Community Context and Challenges

  • Approximately 20% of the region’s population has a four-year college degree or higher, which is lower than the state (29%) and national rates (29%).

  • North Central Nebraskans experience skin cancer at a statistically higher rate than residents in the rest of the state, although it remains unclear why.

  • In 2014, 20% of North Central Nebraskans were ages 65 or older, compared with 13% of Nebraskans overall.

  • The region faces a shortage of health care providers and funding for new health care initiatives; given the vastness of the region and sparse population density, it is not uncommon for residents to live many miles from the nearest health care provider.

  • Five of the nine counties in North Central Nebraska are state-designated shortage areas for general dentistry.

Community Actions: A First Look

As a “Turning Point” grant recipient, the state of Nebraska, along with the North Central region, is working to strengthen the public health system through community-based, collaborative efforts.

In conjunction with the proposals developed through the Turning Point grant, the nine counties formed the North Central Community Care Partnership (NCCCP,) a private, nonprofit organization that supports regional health efforts. In 1999, NCCCP signed an agreement to create a single public health coalition and produced the region’s first Community Health Improvement Plan, which highlighted public health concerns and laid out steps for improvement.


These baseline reports, created in 2016, reflect our initial observations on select community programs and initiatives to gauge ongoing, as well as newer, efforts to improve community health. Future reports will provide more in-depth insights and analysis into this community's activities.

Going Forward: Questions for Consideration

North Central Nebraska is a vast, biodiverse region that economically relies on agriculture. The region is characterized by an aging population with numerous health challenges and a lack of resources to tackle them adequately. NCDHD, formed in 2001, is working to address the region’s health concerns and has made small steps toward that end. Additional surveillance; data and information gathering; analysis; and reporting will examine how initiatives are coordinating their efforts and the extent of their impact. Future reports will also convey how stakeholders are working to create a healthier, more equitable community; the impact of new and ongoing initiatives to address priority health concerns; and whether gaps are emerging in priority areas.

Answers to the following questions could provide insights into the degree to which meaningful change is taking place and can be sustained:

  • To what extent will NCDHD be able to achieve its goals given its limited funding? Where will it find new or additional funding sources? Is the region adopting any innovative approaches to work within funding constraints?

  • How will the region’s physician shortages affect its aging population? What is the region doing to expand access to care? How and when will the region implement telemedicine to address physician shortages?

  • As the region’s population shrinks and hospitals close, what steps is the region taking to ensure that residents have access to health care services, including emergency care needs?

  • How is the region following up on goals outlined in its Community Health Improvement Plans, and how is it working to overcome any barriers to successful implementation?

  • How will the region continue to work to protect the environment, and what impact would any environmental changes, such as the potential Keystone Pipeline, have on the population and its health?