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Is the nursing shortage worse in rural America? In Missouri, yes

por Gus Iversen, Editor in Chief | June 17, 2021
As the U.S. grapples with a nationwide nursing shortage, new research shows that — at least in Missouri — rural counties are getting hit harder than their metropolitan counterparts.

The study, conducted by the University of Missouri, also found rural Missouri counties have a higher percentage of older nurses nearing retirement, which could have a severe impact on the future of the state's nursing workforce.

"Out of the 114 total counties in Missouri, 97 are designated as healthcare professional shortage areas, and a majority of these counties are rural," said researcher Anne Heyen, an assistant teaching professor in the MU Sinclair School of Nursing, in a statement. "By identifying the specific areas where there is the greatest need for more nurses, we can better tailor our response to help Missouri have a more balanced nursing workforce."

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To assess the shortage, the researchers analyzed workforce data of nearly 136,000 licensed Missouri nurses to identify the age and geographical disparities across the state. They found 31% of all Missouri nurses are over 54 years old, and rural Missouri counties had higher percentages of nurses over the age of 54 compared to their urban counterparts, including three rural counties — Dekalb, Reynolds and Worth — where more than half of the nurses are over age 54.

Anne Heyen
"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," Heyen said. "Research has shown nurses tend to stay and work where they are educated, which can influence young nurses to stay in urban areas where there tend to be more educational resources."

To help meet the nursing shortage, the Sinclair School of Nursing is developing a 64,585-square-foot facility that will allow the school to increase class sizes and graduate more nurses. In addition, the school is placing an emphasis on recruiting more students from the 25-county service area MU Health Care oversees, as students who come from a rural area are more likely to return there for work after they graduate.

"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 most," Heyen said. "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."

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