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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