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.

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
PEASAP / FLICKR

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.

 


fhcmo.org

  It’s no secret that health insurance can be a confusing topic.

“There's not a ton of health insurance literacy,” said Aaron Swaney, Outreach Enrollment Specialist for the Family Health Center in Columbia. ”But that's true from people who have never had health insurance before to people who work in the healthcare field.”  

  

Sharyn Morrow / Flickr

Prescription drug abuse can start with a routine problem, like lower back pain. A doctor will prescribe medication for the patient, but the pain doesn't go away. So the patient takes more medicine. 

And this behavior could lead to an addiction, said Len Paulozzi, an epidemiologist for the CDC. He finds patterns of drug abuse. 

NEC Corporation of America / Flickr

There is a long list of to-do’s when applying for a medical license in Missouri. Applicants have to provide detailed verification of their degrees, residency and previous work experience. Tack on several months for the state medical board to review all these items, and the whole process can take a lot of time.

Most physicians go through this process when they are first applying for a medical license. But the Federation of State Medical Boards (FSMB) found that many doctors don’t stop at one license.


Bram Sable-Smith / KBIA

When Mary Ratliff moved to Columbia from Mississippi in 1959, she was leaving one of the epicenters of American segregation and the burgeoning civil rights movement. But that doesn’t mean she escaped experiences of racism and segregation in her new home.

“It was subtle here when I first came," Ratliff said. "In fact I've made the comment many times, that Columbia is 'Big Little Dixie.' It wasn’t a whole lot different from Mississippi.”


Images of Money via Flickr

The Affordable Care Act included a temporary bump in the Medicaid fees paid to physicians for certain primary care services. The intention behind the two-year, federally-funded increase was to encourage more physicians to participate in Medicaid to accommodate an expanding pool of Medicaid patients anticipated by the law.

But a 2012 Supreme Court decision opened a window for states to reject Medicaid expansion – Missouri is one of 23 states that have chosen not to expanded coverage – and as of Jan. 1, the Medicaid fee bump is expired as well.

I spoke with Dave Dillon and Andrew Wheeler of the Missouri Hospital Association (MHA) about the impact the fee increase expiration will have on Missouri hospitals.


Bram Sable-Smith / KBIA

The Missouri Association of Local Public Health Agencies (MoALPHA) was founded in 1994 to support the  city and county public health agencies in the state. I spoke with the incoming chair of the association, Gary Zaborac, about the public health challenges facing Missouri in 2015.


Intel Free Press / flickr

As the use of telemedicine expands it is also growing the footprints of medical professionals, and when doctors licensed in one state begin consulting in another, it presents a problem for state medical boards. KBIA’s Hope Kirwan spoke with Jonathan Linkous, CEO of the American Telemedicine Association, about how states are regulating telemedicine.


Katie Hiler / KBIA

If you’ve ever lived in - or even visited - a small town, you know they can be pretty quaint. And Milan, Mo, population 1,881, is no exception.

Milan’s local hospital, Sullivan Country Memorial, has been around since 1953. Joe McCarty, a local resident and now patient in Sullivan’s long-term care unit, has lived in Milan almost his entire life – he’s turning 100 this year. Joe made his living as a cartoonist and up until just a few months ago he worked for the local newspaper.

Intel Free Press / Flickr

  Dr. Karen Edison is a dermatologist with the University of Missouri Health system. She has been using telemedicine for over 20 years to see patients at clinics in underserved areas of the state, and to follow-up with her rural patients in their homes. She can see photos of her patient’s skin, answer their questions through email, as well as talk with them through video calling.

Edison says telemedicine is a useful tool because it can save rural patients a trip to her office.

But rural patients aren’t only the ones looking to save time and money.

Missouri Foundation for Health

  Open enrollment for health coverage in 2015 is underway, and some Missourians satisfied with their current health insurance may be surprised to learn that parts of their plans, including premiums, are changed for the coming year. The Cover Missouri Coalition, a program of the Missouri Foundation for Health, is encouraging consumers to review their options during this year’s open enrollment period.

I spoke with Ryan Barker, Missouri Foundation for Health’s Vice President of Health Policy, about changes in this year’s health insurance marketplace.


   

healthcare.gov

  Last week marked the beginning of open enrollment for the federal health insurance marketplace, and on the surface it appears not much has changed. By some measures premiums before tax credits are just as affordable as last year - decreasing on average by about one percent according to a report by the Kaiser Family Foundation. But to be a savvy shopper, many consumers should give the marketplace a second look.


Obesity is the number one public health issue in Missouri – it affects more than 30% of adults and nearly one in seven children between the ages of ten and seventeen.

  

The Healthcare Equality Index is a national benchmarking tool that ranks hospitals based on whether their policies and practices include equal treatment for the LGBT community. Missouri’s standing in this index jumped from 37th  in the nation to 6th in just one year.

I spoke with Andrew Shaughnessy, Public Policy Manager of the Missouri LGBT advocacy organization PROMO, about why this ranking is so important and what it means for Missouri. 

    

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