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.

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.

Katie Hiler / KBIA


We’ve been hearing a lot about the Affordable Care Act from a number of politicians - Governor Jay Nixon, Senator Roy Blunt, and, of course, President Obama, to name a few.  These people can talk about the number of people insured and weigh the cost versus economic impact. But behind those numbers they’re citing are people, Missourians. Those dollar figures they throw around, that’s money in and out of our pockets. So how do Missourians who have been trying to utilize the new healthcare law feel about it? 

Marissanne Lewis-Thompson / KBIA

With the March 31 enrollment deadline for health insurance under the Affordable Care Act drawing near, healthcare centers across the state have been ramping up efforts to get Missourians signed-up. The group Cover Missouri organized a number of enrollment events across the state earlier this month.

Katie Hiler / KBIA

On a Thursday morning in late February, a group of 100 middle and high school students gathered in the rotunda of the state capitol building in Jefferson City for a capitol day event organized by the Tobacco Free Missouri Youth Advisory Board. Their goal was to speak with their legislators about making the building smoke-free. Unlike every other public building in Jefferson City, the capitol building doesn’t entirely comply with the city’s smoking ban - lawmakers are unofficially allowed to smoke in their offices.

“They absolutely have the right to smoke and we’re not telling anyone they don’t,” said Youth Advisory board member Alex Higginbotham, age 17. “They can still smoke in their home, but we’re asking them in public not to affect us.”

According to the Centers for Disease Control and Prevention, Missouri is ranked 48th in the nation for number of adult smokers - roughly 1 in 4 Missourians over the age of 18 smoke. And the state ranks 50th for workplace exposure to second-hand smoke.  The state’s Clean Indoor Air law gives business owners the option to declare a public space smoke-free, or to set up a designated smoking area. If communities want to be truly smoke-free, it’s up to local governments to make that happen. In the fall of 2010, Jefferson City banned indoor smoking in public spaces, including the capitol building. But state legislators continue to not-so-secretly smoke in their offices.

Challiyan / Flickr

You’ve probably heard it before: rates of smoking and tobacco use in Missouri are some of the highest in the nation. Roughly 1 in 4 Missourians over the age of 18 smoke tobacco and the state ranks 50th for workplace exposure to second-hand smoke.  But what isn’t clear is why Missouri has consistently ranked so low compared with other states. I spoke with Traci Kennedy, Executive Director of Tobacco Free Missouri, who says it’s because lawmakers have made it particularly easy to be a tobacco user in the state.

Katie Hiler / KBIA

The Affordable Care Act’s online health insurance marketplace has been open for business since October 1 and technical issues that plagued the website early on have mostly been resolved. Yet Missouri residents have been slow to sign-up for health insurance under the new law. According to the nonprofit group Kaiser Family Foundation, only 40 percent of Missourians eligible to enroll have actually chosen a plan. I spoke with U.S. Secretary of Agriculture Tom Vilsack about why signing up is important for Missouri residents, particularly in rural areas.  

Courtesy of Cynthia Hill

When her ex-husband would beat her, survivor Deanna Walters says her family used to ask her "Why don't you just leave him?" 

If only the answer were simple. And for long-time advocate for domestic abuse survivors Kit Gruelle, if only no one would ever ask that question. 

nomadsoul1 / dreamstime

At his sixth State of the State address Tuesday, Gov. Jay Nixon renewed his push to expand Medicaid, the health insurance program for the low-income population, in Missouri. He was careful, though, not to mention the “e” word itself. Instead, the governor called lawmakers to work on reforming the program.

“I look forward to working with all of you to bring affordable health coverage to working families in Missouri, and reform Medicaid the Missouri way,” said Nixon.

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

Matt Pauly has traveled the world  – he’s lived in New York, Paris, South Korea – but he’s still a farm boy at heart.

Grant Gerlock / Harvest Public Media

This is an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.

One sign that you have strong farm roots is when your rural road is named for your family.

Harum Helmy / KBIA News


On an afternoon in early December, 60-year-old Columbia resident Jeannie Wyble sits in a small cubicle at Columbia’s Family Health Center, telling Aaron Swaney, a application counselor, about the heart attack she suffered in 2002.

“I quit smoking when I had my heart attack,” Wyble said. “Smoked my last cigarette on the way to the ER, never smoked another one.”

At the time, Wyble was still insured through her husband’s union plan. But after the heart attack, the insurance company began increasing her monthly premium. Wyble says at one point, she had to pay almost $500 a month.

“And then when we found out they were going to jump even more again the following January,” Wyble said. “It was very clear to us that we couldn’t pay my premiums anymore and that mine would just have to be dropped. In effect, [the insurance company] decided to get rid of me, and it worked. They did. They got rid of me.”

Alan Cleaver / flickr


As an Affordable Care Act navigator, Kate King has been traveling to counties throughout central Missouri spreading awareness of and getting Missourians enrolled in  

King works with the Central Missouri Area Agency on Aging, which serves a 19-county area, 17 of them rural. The agency is part of a nonprofit alliance that received $750,000 in federal grants in August to help with outreach. 


The first thing you need to know about a meat shoot is that they don’t shoot animals.

“That’s not a crazy question, you know, we get that a lot,” said DeeDee Lakas, laughing a bit. “Do you shoot the meat? No, you shoot the target.”

Bridgit Bowden / KBIA News


The USDA estimates that more than 2 million people live in rural food deserts, or low-income communities more than 10 miles from a grocery store.  

Four years ago, the last grocery store in Pilot Grove, Mo., closed its doors, turning the town into a rural food desert.  The town had only a convenience store from which to bu food.   

That is, until 23 community investors came together to open Tyler's Market, a fully-stocked grocery store.  On the market's first day open, Pilot Grove residents gathered at the store.  


Amy Mayer / Harvest Public Media

This is the an installment of the 2013 edition of My Farm Roots, Harvest Public Media’s series chronicling Americans’ connection to the land. Click here to explore more My Farm Roots stories and to share your own.


Danelle Myer owns a small vegetable farm and like many other small farmers, she’s passionate about the kind of operation she wants to grow: a small, local business.

Abbie Fentress Swanson / Harvest Public Media


While doing research for the Harvest Public Media series “In the Shadows of the Slaughterhouse,” reporters Abbie Fentress Swanson and Peggy Lowe called roughly two dozen institutions to get statistics about the children of immigrant and refugee workers at American meatpacking plants. Swanson said she called federal agencies, researchers, unions, and immigration advocacy groups. But she couldn't find anyone who kept data on how many of these children live in the U.S., not to mention their health, education or economic status.

“They’re not on anyone’s radar,” Swanson said. “They’re not being tracked or followed, they’re kind of an invisible population in this country.”

Joel Sager
Joel Sager

A little known part of the U.S. Department of Agriculture’s Rural Development agency is one of the main sources of mortgage credit to low-income families in rural America.