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.

Harum Helmy / KBIA News

At only 17 cents per cigarette pack, Missouri has the lowest tax for tobacco in the U.S. In 2012, Missouri voters said no to increasing that tax to 90 cents per pack. Missouri is also one of 14 states that don't have some sort of a statewide ban on smoking in non-hospitality workplaces, and/or restaurants, and/or bars. All of this adds up to the Show-Me State's top spot as the freest state in the nation when it comes to tobacco. 

But since 2007, about two dozen municipalities in Missouri have enacted a comprehensive smoking ban in all workplaces, including restaurants and bars. This Monday, rural Washington, Mo., joins that list. The City Council voted to pass the ordinance to ban smoking back in January. 

Images of Money / Flickr

The uphill congressional battle to expand Medicaid in Missouri is making rural hospitals that serve areas with high poverty levels really, really nervous. KSMU's Jennifer Davidson has the story.

IntelFreePress / Flickr

  Almost gone are the days when physicians collect your medical records in yellow manila folders stacked ceiling-high behind the nurses’ counter.

More and more medical professionals in the U.S. are using an electronic health records system to do things like store patient data, call up medical records and even prescribe medications. A Department of Health and Human Services survey found that in 2011, 35 percent of all U.S. hospitals have adopted an electronic health records system. It's a pretty rapid growthin 2009, only 16 percent of U.S. hospitals use the system.

Many of these electronic systems are so handy they even have decision-making software—a tool that helps physicians make treatment recommendations and diagnoses.

“The idea is that a physician can open one up and maybe use one to diagnose whether a patient has appendicitis and decide whether they want to operate,” said Victoria Shaffer, an MU psychologist who studies the decision-making side of the electronic health records system.

Not all patients like this high-tech diagnoses tool, though.

Missouri Capitol
File Photo / KBIA

Missouri’s Republican-led House on Tuesday struck down Democrats’ attempts to include Medicaid expansion in the state’s budget.

If that scenario sounds familiar to you, it’s because these rejections have happened a few times before. On Feb. 25, two House committees rejected Rep. Jake Hummel’s (D-St. Louis) bill to expand Medicaid under the terms of the Affordable Care Act. On March 14, the Senate Appropriations committee voted down the Senate Democrats’ version of the expansion bill.

Rep. Jay Barnes (R-Jefferson City) was in one of the committees that struck down Rep. Hummel's Medicaid expansion proposal. Barnes has since introduced his own version of the expansion -- outlined in House Bill 700

Every week, KBIA's Health & Wealth Desk curates the week's most interesting (or so we think) articles and reports on rural health, wealth and society issues. 

Rural post offices in crisis

Libby Burns / KBIA

This is the second in a two-part discussion about health literacy and the healthcare reform.  

Not knowing what the online health insurance marketplace looks like might be problematic for Missourians. 

As part of the Affordable Care Act, Missouri’s uninsured can choose to buy insurance from the state’s health exchange come October. The exchange is an online marketplace where anyone who isn’t already insured will be able to compare and purchase private insurance plans. Some uninsured Missourians would be eligible for help with the cost, too.  

Missouri has missed the deadline to create its own marketplace or start a state-federal partnership. So, the federal government is setting it up. The problem is, even though the marketplace is supposed to be open for enrollment in about six months, no one knows what it looks like yet.

“We’re losing time that could be useful in helping people understand and prepare [for the exchange],” said Catina O’Leary, the director of Health Literacy Missouri, a nonprofit group that’s working to make health care topics more understandable for Missourians. “It would be really great if we could manage people’s expectations and start training on what they’re going to need to know.”

But here's what we know so far: 

Every Friday, KBIA’s Health and Wealth Desk curates the week’s most interesting (or so we think) articles and reports on rural health, wealth and society issues.

Osteopathic Physicians: An Answer To Rural Health Care Needs?

It’s no secret the U.S. is facing a shortage of primary care physicians – especially in rural areas, which is home to some 20 percent of all Americans, but only has 9 percent of all physicians. Compared to specialized medicine such as surgery and cardiology, primary care does not pay as well – and the average student loan debt for med school graduates is $161,290. Only about 24 percent of MD graduates lean to primary care. That’s not the case with recent osteopathic medicine graduates, though.  

