Research shows Missouri's rural residents are likely to have worse cellphone and internet service, diminishing political representation, more addiction and less access to health care, and likely will die sooner than their urban counterparts, just to name some of the disparities.
The question for the Missouri Rural Development Partners is what people can do about it.
The MRDP met Tuesday for what is intended to be the first of its annual meetings. Representatives from several public and private organizations gathered at Missouri Farm Bureau's Jefferson City office to identify and combat problems facing rural communities.
Programs were presented on the results of the MRDP 2017 Rural Survey and the leading demographic and economic indicators for rural Missouri: broadband internet access, rural health and rural community-building strategies known as "place making."
MRDP Chair Gordon Ipson said the partnership's history dates back to the days when every state had a rural development council.
"In the rural areas, due to the redistricting every 10 years, we are getting less and less representation. Somebody has to be paying attention to our rural areas," Ipson said.
Keynote speaker Brian Fogle, of the Community Foundation of the Ozarks, spoke of Bank of America closing 90 percent of its rural branches, rural standards of living diminishing, and deaths of despair like overdose and suicide being more frequent in rural Missouri, which makes it seem like rural life is "under attack."
Rural America is losing jobs, along with incomes and standard of living, while the rest of America experiences increases, he said.
"The American dream of earning more than your parents has turned into a nightmare of sorts," Fogle said. "I do realize this is depressing news but I remain filled with hope for the future of rural Missouri."
Fogle encouraged increased investment in local startups like farm-to-table agriculture, legislative policy and rural school systems where a little money can go a long way.
"We believe that the school system is the lifeblood of a small community," he said. "The stronger the school system, the stronger that community."
The Missouri Rural Survey 2017 was presented by Pat Curry, project manager for the University of Missouri Extension. Among the survey's key findings: more than 80 percent of respondents felt their community needed to change, and half felt it lacked a plan for the future. Respondents were concerned with lacking jobs, increasing poverty and the state of infrastructure, and believed more investments need to be made in business development.
Curry said they need more participants, panels and data to define potential trends and decide how to address these issues.
MFB broadband consultant Janie Dunning discussed the lack of high-speed internet in many rural areas, an issue Gov. Eric Greitens has invested $45 million into for Missouri's schools. Access to high-speed internet affects the ability to apply for jobs, share information and enroll in online education. However, "on any ranking that you look at," Dunning said, "Missouri ranks from 40-49 in health of broadband (internet access)."
All of Missouri has access to mobile internet through cellular services, but only 74 percent can get fixed wireless internet, and just 16 percent have access to the gold standard of fiber cable internet. Approximately 1.2 million Missourians can't access high-speed internet, and even more only have one internet provider.
Dunning said one of the first steps in fixing this problem is educating the rural public on what is available to them and what they are missing out on by not having access to high-speed internet.
"People don't know what they don't know, and they don't know what they don't have," she said. "And it won't be until a young daughter or son they have wants to stream Netflix and wants to do homework that they realize they have a problem."
The next step is encouraging rural residents to voice their internet needs to elected officials, she said.
Melissa Van Dyne, Flex Coordinator of the Office of Primary and Rural Health, said rural Missourians have less access to health care than people who live near cities where large hospitals are common. Hospitals in rural areas offer life-saving services to people who may not have other options, but they are also expensive investments in areas with small populations where male residents are generally less likely to seek out health care.
"Overall, the health of rural Missourians has actually improved over the last decade, but there are still significant health inequities between rural and urban areas," Van Dyne said. "Access to care is uneven in rural Missouri."
Van Dyne said while Missouri exports the second most doctors in the nation, far fewer return to rural Missouri to work because medical students leave for residencies in other cities where they often remain. The result: Five counties have only one practicing physician. She said her agency is working to show medical practitioners what it's like to live in a rural area and offer education opportunities that require recipients to work in rural areas.