On National Rural Health Day, the American Heart Association in Missouri spotlights efforts for healthier rural living.

According to a Pew Research report, rural demographics vary - but rural areas are 80% white overall.

Specific regions see more non-Hispanic Black individuals in the rural South, Hispanics in the Southwest and Indigenous individuals in places such as rural Oklahoma, Alaska, the Great Plains and Southwest.

Tim Nikoli - senior rural health director at the American Heart Association Midwest - flags a concerning trend: Rural populations face three years less life expectancy than their urban counterparts, along with challenges such as more seniors, slower growth and higher poverty rates.

"While there are some commonalities among rural areas, we must tailor our strategies to meet the needs of all communities throughout Missouri," said Nikoli. "Within a matter of near miles, people can have vastly different experiences that impact their health outcomes."

According to data reported in Call to Action, Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association - people living in rural parts of the U.S. are 40% more likely to develop heart disease and have a 30% higher risk of stroke than people who live in urban areas.

Nikoli said a lot of health risk factors in rural communities boil down to access.

He added that rural areas have fewer health care organizations in their communities, and a patient might have to travel 45 or more minutes to get to an appointment, even a basic appointment.

"We think about lack of access to grocery stores, as some of those rural sites have closed, and limited options for healthy food," said Nikoli. "We think about access to, or the capacity of, rural EMS. Certainly those organizations work really hard to keep communities safe, but they're often stretched because of volunteer and staff shortages and are covering hundreds of miles, potentially."

Nikoli said the American Heart Association is committed to improving health-care access of people living in rural Missouri through many programs in coordination with regional libraries and recognition programs.

In 2023, they have proudly recognized health-care organizations for blood pressure control, cholesterol checking and type 2 diabetes management. They want to ensure that rural communities are really ready to respond in a cardiac emergency.

The Texas Department of Criminal Justice is facing a class action lawsuit calling for the agency to add central air conditioning to all its prisons.

Only 30% of the prisons in Texas have central air, and advocates say the sweltering summer heat is inhumane and impacts the physical and emotional health of people who are incarcerated. Four organizations, including the Lioness Justice Impacted Women's Alliance, are plaintiffs in the lawsuit.

Marci Marie Simmons, community outreach coordinator with the Alliance, said during her 10 years at the Dr. Lane Murray Unitin Gatesville, she was concerned about her health and the health of other women.

"I remember worrying about the insides of my body, like, 'What is this heat doing to my organs?' I watched older women have a really hard time in the summer. I watched women fall out with heat-induced seizures, " she explained.

The Texas House of Representatives has passed a bill that would require all Texas prisons have air conditioning by 2029, but the prison system only has to comply if the state provides the funding.

Over the last 10 years, 13 heat-related deaths have been documented in men's prisons in Texas. According to TDCJ policy, when the heat index is above 90 degrees, additional water, ice and cups are provided to people in prison, who also can wear shorts and t-shirts. In certain cases, they can receive permission to go into one of the designated air-conditioned spaces.

Simmons said about 90,000 people behind bars across the state don't have access to cool air.

"The lawsuit is asking for the same regulations that are on jails, which is to keep the temperatures between 65 degrees and 85 degrees. Currently about 30% of beds have climate control," she continued.

The Lone Star State is one of at least 13 in the country where all facilities are not air conditioned. Texas experienced the 2nd hottest summer on record last year and climate experts predict this year will be just as bad or worse.


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The message of the importance of heart health has arrived at construction sites. On Thursday, the American Heart Association is hosting its annual event, Hard Hats with Heart, in Seattle.

Americans are at high risk for cardiovascular diseases, and construction workers have high rates of some of the contributing factors, such as nearly half not getting enough exercise.

Mark Howell, senior vice president of Skanska U.S.A. Building and chairman of Puget Sound Hard Hats with Heart, said the American Heart Association hosts "Toolbox Talks" at job sites to raise awareness about heart health.

"We've had several workers find out they're diabetic and they didn't even know it, and the only way they found out was by going into the blood pressure challenge and ended up deciding to make a doctor's appointment and discovered they had diabetes," he said. "So, just bring that awareness into the industry so people can take care of underlying issues to improve their heart health."

Hard Hats with Heart takes place at The Shop in Seattle's Georgetown neighborhood on Thursday.

Howell added the event highlights cardiovascular risks specific to the industry and ensures people on job sites understand how to be prepared in case of an emergency, such as having hands-only CPR training.

"It's an evening where we celebrate the progress we've made, the number of lives that we've impacted with the message about proper heart health, and it's also an opportunity to hear from some construction workers who have personally been impacted by cardiovascular disease and have been able to maybe make some corrections in their lives as a result of that awareness," he explained.

More than 340,000 construction workers have been diagnosed with cardiovascular disease, according to the American Heart Association.

Experts are traveling across the Commonwealth to help community professionals better understand and advocate for policies that help Kentuckians needing assistance with health care, housing, food, transportation, child care, suicide prevention and other resources. Thrive Roadshow workshops are free and available to the public.

Emily Beauregard, executive director of Kentucky Voices for Health, said attendees will receive updates on policy changes and funding for programs that impact folks in their communities.

"Our focus with the roadshow is to make sure community professionals who are interacting with folks on a daily basis really have the resources and skills that they need to advocate for the policies and programs that are right for their communities," she explained.

More information on Thrive Roadshow events happening in Frankfort, Pikeville, Williamsburg, Murray and elsewhere is online at ThrivingCommunities2024.

Tiffany Taul-Scruggs, patient service outreach manager with Mount Sterling Healthcare, said her team of Community Health Workers relied on the Thrive program to better understand the Medicaid Renewal process, so they could improve serving their patient population.

"One of the things that I really found useful is that they are a group that I can depend on, or if I need to call them to talk about things, they really do a lot of prep work behind the scenes, " she explained.

According to the healthcare advocacy group KFF, more than 1.6 million million people in Kentucky are covered by Medicaid. More than half of the Commonwealth's Medicaid spending is for people who are elderly or those with disabilities.