Harum Helmy / KBIA News

On this week's Health and Wealth Update, the first part of a discussion about health literacy and the healthcare reform. 

With the Rural Reads series, we’re trying something new. Every Friday, KBIA’s Health and Wealth Desk curates the week’s most interesting (or so we think) articles and reports on rural issues.

What’s in a definition? The eligibility for federal grants

In February, the U.S. Department of Agriculture released a report that recommends defining ‘rural’ as areas with 50,000 or fewer residents - a number that's getting some strong reactions. The rural definition determines eligibility for USDA’s rural grants and programs. 

The excellent online news service The Daily Yonder is publishing a series of opinion pieces in response to USDA’s newest recommendation. Last week, Aletta Botts, a legislative staffer who helped draft the 2008 Farm Bill, wrote that the 50,000 size limit is too large and would hurt smaller communities that can’t compete with larger towns to win federal grants.  

Alexandra Olgin / KBIA News

A recent study by researchers at Chicago’s Roosevelt University found that between 2007 and 2011, the number of deaths from heroin overdose in the state of Missouri more than tripled. In 2007, fewer than 70 people died from heroin overdose. In 2011, that number ballooned to 244. 

Studies show most accidental overdoses happen in the presence of others. KBIA’s Alexandra Olgin takes us to a rally in Jefferson City on Tuesday supports a bill that could encourage overdose witnesses to be a Good Samaritan and call 911.

Jeanine Anderson / Flickr

This week -- we’re hearing about the Medicaid expansion debate down in West Plains -- the seat of rural Howell County. A study by the Missouri Budget Project shows that Medicaid expansion would have its most dramatic impact in the state’s rural areas.

Is high-speed Internet the way to attract more people to live in rural Missouri? One MU professor seems to think so. First – let’s dial back a little bit. In a story that KBIA aired on Feb. 13, our reporter Lukas Udstuen investigated the story of Goss, a rural town in Monroe County, Missouri. Its population? Zero.

Flickr / San Jose Library

The Missouri General Assembly now has an oral health caucus. Co-chaired by Reps. Donna Lichtenegger (R-Jackson) and Jeanne Kirkton (D-Webster Groves), the caucus held its first meeting Monday, Feb. 11. A big item on the caucus' agenda? Reinstating the position of dental director in the state's health department. 

Syndicate Mizzou / Syndicate Mizzou

  MU nursing professor Tina Bloom interviewed 24 pregnant rural Missouri women to learn about what makes them stress. She said what she found challenges her idyllic vision of rural life.

Missouri Secretary of State

 A new report by an MU policy analyst warns about the consequences of a ballot measure passed by Missouri voters last November.

The Pew Charitable Trust’s Center on the States recently released a report or oral health that didn’t speak too highly of Missouri. On an A through F scale, it gave the state a D for its efforts to provide access to dental sealants for high-need kids. Dental sealants are plastic coatings put on children’s molars after they first come in that help prevent decay.

My Life My Town: Not all about me anymore

Jan 9, 2013
Kevin Cook / Columbia Missourian

It was winter break of her senior year at Harrisburg High School when Shirley LeBlanc, then 18, found out she was pregnant. She was shocked by the news. Her family, particularly her mother was there to comfort her. Shirley’s son Grayson was born in July 2011. LeBlanc, now 19, struggles with the loneliness and challenges of single teenage parenthood. However, her faith is the thing that keeps her together. Producer Kevin Cook brings us this story, as part of KBIA and the Columbia Missourian’s My Life, My Town project.

My Life My Town: Go, Fight, Win

Dec 19, 2012
Yi-Chin Lee / Columbia Missourian

Alaysha Jefferson loves cheerleading at the Hallsville High School in Hallsville, Missouri. Living in a small town that has the population of 1,300 and without a car to drive around, Alaysha has a quiet life. She spends her time in classes, cheerleading practice, and doing homework at home.

My Life My Town: Because of my dad

Dec 12, 2012
Benjamin Hoste

With her father in the military, Alizebeth Wright is the first to acknowledge that her childhood has been anything but typical. Each time he's re-stationed she's been forced to move around the world, along with her mom, four sisters, and little brother.

