rural health

Army veteran Randy Michaud had to make a 200-mile trip to the Veterans Affairs hospital in Aroostook County, Maine, near the Canadian border, every time he had a medical appointment.

Michaud, who was medically retired after a jeep accident in Germany 25 years ago, moved home to Maine in 1991. He was eligible for VA medical care, but the long drive was a problem.

He's one of millions of veterans living in rural America who must travel hundreds of miles round-trip for care.

hospital room
Fotos GOVBA / flicker

  Compared to their urban counterparts, rural hospitals serve a population that tends to be older, sicker, uninsured and have less income. Rural hospitals provide a lot of uncompensated care and run on more narrow profit margins.

To stay open, these hospitals depend on special federal designations that give them a higher rate of reimbursements from Medicare and Medicaid. For example, when a hospital designated as a critical access hospital, Medicare reimbursements can make up to a third of its entire revenue

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.

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.

Money
Andrew Magill

Coming up we’ll tackle sequestration which is set to occur March 1. But first, when a large group of farmers in the Southeast banded together to sue a powerful dairy cooperative a few years ago, many hoped that the case would bring big changes to the industry. But as Peggy Lowe of Harvest Public Media reports, the recent settlement of the case involving Kansas City-based Dairy Farmers of America has resulted in some money for small farmers in the short term but little long-term reform.

New program eases debt for rural medical students

Feb 22, 2012
Jacob Fenston / KBIA

The average medical school student graduates with close to $160,000 in debt. That heavy burden is one reason why there is a long-running shortage of primary care doctors in rural America. More and more graduating students choose higher-paying specialties over rural primary care. In this weekly update, a new pilot program helps medical students pay off loans as soon as they start residency, so it's easier to choose a lower-paying, but possibly more fulfilling career path.

Recruiting doctors to live and work in rural America is a chronic problem. Most health centers try to attract workers with big salaries and expensive homes.

Shots previously reported that one center in Maine was trying to lure medical students to the countryside for their final two years with the hope that they stick around.

Lydia Mulvany / KBIA

Health is generally poorer in rural Missouri compared to urban areas, yet there is a distinct shortage of primary care physicians in rural Missouri. KBIA’s Jacob Fenston has reported that the shortage is only expected to worsen over the next ten years as the elderly population expands.

This graphic shows some of these inequalities--click through for more detail.  Created by Lydia Mulvany.

Growing doctors in rural Missouri

Dec 6, 2011
Jacob Fenston / KBIA

In rural Missouri, there are roughly half as many primary care doctors per person, compared to urban parts of the state.  That's a problem, when you consider that rural residents are also older (about three years, on average) and poorer (about five percent more live in poverty). In this Health & Wealth report, small towns in Missouri are facing the shortage by "growing their own" doctors and nurses, starting as early as middle school.

Rural women diagnosed later

Nov 23, 2011
Faustine Williams

Women in rural Missouri are more likely to be diagnosed with breast cancer at a late stage than women in urban or suburban counties. In this weekly Health & Wealth update, the urban / rural disparity in breast cancer detection. 

Should Medical School Be Free?

Nov 21, 2011
mskcc.org

Heck yeah!! So should lunch. But two researchers say making medical school free could send more young doctors into primary care and rural practice, thus solving one of the big challenges facing health care today. And they've got a way to pay for it too.

It's Rural Health Day!

Nov 17, 2011
celebratepowerofrural.org

To celebrate, experts from non-profits and government agencies are holding a live webinar on some of the challenges and rewards of providing health care to rural America.

Missouri's Rural Doctor Shortage

Oct 24, 2011
Jacob Fenston / KBIA

There’s a doctor shortage in rural America. This is not news – just the opposite – it’s been going on for ages. Even old Doc Adams, the country doctor in “Gunsmoke,” was constantly overworked. In one episode, when he finally gets a vacation, he’s kidnapped by outlaws in need of his services. Present-day Missouri ain’t Dodge City, Kansas. But many rural doctors are still overstretched. 

Rural Hospitals Face Medicare Cuts

Oct 3, 2011
Jacob Fenston / KBIA

Two weeks ago, President Obama told the nation, “Washington has to live within its means.” As Democrats and Republicans continue to scour the federal budget for over a trillion dollars in possible cuts, one group very likely to be affected is rural hospitals in the Midwest and across the nation.

Mitchell's New Universal Atlas.... (Philadelphia: Charles Desilver, 1857) / Courtesy of Dickinson College

There are 1.6 million people living in rural Missouri, and many have a hard time accessing health care. In the 2011 Robert Wood Johnson Foundation’s healthy county rankings, Hickory County in West Central Missouri is rated one of the worst in the state in terms of mental health. It’s so bad, residents say they experience just over a week’s worth of poor mental health days each month. They are also unhealthier and experience more poverty than the national average.