feet and that’s why someone did for me,” Duran said. “And if I can help someone else get on their feet, why not?”

Kyle Spradley / MU News Bureau

Over 1 million Missourians experience some level of food insecurity and the Food Bank of Central and Northeast Missouri is looking to do something about it. Through MU's Grow Well Missouri Project, people enrolled in Missouri's Food Bank program can receive fruit and vegetable seeds and transplants along with their monthly package of food.

Hope Kirwan / KBIA


  As Father Knute Jacobson of Calvary Episcopal Church in Columbia prays, farmers and their families bow their heads and press their hands to a big, green, John Deere combine.

The combine blessing was just one of the events at the Boone County Farm Bureau’s Safety Expo held in Columbia Saturday, August 2. It was the first time attendees had been invited to pray for the collective safety of farmers this upcoming harvest season.

woodleywonderworks / Flickr

Missouri is headed to the polls this week to vote for, among other things, a ¾ cent sales tax increase that would be used to fund Missouri’s Department of Transportation, or MoDot. Missouri citizens have the special privilege of deciding whether to bankroll a decade of transportation projects, thanks to former Missouri congressman Mel Hancock.

Hancock grew up in Springfield, Mo and before being elected to the U.S House of Representatives in 1989, he forever changed Missouri’s tax code with something called “The Hancock Amendment.” The amendment limits the power of the state legislature to raise taxes on its own, only allowing for small, inconsequential bumps. Voters have to approve bigger tax increases in an election, like the one Missouri is having this week.

Hope Kirwan / KBIA


  Zane Volkman has been riding for as long as he can remember.

From the steer he would ride through his family’s pasture, to a donkey and finally to his grandpa’s horse, Volkman was already an experienced rider when he started training colts for a local rancher at age 12.

But an accident in the summer before his senior year of high school made it unclear if Volkman would be able to continue his career on a horse. While working at a livestock market in Kingdom City, Mo., a routine dismount caused Volkman to break his back and sustain three brain bleeds.






MU medical student Kayla Matzek is working at Cox Hospital in Branson, Missouri this summer. While a community with a population of only 10,000 might not seem attractive to some medical students, southwest Missouri is right where Matzek wants to be.

“I specifically want to go to a rural community because I think that you just get to know people more and it’s more of an intimate setting,” said Matzek, who grew up in a small town less than 30 minutes away from Branson.


Have you ever left a doctor’s office with more questions than answers? Don’t let that happen again. 

Join us Thursday, July 24th for an evening of conversation with health literacy experts Dr. Steve Pu and Dr. Ingrid Taylor of Health Literacy Missouri. Come take part in a live taping of KBIA’s local talk show Intersection, hosted by Ryan Famuliner.

epSos .de / Flickr

 Last month the U.S Department of Health and Human Services announced that more than 150,000 Missourians have signed up for health insurance under the ACA and many will be paying $60 or less a month for their plan after tax credits.

I talked with Karen Edison, founding director of the MU Center for Health Policy about why this could be called a success in Missouri.

COM SALUD / Flickr


Almost 800,000 uninsured Missourians became eligible for coverage through the federal health insurance marketplace earlier this year. As the state continues to consider extending coverage to even more individuals through Medicaid expansion, the need for primary care doctors will increase as well.

Closed Loop Healthcare / Smart America

 Your medical record can be more than just the file in which your doctor scribbles notes during your appointment. With help from movement sensors similar to those in an Xbox Kinect, patient data can be recorded in the home and shared easily with your network of doctors and hospitals, creating a comprehensive and accessible medical file. 

Hope Kirwan / KBIA

  The Columbia Farmer’s Market brings many different people together on Saturday mornings. Thanks to a local food program run by Sustainable Farms and Communities, this includes low-income families who can receive extra help to purchase fresh and locally-produced foods.

David Sachs / SEIU


  By now Missourians are familiar with the debate over expanding Medicaid in the state.

The Affordable Care Act gives most people the opportunity to purchase health insurance with help from federal tax credits. But individuals earning too little to qualify for these tax credits but too much to be covered under for Missouri Medicaid are stuck in what is called “The Gap.”

US Navy / Wikimedia Commons

In the discussion about veterans healthcare, the severity of the problem really depends on who you talk to.

Some lawmakers say the secret patient lists and unreasonable wait times are unfortunate but isolated instances. But others are calling for serious reforms of the whole VA system.

While the opinions of these lawmakers are important to the future of veterans healthcare, what about someone who works with the healthcare system every day?


 The Missouri legislature passed a resolution to establish a Multiple Sclerosis (MS) Task Force on May 6.

According to the resolution, Missouri lawmakers created the task force to “identify and address the unmet needs of persons with MS.”

