Health & Wealth Desk | KBIA

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.

Contact the Health & Wealth desk.

Sebastián Martínez Valdivia / KBIA

Starting Monday, May 18, the Missouri Department of Health and Senior Services will be recommending more testing in long-term care facilities, in an effort to increase COVID-19 testing within high-risk environments.


Diane McMillen

For hundreds of elderly and disabled residents in Missouri, personal care attendants, or PCAs, are a lifeline that stave off isolation and help them stay out of nursing homes. The field was already facing a shortage of workers before the COVID-19 pandemic began, but now, things are even worse.


Missouri Highlands Healthcare

Correction: a previous version of this story reported a COMTREA Health employee tested positive for COVID-19. The individual was exposed to the virus outside of work and quarantined, but was not symptomatic.

If someone gets sick in a seven county swathe of the Ozarks of southeastern Missouri, the closest place they can go for care is a clinic run by Missouri Highlands Health Care. Highlands is a federally qualified health center or FQHC, with clinics in some of the least populated and poorest counties in the state. Now, some of those clinics are are cutting back.

Karen White is Highlands’ CEO. She says dental care - a major source of revenue - is now restricted to emergency procedures. "“We just shuttered our dental clinic — we have three of them operating throughout the organization plus a mobile dental,” White said. She’s had to furlough a tenth of Highlands' 200 members so far, and has reduced hours for many others.


Provided by Dr. Preethi Yerram

By now, most people will probably have heard that older and immunocompromised individuals have a higher risk for serious complications from COVID-19. But for one group of patients, those who need dialysis – the normal recommendations of simply isolating at home, isn’t really an option.

Dr. Preethi Yerram is a nephrologist for the University of Missouri Health Care System, as well as the Medical Director at the DCI Transitional Care Unit and Home Dialysis Unit here in Columbia. She spoke with KBIA’s Rebecca Smith about the additional risks that individuals receiving dialysis are having to navigate during the COVID-19 pandemic – as they have to risk exposure every time they receive necessary, life-sustaining treatment.

KBIA's Rebecca Smith's cat, Pip, sleeps on his windowsill bed while keeping her company in her home office.
Rebecca Smith / KBIA

When my cat, Pip, started sniffling and sneezing a few weeks ago, I didn’t give it much thought. But as the sneezing continued, I started to get worried – both about Pip, of course, and about how I was going to safely get him to the veterinarian during Columbia’s stay-at-home order.

So, I called my vet and found out they had changed the way appointments were handled. Instead of going into the office with my cat, I would call when I was parked outside, hand Pip over in a carrier from my car, and then talk to the vet over the phone about a treatment plan.

A drive-up, hands-off vet clinic.


Provided by Matthew Huffman

As COVID-19 cases have gone up in Missouri, more and more stay-at-home orders have gone into effect. But these orders, which are an attempt to reduce transmission, could, in some cases, be increasing the risk of domestic and sexual violence.

Matthew Huffman is the Public Affairs Director for the Missouri Coalition Against Domestic and Sexual Violence, and he spoke with KBIA’s Rebecca Smith about how domestic violence programs offering direct services to survivors – things like shelter, counseling, food, and more – are adapting and where people can still turn for help.


Citizens Memorial Healthcare

As COVID-19 cases have increased exponentially in the U.S., CDC guidelines have led healthcare providers across the country to cancel outpatient procedures and elective surgeries. In rural areas, that's left already struggling clinics and hospitals without a vital source of income. Tim Wolters, director of reimbursement at Citizens Memorial Hospital in Bolivar says his health system now has to balance preparing for COVID-19 cases and maintaining staff. 


Sebastián Martínez Valdivia / KBIA

On a sunny Tuesday afternoon, the Broadway Diner was empty. The ‘50s-style greasy spoon has been a fixture of downtown Columbia for decades. But owner Dave Johnson said he’d never seen anything like this. “I was here when the planes crashed into the World Trade Center, and I thought that was horrible, but it’s nothing like this,” Johnson said.

The diner closed its dine-in space three days ago, following an order from the city government. A few days earlier, Johnson announced the diner would feed any students and community members, after local colleges and the public school system closed.

