Access to Healthcare in Rural Missouri

Access to Healthcare in Rural Missouri

Access to Healthcare in Rural Missouri

Uninsured and Underserved



According to the Missouri Department of Insurance, Financial Institutions & Professional Registration, 12.1% of Americans lacked healthcare coverage in 2017. At a statewide level, 10.5% of Missourians aged 18-64 are without coverage, ranking 28th nationally. Residents in 15 rural counties had uninsured rates of 15% or more. Barry, Carter, Daviess, Dent, Douglas, Hickory, Knox, McDonald, Morgan, Ozark, St. Clair, Schulyer, Scotland, Taney, and Wright are all severely under-insured. Sadly, nearly one third–29%–of all working adults residing in Knox County are uninsured. Not surprisingly, with a few exceptions those are the same counties where there are no hospitals. The bottom line? There is a severe lack of healthcare access in rural Missouri. The situation is dire, according to Missouri Census Data:



MO Hospital Availability and 2013 Estimated Unisured Population.png



To make matters worse, a lack of access to doctors and hospitals in rural parts of the Show-Me State is significant, according to the Missouri Hospital Association (MHA). According to a 2017 report, nearly 1/3 of all Missourians reside in rural areas, but there are 42 rural counties without a hospital. Even worse, 13 of those counties have only one primary care physician. Data reported from the Sheps Center for Health Services Research confirms that 7 rural hospitals have closed in Missouri since 2014, one of which was classified as a primary care clinic. iVantage Health Analytics identified twelve Health Disparities metrics that make hospitals and clinics particularly vulnerable to closure:



  • Adult Obesity Rate
  • Child Poverty Rate
  • Unemployment
  • No Medical Insurance
  •  Healthcare Costs
  • Smoking
  • Access to Affordable, Safe Housing
  • Access to Mental Health Providers
  • Diabetes Screening Rate
  • Access to Primary Care Physicians
  • Access to Dental Care Providers
  • High School Graduation Rate



Areas with the greatest percentage of health disparities are those most vulnerable to hospital closure. In other words, those who need quality healthcare the most are the ones who will be left behind.


The Lack of Access to Healthcare in Rural Missouri: A Far-Reaching Impact


The problem of closing hospitals and clinics doesn’t just mean residents will have to drive a little farther to see a doctor; it has far-reaching economic impact. When residents do not have access to quality healthcare, they aren’t able to work; this impacts local business and industry productivity. When they earn less money, workers don’t have as much to spend in local grocery stores, gas stations, or restaurants. When sick children aren’t able to go to school, local districts receive less funding. And, when facilities close, local residents trained in healthcare lose their jobs and are often forced to move elsewhere for work. In other words, unhealthy residents lead to unhealthy towns.


One Option: Telemedicine


Founded in 1994, the Missouri Telehealth Network (MTN) began as one of the nation’s first public-private partnerships in telehealth. The model has proven to be effective for underserved populations such as those in rural areas such as the small town of St. Robert with one important caveat: The area must have broadband (high-speed) internet service in order for the technology to work as it should. Leaders of industry, government agencies, and legislators must work together to solve this challenge.





One Missouri is committed to  research, education, advocacy, and policy development on behalf of all Missourians.


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