A Sociological Analysis of The Nebraska Medical Center and the University of Nebraska Medical Center

Ty Whitfield, Jonathan Cooney, Tayla Nathoo, Mnirnal Maudhoo

Dr. Edwards; Sociology 1010-006

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.

Sources

(Economics)http://www.unmc.edu/news.cfm?match=16496

(Ebola)http://www.unmc.edu/news.cfm?match=15738

(Farmers)http://www.unmc.edu/news.cfm?match=15233

(Gang Violence)http://www.nebraskamed.com/mobile/news/64/gang-violence-intervention-partnership

(Science Café)http://blog.unmc.edu/podcasts/category/sciencecafe/

(Infant Mortality)http://app1.unmc.edu/PublicAffairs/TodaySite/sitefiles/today_full.cfm?match=9537

http://www.douglascohealth.org/modules.php?op=modload&name=NS-Indicator&file=indicator&iid=17394752

(Diabetes)http://www.douglascohealth.org/modules.php?op=modload&name=NS-Indicator&file=index&group=category&breakout=all

http://www.nebraskamed.com/diabetes

http://www.douglascohealth.org/modules.php?op=modload&name=NS-Indicator&file=indicator&iid=733689

(Renal Disease)http://www.kidneyfund.org/are-you-at-risk/risk-factors/race-kidney-disease/#african-americans

http://app1.unmc.edu/PublicAffairs/TodaySite/sitefiles/today_full_print.cfm?match=6177