About one-third of Missouri is considered rural, and people who live there often have health challenges. The latest research suggested overlooking rural areas has major consequences.

A new report from the Missouri Rural Health Association outlined the need for continued investment in rural Missouri.

Katie Reichard, director of government affairs for the Missouri Primary Care Association, said many factors contribute to worse health outcomes in rural communities but access to care is at the top of the list. Community health centers help close the gap, seeing patients no matter their ability to pay, and helping those who might otherwise end up at hospitals for nonemergency needs.

"You don't have to go to the hospital for a toothache or strep throat; a community health center can provide those services to you, "Reichard explained. "It's on a sliding fee scale and so, it's income-based. Also, they cover behavioral health services, a lot of them cover women's health services, and all of them cover primary care and dental."

According to the report, for the first time ever, Missouri recorded more deaths than births during the pandemic. It caused a 19% increase in deaths for Missourians overall, and decreased overall life expectancy by more than two years.

Heidi Lucas, executive director of the Missouri Rural Health Association, thinks investing in rural areas of the state is imperative not only for Missouri, but for the nation.

"Rural Missouri is America's breadbasket," Lucas pointed out. "We have some of the highest producers of grain and cattle in the entire country, so we really need to take care of folks who are living in rural Missouri, because they are providing for America, widely."

Missouri is home to more than 95,000 farms, the second-highest number in the U.S. It's also the second-largest producer of hay and is second-highest in the nation for beef, with more than 2 million head of cattle.

Lucas added while the report identifies areas of concern, there are many solutions.

"Upping broadband to have more telehealth services; reducing restrictions on providers so that they're able to provide more widely to the full extent of their education and training; finding preceptors for nurses or physicians; getting transportation taken care of, to get there," Lucas outlined.

Lack of affordable health care affects more than farmers' personal health, according to a Missouri Rural Crisis Center report. It also causes financial strain and delays in farm investments.

Arizona's primary election will take place in July, and a new Rural Democracy Initiative poll shows that likely voters from rural areas of the state are up for grabs.

Researcher Patrick Toomey, a partner with Breakthrough Campaigns, said the poll data show rural voters are what he calls "economic populists," and don't want the government calling the shots on certain issues, such as abortion.

"Rural voters do feel like things are getting worse for them and in their communities economically, but again, the vast majority of rural voters -- they are economic populists and their policy preferences align with many progressive goals," he said. "It is very clear that rural voters are not a cultural monolith either."

Toomey added that while rural America tends to be more conservative than its urban and suburban counterparts, certain conventionally progressive policy items -- such as focusing on retirement security and making taxes more fair -- aren't being associated with President Joe Biden or Democrats. He contended that the Democratic Party will need to "rebuild their brand."

The poll found 15% of rural voters in swing states are unsure for whom they will vote, or if they'll vote at all in the upcoming election, something Toomey contended could directly impact the outcome.

Toomey said half of rural voters consider Republicans to be more dedicated to prioritizing the needs of working families, compared with just 32% who shared those sentiments for the Democratic Party. While the increasing costs of housing, health care and child care are all important issues to rural voters, the data show that reproductive freedoms are also a top priority.

Toomey claimed Democrats can use that to their favor.

"Rural voters are opposed to abortion bans," he said. "They have nuanced views around abortion itself, but three-quarters either support it or don't want the government interfering in something that should be left up to women and their doctors."

More than 1,700 voters in 10 states participated in the poll, which found nearly half of rural voters would choose a "culturally aligned" rural Democrat over a Republican businessperson from a big city on the East Coast.


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Petitions are being circulated to get a marijuana legalization question on North Dakota's fall ballot.

Some local officials said marijuana laws could affect their small cities and towns in unique ways. A North Dakota group called New Economic Frontier is behind the ballot initiative. If put before voters, it would be the third time they'd consider the idea. Similar questions failed in 2018 and 2022.

Scott Decker, mayor of Dickinson, said if it wins this time, the state has to honor the will of the voters. Whether his area would see economic benefits or new residents, he pointed out energy jobs have a big presence and there is a potential conflict.

"Even if recreational marijuana is passed, individuals working in the energy sector are still gonna have to pass drug tests," Decker explained. "That's just a standard in the industry. Safety is paramount. "

He also wondered about local police having enough resources to secure technology for field sobriety tests, especially if revenues do not trickle down to his city of nearly 25,000 people. But Decker acknowledged other criminal justice aspects of legalization, noting there are too many people with low-level marijuana offenses who are incarcerated.

Tom Erdmann, mayor of Carrington, said his constituents are fairly conservative on the issue. He doubts his town would ever be a hotbed for marijuana retail sales but no matter the dynamics, he said any possible revenue would be a bonus.

"You know, any tax revenue that we get, whether it's from tobacco sales or highway use tax or any of those things that are not necessarily listed every year in our budget, we don't send it, that's for sure," Erdmann emphasized. "We keep it and use it in places where we need the funds to go."

He added Carrington has a solid economic base but his revenue sentiments illustrate the pros and cons communities have to wrestle with as legalization debates resurface. Petition organizers tout a range of economic boosts, while also stating their proposed policy is pretty restrictive compared to other states.


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Work is being done in rural areas across Texas to make sure students are prepared for the workforce even if they intend to stay put after graduation.

One new study showed only 31% of adults in non-metro areas have a degree from a junior college or university. The nonprofit Jobs for the Future creates opportunities for the education system and local businesses to work together in hopes of increasing the number.

Sarah Jenness, senior manager of the group, said there are three key changes leaders in rural areas could make to improve training for students.

"Strategy number one, build on your local strengths and contacts," Jenness outlined. "Strategy number two is thinking about how to prioritize inclusive economic development. And then finally, the third strategy was around embedding remote opportunities."

Jenness argued schools, local economic development agencies and businesses need to collaborate to create opportunities. A couple of options are dual enrollment, where high school students also earn college credits, and work-based learning, so they can hone their skills on the job.

The study found in the U.S., the benefits of economic systems are unevenly distributed and certain groups and communities suffer the most, particularly rural areas. Disparities are also seen across lines of race, ethnicity and gender.

Jenness stressed gaps can be closed if rural students receive training for the types of jobs available in their communities.

"What are the industries that employ the most rural workers? And the top three that we think tend to be -- you know, have good quality jobs -- are industries like government, manufacturing and health care," Jenness explained.

She added remote work is also a key strategy to ensure rural students have access to a variety of well-paid jobs.


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