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a cce s s H ea l t h N ews . n e t J a n u a ry 2 0 2 6 Volume 11 | Issue No. 103 10 T he Missouri Rural Health Association (MRHA) recently published a community needs assessment that underscores the state of rural health. The outcomes of the assessment are sobering. According to the report: "Rural Missouri is dying. Citizens of the region consistently experience worse health outcomes in most areas of life. The rural population accounts for 1.5 million people who are overrepresented in every leading cause of death. Life expectancy is shortening, and there are not enough providers to meet health care needs. Overdose, suicide, and mental health outcomes are growing exponentially, resulting in devastating outcomes. The rural health crisis is overwhelming, complex, and in immediate need of intervention." The outcomes There are 114 counties in Missouri, of which 99 are considered rural. According to the assessment, rural Missourians outpace their urban counterparts in all 10 leading causes of death. This includes a 7% higher infant mortality rate. And over the last decade, fatal drug overdoses have increased by 127%, with only 20% of those individuals receiving prior substance use treatment. Education and economics also contribute to increased poverty, leaving children the most vulnerable. Higher levels of education are independently associated with lower prevalence of chronic disease, according to the National Institutes of Health. The life expectancy for those who hold a bachelor's degree is greater than that of those with a high school diploma or equivalent. aH Recently Published Needs Assessment Underscores the State of Health for Rural Missourians In rural Missouri, approximately 13%-14% of residents lack a high school diploma. The result is higher incidences of cardiac disease, alcoholic liver disease, drug overdose, and suicide. Additional outcomes include higher uninsured rates, circumventing access to quality care. A lack of economic opportunities further exacerbates social drivers of health. This leaves rural Missourians strapped when it comes to acquiring food, housing, and transportation. 16% of rural Missourians — including children — live in poverty. "One in six children in rural counties experience poverty; this results in substandard child health outcomes and decreased psychological well-being into adulthood," according to the assessment. Higher unemployment rates for rural Missourians are another social driver that fuels deaths of despair, drug use, poor health, mental health disorders, and shorter life expectancy. Access to health care poses yet another barrier for rural Missourians. The majority of rural Missouri is designated as a health professional shortage area (HPSA) by the Health Resources and Services Administration. A HPSA is a geographical area, population group, or facility lacking enough primary medical, dental, or mental health providers to meet community needs. To bring this home, rural Missouri has 62% fewer providers per 100,000 rural residents compared with metropolitan areas. By Tonia Wright, Publisher/Editor in Chief ToRCH, Rural Health Transformation Program Have Potential to Improve Outcomes