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.

A new report found Missouri's public health agencies are not sharing information effectively and fixing the problem could lead to better health care for people in the state.

The Missouri Department of Health and Senior Services released its first assessment of the state's digital health system, highlighting ways to improve how health data is shared and used. The evaluation uncovered significant gaps in sharing critical information such as disease rates, hospital visits, birth outcomes and access to care.

Joshua Wymer, chief health information and strategy officer for the department, shared key insights from the report.

"Data is still often siloed," Wymer pointed out. "There was an opportunity with data to advance inoperability, there's an opportunity to always be better at privacy and security because we know that the threat of that is always evolving."

The report recommended establishing clear rules and strong leadership for better data management. More than 200 organizations took part in the assessment, through 25 meetings across nine regions.

A separate study found health care providers said patient access to electronic health records improved communication and treatment discussions. Wymer also shared what citizens expect from the systems as health data grows in importance.

"They expect their data to not only be available and readily accessible, but they expect it to be private and secure," Wymer reported. "And they expect an experience that moves closer and closer to them and their routine and their priority."

The assessment revealed Missouri's public health agencies have different digital capabilities but are ready to adopt new data systems.


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Wednesday is National Healthcare Decisions Day and advocates are calling attention to Florida's pressing need for advance care planning, particularly among vulnerable groups.

About one in five Floridians is over 65 and the state also struggles with one of America's highest uninsured rates, at 10.7%, significantly above the 8% national average.

Brandi Alexander, chief engagement officer for the national end-of-life advocacy group Compassion & Choices said Latino residents have nearly double the uninsured rate of white Floridians. She noted there are good reasons for anyone to plan for their future health care needs.

"Nearly half of the population are people of color in Florida," Alexander pointed out. "A 2021 study found that the preventable mortality rate for Black individuals was 1.5 times higher than it was for their white peers."

The annual awareness day encourages families to discuss and document their medical preferences before a crisis strikes. Florida's 52 licensed hospice organizations serve patients through hundreds of care teams statewide, according to state health data. Alexander emphasized clarifying care wishes can alleviate burdens on families and reduce preventable suffering.

Alexander added normalizing the conversations can empower patients and reduce disparities.

"The more we have tools and the more we normalize the conversation, we can start changing some of the negative stigma that comes with talking about death," Alexander stressed. "Because once you're talking about it and you know what options are available to you, you can then really advocate for yourself within the health care system - and that's how we really create change."

Free resources, including advance directive forms and multilingual guides, are available through the state health department and advocacy groups like Compassion & Choices.

Gov. Mike Braun rolled out a sweeping health and government assistance initiative Tuesday, backed by U.S. Health and Human Services Secretary Robert F. Kennedy, Jr., and Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz.

The "Make Indiana Healthy Again" program seeks to reduce welfare spending, increase work participation among benefit recipients, and launches new health studies. Braun signed several executive orders to overhaul the Supplemental Nutrition Assistance Program. He said the changes require work participation for able-bodied adults, reinstate income and asset checks, and end the use of SNAP dollars to buy some sugary items.

"Today's first executive order removes candy and soft drinks from taxpayer funded SNAP benefits," Braun stated. "More SNAP money is spent on sugar drinks and candy than on fruits and vegetables. That changes today."

The governor also ordered studies into diet-related chronic illness in children and the health risks of food dyes. The Indiana Department of Health will lead the research and recommend policy changes based on its findings.

One of Braun's orders targets Medicaid eligibility, aiming to reduce improper payments by ending self-attested applications and requiring hospitals to meet stricter standards.

"A study found 28% of Indiana Medicaid spending - our largest budget line item - was improper spending mostly due to eligibility errors," Braun noted. "Today we're taking action to make sure everyone on Medicaid is eligible for it in the first place."

Other directives promote physical activity and improve local food access, including a new Governor's Fitness Test for students and a review of how to expand direct-to-consumer sales from Indiana farms.


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