Among many issues, the task force will be looking at MS treatments for Missourians.  Medical expenses for a person with MS can reach almost $70,000 per year. Access to these treatments can also be a concern.

Rural Assistance Center


Rural hospitals play a vital role in delivering quick emergent care to people in some of the more isolated areas of the country. These institutions provide 24/7 emergency services to rural communities where the next closest hospital could be 35 miles away or more. But because they often serve so few people, it’s hard for them to be financially successful. So the federal government set up the critical access hospital program, whereby hospitals meeting certain criteria would receive Medicare refunds at 101 percent of reasonable costs.  

Since the program began in 1997, 1,331 hospitals have been given critical access hospital status, 35 of which are in Missouri. But policy makers are beginning to question whether that’s too many for the government to handle financially.

Katie Hiler / KBIA

  Note: A portion of this story was aired as part of the Health & Wealth Update for 5/14/2014

When I think about adult dental care in Missouri, I think of Ben Affleck. In the movie Argo, CIA agent Tony Mendez, played by Affleck, pitches his plan to extract six American hostages from Iran by pretending to be on a Hollywood scouting trip. The CIA director doesn’t think it’ll work and wants to look for a better option. That’s when Mendez says:

“There are only bad options. It’s about finding the best one.”

That’s what it’s like for Missourians who can’t afford private dental insurance. Back in 2005 Missouri de-funded dental care for all Medicaid recipients except, children, pregnant women and the disabled. And it’s left a lot of people with only bad options.

Katie Hiler / KBIA

Back in 2005, Missouri de-funded dental care for all Medicaid recipients except, children, pregnant women and the disabled. And it’s left a lot of people with only bad options.

Walmart / Flickr

Summer is coming, and Missourians are hitting the open road, which, after a brutal winter, has taken quite a beating. The Missouri Department of Transportation is looking into making Missouri roads safer, not just by filling in potholes but also widening shoulders on rural roads and expanding Interstate 70 from two lanes to three. That sounds expensive, but the Missouri state legislature has a plan for drumming up close to $800 million a year over the next ten years for Department of Transportation projects – a one percent increase in sales and use tax.

MU Student Parent Center

Naomi Clark, a doctoral candidate in the English department, began taking her children to the Student Parent Center in 2009. Over the past five years, Clark has completed her Master’s degree and will be getting her PhD this semester.

Clark said she would not have completed her degrees without the Student Parent Center and that many of her classmates feel the same way.

“The daycare has been really instrumental in making so many degrees possible, increasing retention and increasing the completion rate,” Clark said.

MU Extension Center

On April 24, the family resource organization Parentlink will hold a special conference in Jefferson City for Grandparents raising grandchildren in the state of Missouri. The free event will provide Seniors with resources, practical information as well as support to help them meet the significant financial and legal challenges they face. But events like this one happen only occasionally - more sustained outreach programs for these Grandparents are harder to find. Diana Milne runs the "Northland Grandfamilies" program, part of the MU Extension Center. It's the only program specifically targeting grandparents and aunts and uncles who are raising children in the greater Kansas City area.

Conor Lawless / Flickr

The Missouri House of Representatives has proposed adding $48 million in federal and state funds to next year’s Medicaid budget to cover adult dental care. Last week the Senate Appropriations Committee agreed to the additional $48 million, but with some caveats. The money would only be used to pay for preventative dental care, like maintenance and extraction procedures. Part of the $48 million would also go towards paying dentists more for these procedures. Currently, the state only reimburses dentists up to 35 percent of usual and customary costs.

Gaijin Biker / Flickr


The Silver Haired Legislature is an elected body of Missouri senior citizens who advocate for legislation that addresses the concerns of older adults, like pay day loan restrictions and elder abuse. But recently they’ve thrown their support behind a unique issue – children in the care of grandparents, and the complicated process of obtaining legal guardianship in the state of Missouri.  

Lois Fitzpatrick is a 76-year-old woman who lives in Clay County. In 2001, Fitzpatrick and her husband agreed to be the legal guardians of their granddaughter - the child’s mother, Fitzpatrick’s daughter, was in favor of it. According to Fitzpatrick, to obtain uncontested legal guardianship at that time you had to fill out an application, get the parents signatures notarized, and pay a $25 filing fee. The county clerk’s office would then set a date for you to stand in front of the judge. It was simple, she said. A few years later, it wasn’t.

Anderson Mancini / Flickr

While the Affordable Care Act and Medicaid expansion have been the topics du jour in recent weeks, one of the most overlooked aspects of healthcare in the state of Missouri may be oral health. In 2012 The Pew Charitable Trust’s Center on the States issued a report card for all 50 states based on eight benchmarks that they consider important steps to improve and expand access to dental health. Missouri received a grade of C, having met or exceeded only half of those benchmarks.