The only county in Missouri with enough health care professionals to serve its population is Platte County north of Kansas City.
The remaining 113 counties in the state have a nursing shortage, according to a recent report in the Journal of Nursing Regulation.
Adequate health care coverage is based on a ratio of providers to population. Close to 1.7 million Missourians live in an area that has been designated as having a shortage of health professionals.
"Show Me the Nursing Shortage: Location Matters in Missouri Nursing Shortage" surveyed nearly 136,000 nurses in Missouri with an active license as of June 23, 2020. The study was contracted by the Missouri State Board of Nursing with the help from the Center for Health Policy at MU.
In addition to the widespread shortage of nurses, the study also found that rural areas in Missouri have about 40% fewer nurses than metropolitan areas.
More job opportunities and higher pay in cities are reasons for this disparity, as well as a tendency for nurses to remain and work in places where they were educated.
The study also reported that 31% of all nurses in Missouri are older than 54, which raises a concern about long-term availability.
The study recommends taking action before matters become worse in rural areas: "Actively try to recruit nurses now, rather than when the situation becomes more urgent."
"Having enough nursing staff plays a critical role in patient health and safety," said Lori Scheidt, executive director of the Missouri State Board of Nursing and lead author of the study.
"It stands to reason that the overall number of nurses can impact nurse-patient ratios," she said.
Adequate nursing staff in the future is especially important in counties like Dekalb, Reynolds and Worth, where more than half of the nurse workforce is over the age of 54.
Scheidt said a one-size-fits-all approach to addressing the nursing shortage is "simply not effective."
New nursing education models could offer solutions, such as the existing partnerships between employers and nursing programs that are funded by the Missouri Board of Nursing.
Senior-level students are paired with experienced nurses where they can be paid while still working toward their required clinical learning.
Such a partnership is already in place at East Central College in Union, which has connections with both Mercy Hospital in Washington, Missouri, and Missouri Baptist Sullivan Hospital in Sullivan. Other programs are taking place at Crowder College in Neosho and Freeman Hospital in Joplin.
"The public should know that we now have data that gives us a clear picture of the nursing workforce," Scheidt said. "That is the first step to targeting solutions."
Nursing shortages aren't just an issue in Missouri. According to data provided by LinkedIn, nursing ranks seventh among the most in-demand jobs in 2021.
Data from the Bureau of Health Workforce shows there are currently 12 nurses for every 1,000 people in the U.S., with South Carolina, Nevada, California, Texas and Georgia as the top five states with the lowest nurse-to-population ratios.
Missouri is ranked at 41, with approximately 15 nurses for every 1000 people in the state.