ECHD UNMC

Representatives of East Central District Health Department and the University of Nebraska Medical Center pose for a photo. The two health care providers are partnering on a research project focused on tobacco use.

Courtesy photo

COLUMBUS — What do different medical professions such as dentistry, radiography and nursing have in common? The unfortunate answer is tobacco.

When the University of Nebraska Medical Center and East Central District Health Department were deciding on a subject for an interdisciplinary research project, ECDHD executive director Rebecca Rayman said one of the reasons they ultimately chose tobacco and smoking prevention is because it applies to many medical disciplines and many of the health issues ECDHD treats.

“When this opportunity came to us, we looked at what are the major causes in the community for population mortality. The big two are heart disease and cancer, both of which are related to smoking and tobacco use,” Rayman said. “Then we looked at what if we could reduce smoking. We’d save millions of dollars and improve quality of life.”

The three UNMC students have seen the effects of tobacco in their rotations at rural hospitals.

Erica Boyd, a dentistry student, has done a rotation at ECDHD before. She’s seen the consequences of tobacco use and the lack of access to medical care in rural areas firsthand.

“What I found stunning is how far some people from the country will let their cancers get before coming to the doctor,” she said. “It’s hard to wrap my head around how they won’t come in until they’re not able to eat or breathe.”

Nursing student Paula Schaefer seconded that based on her experiences.

“We’ll see people coming into the hospital that their disease has progressed to an extensive level. Whether it's cancer or cardiovascular disease, whether it's respiratory disease, it magnifies it when they’re from a rural setting, and they’re less able to or less likely to seek medical treatment until it gets to a certain threshold where they have to,” Schaefer said. “And there’s many diseases that if you reach that tipping point, you’re on the way down and there are limited things we can do as interventions.”

Even though Tori Bailey, a radiography student from Norfolk, may not come into direct contact with patients, she sees the effects tobacco has.  

“I do a lot of chest X-rays. You’ll get (the patients) coming in, and they’ll be coughing and everything and its COPD (chronic obstructive pulmonary disease). Their lungs just look terrible,” Bailey said. “You’ll see the radiograph, and it’s just like, ‘Wow.’ You can tell how much it’s affecting their body.”

For their three-week public health rotation at ECDHD, Bailey, Boyd and Schaefer are researching smoking prevention measures, what legislation has been passed and what has been effective.

Next semester’s group of UNMC students will conduct community-based research to help ECDHD and its affiliated health organizations develop strong, research-based legislation to reduce tobacco use in Nebraska.

“These three students will have the potential to have the biggest impact on the health of Nebraskans than any single physician if this project leads to legislation that reduces tobacco use,” Rayman said. “It’s a health issue, it’s an economic issue and a family issue.”

The project also indirectly addresses two other important medical issues. First is the difficulty rural communities have attracting medical professionals, even in a larger city like Columbus.

Patrik Johansson is director of the Rural Health Education Network at UNMC, which collaborates on rotations in rural clinics and facilities.

“Part of it is providing students the opportunity to work in a rural setting, which will hopefully raise awareness of opportunities and careers in rural care,” Johansson said.

Boyd said the walk-in dental clinic at ECDHD is always full because of the scarcity of dentists in surrounding areas. She just completed a rotation at a private dental practice in a town smaller than Columbus.

“The need is just much higher,” she said. “He’s booked out six months in advance.”

The project is also meant to encourage collaboration between different medical disciplines and counter the siloing that occurs when disciplines don’t communicate with one other.

“Everyone has unique gifts that come to the table. They’re trained in a specific path, but when you’re only using your path, you might miss something that they would be able to pick up,” Schaefer said. “It becomes a dynamic interchange. And the patient or the person you’re serving is the one who wins on that because they’re going to have the latest evidence and the best information instead of someone just guessing.”

“Anytime you pull in multiple perspective, multiple schools of thought or even multiple colleges of thought, it’s going to be beneficial to a project,” Boyd said.

The students will complete their three-week project next week, when they’ll give a presentation on their research.

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