Rebecca Smith / KBIA

By now, most people will know that the Centers for Disease Control and Prevention consider older individuals "at higher risk" for serious complications of COVID-19, but there are several other groups that also have higher risk – and are maybe not as obvious to the naked eye. 


Christina Ingoglia stands, holding her five-year-old daughter, Lilly, in her arms.
Provided by Christina Ingoglia

According to the Missouri Department of Elementary & Secondary Education, all 555 of Missouri’s schools are currently closed in an effort to slow down the spread of COVID-19, but for the parents of children with disabilities, this can present even more challenges.

Christina Ingoglia is the President of the Missouri Disability Empowerment, or MoDE, Foundation, and the mother of Lilly – a five-year-old who has cognitive disabilities from a rare genetic condition.

She spoke with KBIA’s Rebecca Smith about how she and her family are coping, and about how they are keeping Lilly busy at home.


The Javorac / Flickr

The opioid crisis has driven states to look for ways of providing alternative treatments for chronic pain, to reduce people’s exposure to the potentially addictive pain-killers. Here in Missouri, the state’s Medicaid programs offer a range of alternatives, but their reach seems limited so far. Kaiser Health News Midwest Correspondent Lauren Weber has been covering the story and she sat down to talk about some of the reasons the state's efforts haven't yielded significant results. 


Sebastián Martínez Valdivia / KBIA

On a chilly afternoon, Terry Cox had come to Mountain View, Missouri, to see a dentist and was waiting on a bench outside a converted rectory.

“Came to get a tooth check and see what they got to do to it," Cox said. "Maybe get ‘em all out."

The 56-year-old works in northern Arkansas, and drove an hour and a half to the Good Samaritan Care Clinic.

Zia Kelly / KBIA

Right now when former offenders are released from prison into Boone County, they’re sent to a parole officer stationed in a strip mall on Providence Road. But early next year, their first stop will look more like a community center than a government office. 


Sebastián Martínez Valdivia / KBIA

On a sunny afternoon in Sedalia, Jennifer and Matt Boatright escorted some unusual visitors into a pasture on their farm. They opened the heavy gate and called their sheep over to meet a half-dozen medical and health professions students from the University of Missouri system. 

The farm tour was part of a week-long program designed to introduce future doctors, pharmacists and nurses to rural life.  The goal: Get the students interested in working in rural areas.

KBIA/file photo

Georgetown University professor Tricia Brooks focuses her research on access to health insurance for children in low-income families with a particular focus on Medicaid and the children’s health insurance program, or CHIP. In this week's episode of Health and Wealth, Brooks talks about how Missouri's Medicaid enrollment drop compares to the rest of the country, and some of the factors behind it.


Eldon School District / Photo Provided

In rural school districts, teachers and staff can often wear a lot of hats. When it comes to addressing mental health and taking care of students, the responsibility is shared between teachers, counselors and other administrators. This is true in Eldon, where elementary school teacher Katie Schulte and high school counselor Tara Jenkins sat down to talk about looking out for their students' mental well-being. 


Sebastián Martínez Valdivia / KBIA

It’s the middle of summer but Harrisburg Middle School is a hive of activity. Between summer school classes and renovations, it’s a little chaotic for school counselor Brett Rawlings, who just wrapped up his first year at the school.

Harrisburg itself is a small town of fewer than 300 people, but the school serves the larger surrounding area, which is primarily farmland. As the K-through-8 counselor, Rawlings is responsible for some 400 students, and he deals with a range of issues.


Trevor Hook / KBIA

David “Racin’ Dave” Stevens has ridden a lot of motorcycles. “The name actually came from car racing days cruising the loop back in the ‘80s,” he said. He fixes a lot of them too. Stevens is a mechanic at Gilbane Motorsports in Columbia.

He has ridden a variety of bikes – motorcycles, dirt bikes, three-wheelers - for more than 45 years. And not always while wearing a helmet. “If I’m riding my bike into town, I’m not being stupid or unruly. I feel like I should have the choice of not wearing a helmet if I don’t want to,” Stevens said. Senate Bill 147 may give him that choice.

