The Rural Health Divide

While Caucasian populations in Missouri are generally seeing a decrease in mortality rates, health disparities between Missourians in more affluent areas, and rural Missourians of European descent continue to persist. The decline in mortality in higher population areas is because of advances in public health and medical advances. But many of the latest health advances aren’t making it to lower population areas. Persistent poverty is also contributing to the increase in white mortality in rural areas.

The mortality rate is increasing among white Missourians age 25 to 59. The most significant mortality increases are in the Ozarks and Bootheel regions. Lower household incomes characterize populations in these regions, higher rates of unemployment, poverty, and food insecurity. Whites in the Ozarks and Bootheel regions also have less access to health insurance and health care providers. Transportation to primary care and mental health providers is also a big concern.

Each year, millions of Americans put off health appointments because they can’t get to a health provider. The lack of transportation is a hallmark of life for lower-income, rural Missourians. The differences in health outcomes for Missourians with access to transportation services are evident, according to Lewis et al. People with access to public transportation services generally have a higher life expectancy and an increase in work productivity.

Rural white Missourians are experiencing some alarming increases in non-communicable disease rates. Heart disease and chronic lung disease are both up 70% since 1999, according to the Missouri Foundation for Health in rural white populations. The suicide rate up 40%, also since 1999.

Communicable disease rates in rural areas are also rising. Deaths from viral hepatitis are up more than 200% since 1999. Viral hepatitis can be spread through needle sharing, a practice associated with an increase in opioid abuse.

Thanks to Missouri Foundation for Health for their in-depth reports and research on health disparities in Missouri.