My Life My Town: A Different Path

Dec 4, 2012
Photo by Greg Kendall-Ball / Columbia Missourian

Monica Smith is consumed with school, work and so many extra curricular activities she can't keep count. People find it surprising that at 18, Monica keeps straight A's, works and participates in sports… when they find out what she has gone through. Monica's parents have been in and out of jail since she was 8 years old. She currently lives with her grandparents in Higginsville, Missouri. 

Producers Greg Kendall-Ball and Alexandra Olgin bring us Monica’s story, as part of KBIA and the Columbia Missourian’s My Life My Town project.

Amy Mayer / Harvest Public Media

Beyond subsidies and food stamps, what’s in the farm bill?

With the election over, lawmakers are now returning to Washington for the final weeks of the 112th Congress. Their schedule is packed, but House majority leader Eric Cantorhas said addressing the expired Farm Bill is on the agenda.

Lee Jian Chung / KBIA

A shortage of rural health care professionals throughout the state has health systems connecting with patients in remote areas through telehealth.

At the University Hospital in Columbia, telehealth coordinator Samuel Woodard thumbs a remote which sends a camera at the far end of the room spinning around to face him. His co-workers at the Missouri Telehealth Network offices across town appear on the screen.

“Hey Katie, how’s it going? We’re just going over the equipment, showing him how the telehealth unit works.” Woodard says.

Telehealth can connect rural areas with medical care

Oct 23, 2012
Lee Jian Chung / KBIA

In September, the state awarded grants to eleven rural Missouri hospitals to improve broadband internet connections speeds. The connection would be used for telehealth, a way rural towns access physicians in bigger cities electronically. KBIA’s Lee Jian Chung brings us the first of a two part series on the expansion of telehealth services in Missouri.

Jacob Fenston / KBIA

Herculaneum, Mo., a small town on the bluffs above the Mississippi River, was always a company town.  The company, Doe Run, is the largest lead producer in North America, trucking in lead from Missouri's rich mines to a 120-year-old smelter on the river.  For 25 years, the smelter didn't meet federal air standards for lead, and now, after decades of battling government regulators and angry parents, Doe Run is leaving town at the end of next year.


Jacob Fenston / KBIA

As more and more children are diagnosed with autism, there's also a lot more research on the disorder.  Now, a new guidebook can help Missouri parents and people who work with kids on the autism spectrum sort through it all.

Jacob Fenston / KBIA

Initiatives that would cap payday loan interest rates, raise the Missouri minimum wage, and raise the state's tobacco tax are a step closer to the November ballot, after a Missouri Supreme Court ruling yesterday. The three initiatives were tied up for months in court – one judge struck down the payday petition, ruling the ballot summary was "likely to deceive petition signers." But yesterday, the Missouri Supreme Court upheld all three ballot summaries.

MU Thompson Center for Autism and Neurodevelopmental Disorders

The MU Thompson Center for Autism is one of the nation's leading autism centers, combining treatment, training and research. Starting in September, the center will have a new director. I spoke with Stephen Kanne about the challenges and opportunities ahead for autism research, treatment and accessibility of treatment.

Congress votes to repeal 'Obamacare,' again

Jul 11, 2012

The Republican-led U.S. House of Representatives voted today to repeal the federal health care law. The House has voted more than 30 times to repeal or defund the Affordable Care Act. Every Republican in Congress voted for the repeal, including mid-Missouri's two representatives.

covermissouri.org

In Missouri, an estimated 835,000 people don't have health insurance – that's about 14 percent of the state's population. But in the next couple of years, that figure is going to change. Now that the U.S. Supreme Court has upheld most of the federal health care law, about half a million Missourians will join the rolls of the insured – either through Medicaid, the private insurance market, or with the help of subsidies provided by the federal government. The percentage of uninsured will drop to five percent of the population.

Missouri Medicaid expansion up in the air

Jul 4, 2012
whitehouse.gov

After last week's Supreme Court decision upholding most of the Affordable Care Act, President Obama declared victory. But there was one major gray cloud -- or silver lining, depending on your point of view -- leaving open the question of Missouri's participation in the expansion of Medicaid envisioned by the federal health care law.

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