“North Central Nebraska is illustrative of many rural communities struggling to remain viable as economic and generational shifts challenge existing structures and paradigms.”
—RAND Corporation
RWJF 5-Year Culture of Health Community Landscape Report: North Central Nebraska
Report Apr-01-2022 2-min read
Table of Contents
Table of Contents
Report Publish Date: April 2022
This report summarizes North Central Nebraska’s health, wellbeing, and equity journey from 2016 to 2021, as part of RWJF’s Sentinel Communities Surveillance project.
Primary Takeaways
“North Central Nebraska’s community capacity to promote health and well-being has remained relatively stable over the past five years under the leadership of the North Central District Health Department (NCDHD) and critical access hospitals,” the authors write. “Regional and state organizations that include North Central Nebraska and neighboring counties also provide important capacity to promote health and well-being, as do a small set of social service agencies, economic development organizations, and nonprofits. There are no formal cross-sector collaboratives for health in the region.”
NCDHD coordinates most health and wellbeing-related efforts, with some help from housing and food access organizations.
Overview and Objectives
Begun in 2016, RWJF’s Sentinel Communities Surveillance project tracks how a Culture of Health is developing in 29 communities across the country. The authors wanted to describe key challenges, opportunities, and insights in North Central Nebraska.
Hypothesis or Approach
For this report, the authors conducted 28 hourlong, semi-structured interviews between early 2017 and early 2022. Interviewees came from several different types of organizations and sectors.
How This Influences Change
“Local community organizations struggle to collaborate formally and sustainably to be able to tackle large-scale challenges,” the authors write. “And the community will likely continue to be challenged by a prevailing mindset that individuals are responsible for their own health.”
Research: Go Deeper
North Central Nebraska is a vast, sparsely populated region composed of nine counties: Antelope, Boyd, Brown, Cherry, Holt, Keya Paha, Knox, Pierce, and Rock. Changes in the agricultural economy and an aging population have contributed to a declining population, though efforts are ongoing to attract young families to the region, including expanding child-care access, rehabilitating and building new housing, and increasing access to well-being amenities. Over the past five years, leadership for health has remained situated in the North Central Nebraska Health District and local critical access hospitals, and these organizations have consistently focused on healthcare access, chronic disease prevention, and substance use, in addition to taking on the COVID-19 response starting in 2020. Organizations in non-health sectors have begun to act on emerging community priorities, including mental health concerns for youth and agricultural producers. While the community is tight-knit and committed to a shared future, and health is becoming more of a personal priority for families, most residents and organizations still think of health as an individual responsibility. Most organizations do not explicitly prioritize health equity, and equity is rarely part of the local dialogue about health, though individual leaders and ad hoc conversations, coupled with new federal and state foci, may elevate the topic.
Robert Wood Johnson Foundation, April 2022
Figure 1: Population characteristics for North Central Nebraska Page 2
Research Team
This study and report was conducted and created by the following people.
- RAND Corporation
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