St Joseph, Missouri is a small city about an hour’s drive north of Kansas City, Missouri.  The population here is recorded to be a little over 70,000 residents.  Regarding size, St Joseph is, by far, the largest city in northwest Missouri surrounded by much, MUCH smaller villages and towns.  A good percentage of the population in this area still farm for a living, many of the roads are still gravel and everyone proudly considers this part of the country as rural.


Not so different than Northwest Missouri’s small towns, I grew up in a little village by the name of Jack’s Creek, Tennessee.  Many of the rural villages around St Joseph are similar to my home town.  The folks living in those villages act and feel like family and friends.  So, when we started our pilot project at Northwest Health Services (a Federally Qualified Health Center in St Joseph) in 2016, it almost felt like coming home.  Settling into this culture sure hasn’t been difficult for me.


St Joseph has a lot of good restaurants.  More than you’d expect from this size town.  One in particular has garnered a lot of local love and touts itself as a Mediterranean restaurant. They serve gyros, feta cheese, Mediterranean olives and many other odd but delicious things including that strange sounding noodle couscous.  While sitting at my table one afternoon, a couple came in and ordered that delicacy and I couldn’t help but notice how strange it sounded to hear that ordered in the middle of the American prairie.


Now, don’t get me wrong, the people in St Joseph are as good as gold, they are as educated as any you would expect to meet in large cities around the Midwest.  The issue is that like most of rural America a diverse diet isn’t an expected attribute.


When I heard couscous being ordered my mind immediately went to the pilot project we are implementing here in NW Missouri.  We are promoting things like prevention and wellness and those can sometimes seem completely out of line with the way folks in these parts have approached healthcare. It wasn’t uncommon for a patient to tell me, after I called to schedule them for their Annual Wellness Visit that, “I don’t get doctored til I’m sick,”  or  “If it ain’t hurtin me, ain’t no use thinkin about it.”  Until now, many of our rural patients haven’t considered preventing disease or modifying personal behavior to stay healthier as a need or a priority.  That is where our efforts have begun to sound a lot like couscous.


This is true even though prevention is an old concept, with the father of western medicine Hippocrates known for preaching the importance of prevention and our founding father Ben Franklin famously saying, “An ounce of prevention is worth a pound of cure.” Despite it long history, prevention has somehow taken a back seat in the modern healthcare industry and nowhere is that more apparent than in our rural areas.  


This concerns me as the CDC reports that rural patients are more likely to be obese, suffer from high blood pressure or have cancers diagnosed at later stages.  If for no other reason, that is why we must start a new conversation in rural areas regarding prevention and wellness.


As I looked over at the young couple eating their couscous, I saw nothing but pleasure on their faces. What immediately became apparent to me as I watched them enjoying their couscous was prevention and wellness may currently sound like a strange conversation in these rural settings but no matter how strange it may sound today, now that the practice is becoming more and more available, folks will eventually wonder why it took so long to get here.

To learn more about Innovative Health Media’s pilot projects visit our website at