In Missouri, six rural hospitals closed in the last five years. It's part of a group of states that have seen higher rates of closures -- states that haven't expanded Medicaid.

The Midwest is home to one of the largest Amish populations in the nation. And many of these settlements overlap with rural Appalachian counties, where access to healthcare is hard to come by.

This five-part series examines the financial problems faced by rural hospitals across the U.S. More than 110 have closed in less than a decade, and the trend accelerated last year. Others have cut services such as maternity wards to survive.

To survive, Wisconsin's rural hospitals are consolidating, getting creative about doctor recruitment and tapping new segments of the medical market.

To help address a shortage of medical professionals, a University of Missouri program immerses future doctors, pharmacists, nurses and other health workers in small-towns.

The Big Fork, Minnesota municipal hospital is a chronic money-loser. But without it, local leaders fear the community's health would suffer and employers would melt away.

To avoid closing, some hospitals have cut services, including labor and delivery units. That's had a big impact on small Iowa communities.

Planned Parenthood plans to stop taking money from the federal Title X program. That has some health providers worried about the potential impact on rural and low-income Hoosiers.

In 2017, some 63,000 children were in the care of grandparents; thats 6% of kids statewide. And of those grandparents, 38% were age 60 or older.

Loneliness can lead to cognitive and physical decline. This is especially an issue in rural America, where older adults tend to be more isolated.