Rural Healthcare

Bram Sable-Smith / KBIA/Side Effects Public Media

This story was originally published February 6. It has been updated as of February 9 at 1 pm.

The Atchison-Holt Ambulance District spans two counties and 1,100 square miles in the far northwest corner of Missouri. The EMTs who drive these ambulances cover nearly 10 times more land area than their counterparts in Omaha, the nearest major city. 

For those not familiar with Missouri, the so-called "Bootheel" refers to the wedge of the state that juts down between Tennessee and Arkansas — a area that's been profiled by Side Effect's own Bram Sable-Smith, who covered a struggling rural hospital there in 2017.

Bram Sable-Smith / KBIA/Side Effects Public Media

When the hospital closed in rural Ellington, Missouri, a town of about 1,000, the community lost its only emergency room, too. 

That was 2016. That same year, a local farmer had a heart attack.


Bram Sable-Smith / KBIA/Side Effects Public Media

It’s a familiar story in rural America. Four years ago the Pemiscot County hospital, the lone public hospital in Missouri’s poorest county, nearly closed. What’s keeping it in business today has also become increasingly common in rural healthcare: relationships with a handful of local pharmacies.


Seth Herald / for WOSU

On a fall morning, Gary Jones takes a walk in his wooded property in Licking County, Ohio. Like many people, long walks helps him to clear his head.

“So it’s all kind of a similar thing, it’s just a little exaggerated with, uh, post-traumatic stress,” Jones says.


Dan Margolies / KCUR

No one at the hospital in Fulton, Missouri (population 12,790) had ever heard of a management consultant named Jorge Perez until he showed up at its potluck in September.


$5 Per Tooth Extractions Draw Those Without Affordable Dental Care

Oct 3, 2017
Marissanne Lewis-Thompson/KRCU

After 20 years of selling and using meth, 38-year-old Andy Moss turned his life around. He got off drugs and got a good job. Next step: he wanted to fix his teeth, which had disintegrated, leaving nerves exposed.

Bram Sable-Smith / KBIA/Side Effects Public Media

When Sarah Scantling went into labor this summer, she had to drive 30 miles and across state lines.

Three years earlier, the only maternity ward where she lives in Pemiscot County, Missouri closed down. Scantling had to choose between a handful of other hospitals in the region between 20 and 70 miles away. She chose to give birth in the hospital in Dyersburg, Tennessee.


Without Price Breaks, Rural Hospitals Struggle To Stock Lifesaving Drugs

Sep 18, 2017
Sarah Jane Tribble / Kaiser Health News

Hospital pharmacist Mandy Langston remembers when Lulabelle Berry arrived at Stone County Medical Center’s emergency department last year.

Berry couldn’t talk. Her face was drooping on one side. Her eyes couldn’t focus.

“She was basically unresponsive,” Langston recalls.

Pages