Ty Whitfield, Jonathan Cooney, Tayla Nathoo, Mnirnal Maudho
Throughout our research, we focused on three main aspects of how The Nebraska Medical Center (TNMC) and the University of Nebraska Medical Center (UNMC) positively impacts our community. We compared TNMC and UNMC with traditional clinics and universities in how they function in their communities, the paradigm of what hospitals contribute to their communities, and the latent functions that hospitals may have in their communities.
A functionalist would view TNMC as an interrelated and an integral part of this society. Not only does this clinic meet the biological needs of the individuals through the treatment of illnesses, but it also serves a higher, social function. This clinic impacts every individual, sick or healthy, through its economic impacts, creating jobs and bringing money to the community. TNMC also brought international recognition to this community through their work with the Ebola virus. The international recongnition will bring in more funds for research and treatment, which will in turn create more jobs and will supply the city of Omaha with more tax revenue. The profits of TNMC can then be used to advance their outreach programs while the increased tax revenue will allow the city of Omaha to increase funding to social programs, such as planned parenthood.
These functional aspects change the paradigm of what hospitals contribute to their community. Traditionally, clinics tend to only serve the ill and treat the symptoms. However, TNMC is also involved in other programs that target the source of these illnesses. This mentality of treating the source of the disease as opposed to the symptoms of the disease is a novel approach that is not only revolutionary, but altruistic. It would be all too easy for clinics to let the community suffer from health issues and rake in money from treating the people, but TNMC acts in the best interest of the people. Furthermore, these initiatives also serve latent functions that also benefit the community.
One of the initiatives, funded by The Central States Center for Agricultural Safety and Health in the College of Public Health, focuses on the improvement of immigrant farmers. Their focus alters the way hospitals typically deal with physical and emotional problems in the community. This initiative focused on treating the mental and physical illnesses present in immigrant workers, primarily depression and substance abuse. Through the treatment of these migrant workers, a latent function could manifest itself: the families of the farmers are also a lot healthier. The wives and children of these workers are less likely to be abused if the paternal figure is in a health state of mind.
Another initiative is TNMC’s involvement with Impact One to reduce gang violence and crime. The paradigm through which hospitals keep a community healthy is being transformed through the works of this clinic. Hospitals traditionally serve to make communities healthier by simply treating the sick or wounded, not by targeting the source of these health problems. This initiative is a novel approach that not only makes the society healthier and safer place to live, but also has several latent functions, such as reducing economic strain caused by violent incidents and by compelling youth to focus on school instead of gang activities.
The science café is an outreach program designed to educate the public about various health topics. Though this approach to a healthy community isn’t exactly novel or paradigm shifting, it does have multiple latent functions. Not only does this outreach program serve to increase public awareness of diseases, but it can also catalyze social reform. The largest potential impact from this program is that the individuals in this society will be inspired to lead healthier lives, whether it be from health-conscious choices when it comes to diet that leads to an overall healthier society, or less risky sexual behavior that leads to a city in which sexually transmitted diseases aren’t rampant.
However, though TNMC and UNMC differ from other clinics and universities in terms of its initiatives and impact on the community, there is one problematic aspect of healthcare that all hospitals work towards in creating a solution. The problem is the discrepancy between the care and health that the minorities recieve and the care that could be given. Healthcare disparity exists because lack of healthcare insurance coverage, difficulty in accessing healthcare, and predispositions to disease. TNMC and UNMC currently has several ongoing projects in which it aims to reduce these disparities, with programs focusing on infant mortality rates, diabetes, and renal disease. Conflict theorists have expounded on the problems that manifest in a capitalistic fee-for-service model when healthcare is made a commodity instead of a necessity. The dominant group will be able to afford coverage and medical expenses whereas the subordinate group cannot afford the insurance coverage and therefore has limited options to manage their own personal care. The conflict arises when certain groups that lack healthcare coverage have limited access to services that require routine checkups and annual screenings to address medical conditions such as pregnancy and chronic illnesses. Certain groups that are affected by these disparities are Low Income families, African-Americans and communities based in the Northeast and Southeast Omaha.