Henry Domke / Photo Provided

It was humid spring morning in the woods of central Missouri and Henry Domke was lining up a shot. His target? The vibrant petals of a red buckeye bloom.

"I want to level it. Make sure it’s really sharp," Domke said as he adjusted his tripod and focused in before snapping the photo. 

Domke — a retired family doctor — has been photographing the wildlife in his back yard for years. When he was a doctor, he decorated his practice with his photographs, and after he retired he started exhibiting his work.

 

Photo provided by Mat Reidhead

In 2017, the Missouri legislature expanded Medicaid managed-care organizations, or MCOs, state-wide, putting third-party contractors in charge of hundreds of thousands of patients. Advocates say managed care programs allow for more personalized care for patients and more predictable budgeting. But hospitals have criticized MCOs, saying they cover less and take longer to reimburse for care than traditional Medicaid.

Now, a new study from the Missouri Hospital Association suggests switching from traditional Medicaid to MCOs could be linked to increased risk of suicide in teens. Mat Reidhead is the Hospital Association's lead researcher.


Photo provided by Mei-Ling Wiedmeyer

The language barrier can cause  a lot of problems when it comes to refugees getting health care, but there are other obstacles as well.

Mei-Ling Wiedmeyer, a family physician who grew up in Columbia, but now works with refugees in Vancouver, Canada and is on the faculty of the North American Refugee Health Conference. She spoke with Health and Wealth about the other barriers to care, and how communities can get around them.


At a pediatric clinic in Kirksville, Missouri, a young boy is waiting in an exam room to be vaccinated. A nurse explains the shots to his mother, and Lisette Chibanvunya translates.

Chibanvunya is one of two Congolese interpreters the Northeast Health Council has hired to help the clinic care for refugees and immigrants from central Africa. She first came to town to study at Truman State University in 2013.

Chibanvunya says, "When I came I faced discrimination, because they didn’t have a lot of black people." But now, she says, "They start accepting people because they finally understand that people kind of decided to make it home." 

Rebecca Smith / KBIA

Poplar Bluff, Missouri, is located deep in the southeastern part of the state, in the area known as the Bootheel. One resident joked to me that if something bad is going to happen in Missouri, “it’s gonna happen here.”

It’s also the location of an on-going hepatitis A outbreak. As of March 4, there have been 266 cases of hepatitis A identified throughout southeast Missouri. Nearly 50 percent of those cases have led to hospitalizations and there has been one associated death. 


Sebastián Martínez Valdivia / KBIA

About 15 miles southwest of St. Louis, is Fenton City Park. It’s pretty unremarkable, with picnic shelters, softball fields, and flags waving gently from a memorial to fallen soldiers. It's also where Kevin Mullane sought refuge as he struggled with an opioid addiction.

"Anybody that knew Kevin knew he loved Fenton Park," Kevin's mother Kathi Arbini said, recounting how her song became increasingly isolated. Mullane turned to prescription opioids to deal with depression. He eventually started stealing medications from friends and family members, and doctor-shopping for more.

Ashoor Rasho has spent more than half of his life alone in a prison cell—22 to 24 hours a day. The cell was so narrow he could reach his arms out and touch both walls at once.

Smoking looks a lot different these days. It’s been on the decline, due to restrictions at work and in bars and restaurants. But there is one segment—teenagers who use e-cigarettes—that is growing fast. And health experts are worried about the consequences.

 


Physicians across the country have a message for the National Rifle Association: Gun violence is our concern. It's part of a battle being fought vigorously on Twitter in recent weeks.

Alisha Floyd bounces her son Chance on her lap. He giggles and pulls her hair.

“He’s the fattest baby here,” she says, laughing.

A new Illinois statute aims to boost flu shot rates among healthcare workers by making it harder for employees to decline the vaccine.

Lawmakers say this is important in light of last year’s flu season that killed more people than car crashes and drug overdoses. But some on the frontlines of public health worry that a law that’s not enforced will have little effect.


Paulina Nieto, who grew up in Columbus, Indiana, was only 2 months old when she started to have heart problems due to a narrow artery.

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