Rural Counties in Missouri See Higher Rates of Nursing Shortages

June 21, 2021 - Rural counties are experiencing increasing rates of nursing shortages and higher percentages of older nurses, largely due to geographical disparities that metropolitan counties do not encounter, according to a study from the University of Missouri.

The study looked at 136,000 licensed nurses in Missouri and found that 31 percent of all nurses in the state were older than 54. This percentage was greater in rural counties compared to urban counties, with some rural counties seeing more than half of their nurses on the older side.

“Out of the 114 total counties in Missouri, 97 are designated as health care professional shortage areas, and a majority of these counties are rural,” Anne Heyen, assistant teaching professor in the MU Sinclair School of nursing, stated in a press release.

“By identifying the specific areas where there is the greatest need for more nurses, we can better tailor our responses to help Missouri have a more balanced nursing workforce.”

In a ratio of the number of nurses per 10,000 residents, 11 metropolitan, 4 micropolitan, and 12 rural counties had the lowest ratio at 18 to 49, the study found.

Geographical disparities are the main cause of nursing shortages in rural counties. Graduating nursing students who attend college in urban areas tend to remain in those areas when searching for work. More job opportunities, better educational resources, and higher salaries are a few factors that make cities more desirable for aspiring nurses, according to the press release.

“In some of these rural areas where nearly half of the nursing workforce is nearing retirement, now is the time to be proactive and start thinking about who is going to replace them 10 years down the road,” said Heyen.

With a high number of older nurses making up the hospital workforce in rural counties, turning the focus to the recruitment of incoming nurses is critical. Higher education institutes can help direct graduating nursing students to the hospitals experiencing shortages.

“Whether it’s potentially partnering with community colleges in rural areas or establishing satellite campuses with dual credit options or more outreach programs, universities and their nursing schools can use this information to brainstorm solutions to assist underserved communities and provide more educational and employment opportunities to nursing students in the areas that need it the most,” Heyen explained.

“The overall goal of this research is to make sure everyone in Missouri ultimately has access to the health care they need, regardless of where they live, and identifying where the nursing shortages occur is a key first step.”

The University of Missouri is taking initiative to address this geographical disparity that stands to inhibit access to care for Missourians in rural areas and contributes to nursing shortages.

The MU Sinclair School of Nursing is building a new facility on campus that will allow for bigger class sizes and in turn, graduate more students. The facility is expected to be completed by spring 2022. MU will also focus on recruiting students from rural areas, specifically the 25 counties that MU Health Care serves, in hopes that they will pursue careers there after they graduate.

“It feels rewarding to see the nursing students I have taught go out into the world and make a positive difference at a time when they are so desperately needed,” Heyen concluded.

“Mizzou and the University of Missouri System are well poised to help address these challenges going forward, given their influence and impact throughout the state.”

The COVID-19 pandemic increased the need for nurses by 245 percent, emphasizing the importance of addressing nursing shortages, whether it be on a county, state, or country level.

Rural areas have also faced clinician shortages when it comes to primary care physicians. A past study published in JAMA Network Open found that despite both rural and urban areas seeing increases in primary care clinicians, urban areas saw less growth.