The Douglas County statistics show a consistent trend of disparity based on income, ethnicity, and location in the county. Factors such as Low Income, African Americans, and living in Northeast or Southwest Omaha show these disparities.
“Connections Project” is a grassroots outreach-research partnership between North Omaha community leaders, UNMC and state and county personnel. Their goal is to improve birth outcomes in African-American community. The infant mortality rate for African Americans in Douglas County was 17.6 per 1,000 births, as compared to 2.7 per 1,000 for Hispanics, and 4.8 per 1,000 for White/Non-Hispanic individuals. Factors being considered in this effort are environment, peer supporters, programs that fosters maternal-infant interaction for early language development are conducive for healthy infant brain and behavior development. Infant mortality in Douglas county reached an increased outcome of 7.0 deaths/1,000 deaths. The Douglas County reports infant mortality is one of the most widely used indicators of the overall health status of a community. The community effort focuses on many factors to improve outcomes such as improving the environment and providing a peer support programs that foster maternal-infant interaction for early language development conducive for healthy infant brain and behavioral development.
Adults being diagnosed with Diabetes, the disparity is almost two times more represented in every demographic of Low Income, Black/non-Hispanic, and Northeast and Southeast Omaha. UNMC has a diabetes prevention program called the Center for Disease Control’s Diabetes Prevention Program that has open enrollment. The cost for the program is subsidized for anyone over the age of 65. TNMC provides support services in a life-long wellness plan that includes custom meal planning with a registered dietitian and activity schedules with an exercise specialist to help patients successfully manage their diabetes. The strong emphasis is on American Association Diabetes Education Self-Care Behaviors: monitoring, taking medication, healthy coping, healthy eating, problem solving, reducing risk and being active.
Adult diabetes disproportionately affects demographics with lack of health care access as it is almost two times more represented in Low Income, Black/non-Hispanic, and Northeast and Southeast Omaha. They also state nearly, 1 in 3 patients are kidney failure patients. Kidney failure results from the untreated, mismanaged and advanced stages in diabetes and high blood pressure. African-Americans represent 1 in 9 adults with diabetes and even more so as 1 out of 4 cases of high blood pressure. Also, African-Americans are six times more likely to develop kidney failure from high blood pressure. UNMC’s professor and research of Pediatrics, Pascale Lane M.D. works with the Nebraska Kidney Association as a leader in research of factors accelerating kidney disease and as a provider for outreach programs. These programs provide patients with information and awareness of risk factors such as diabetes, and conduct screenings for early detection, and offers services to kidney and transplant patients and their families. Dr. Lane stated his outreach has most impact with minorities: “The Nebraska Kidney Association provides important outreach and screenings for kidney disease to populations across the state, including minorities who are at greater risk.”
Douglas County reports that 10.8% of our population in Douglas County and why it is important to address the problem of diabetes: “Diabetes mellitus affects an estimated 23.6 million people in the United States and is the 7th leading cause of death. Diabetes mellitus: lowers life expectancy by up to 15 years; increases the risk of heart disease by 2 to 4 times; and is the leading cause of kidney failure, lower limb amputations, and adult-onset blindness.”
In summary, we have shown that TNMC and UNMC contribute to the overall welfare and social progress in Omaha. From economic support provided by the hospital, to outreach programs intended to educate the masses, to the initiatives taken to reduce disparities in healthcare, these two entities have changed Omaha for the better.
Dr. Sacra is the first patient in The Nebraska Medical Centers bio-containment unit
Athena Ramos and her pilot project involving the treatment of mental and physical ailments of migrant farmers
Participants of the gang violence intervention partnership
The science café program is an outreach program designed to educate the public about various scientific topics. In the picture above, a specialist for Autism is lecturing about the disease itself as well as the analysis of behaviors of autistic people, verbal behavior, and skill acquisitions across the autism disorder spectrum.
The Connections Project Outreach Group pictured above. from left, Gail Ross, UNMC’s Jack Turman Jr., Ph.D., Thelma Sims, Steve Jackson of the Douglas County Health Department, UNMC postdoctoral researcher Kellee Hanigan, D.P.T., and Kathy Trotter.