Episode 4 | Minorities in Rural

Nov. 16, 2017

Show Notes:

In this episode of Catch Up With Chuck, University of Nebraska professor of sociology Kirk Dombrowski joins Chuck to discuss the RFI-funded research project, “Minority Health Disparities Initiative.”

Along with being the John G. Bruhn Professor of Sociology at the University of Nebraska-Lincoln and the director of UNL’s REACH Lab, Kirk is the director of UNL’s Minority Health Disparities Initiative. MHDI has partnered with Lexington, Nebraska to create the Looking Past Skin: Our Common Thread exhibit coming to the The Nebraska History Museum in spring 2018.

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Full Transcript:

[0:01] Listen. [0:01] Welcome back to Catch Up With Chuck, [0:03] this periodic broadcast [0:05] from the Rural Futures Institute [0:07] at the University of Nebraska. [0:09] I’m Chuck Schroeder. [0:10] I’m the Executive Director of the Rural Futures Institute, [0:13] and today we’re gonna talk about [0:15] some very innovative research [0:17] into some of the most difficult challenges [0:20] facing rural communities, [0:21] and the impact of that research on rural Nebraskans. [0:25] I’m delighted today to be joined [0:27] by a good colleague here at UNL [0:30] that I very much enjoyed getting to know [0:32] over the last year, Dr. Kirk Dombrowski. [0:35] Kirk is the John Bruhn Professor of Sociology at UNL, [0:39] but I think it’s important to know [0:41] that he’s an internationally respected scholar [0:44] whose worked from Nebraska to Alaska to Puerto Rico, [0:47] and all kinds of other places around the globe [0:50] really going face-to-face with rural issues [0:54] ranging from opioid addiction [0:56] to minority health disparities among other things. [0:58] In that role, I think it’s important for you to know [1:02] as a colleague here at the Rural Futures Institute, [1:05] Kirk works across a number of fields, [1:08] that include sociology, [1:09] but also anthropology, psychology, [1:12] political economy, [1:14] and there are [1:14] maybe some others. Nutrition. [1:15] Nutrition. [1:16] Hang out with artists a little bit. [1:18] I even hang out with artists. [1:19] Yeah. [1:20] So anyway, Kirk, why don’t you give us a little snapshot [1:24] of your background and your work at UNL.

[1:26] Sure, I’m happy to. [1:28] Prior to coming to UNL, [1:30] I was in New York City as a researcher [1:33] at The City University of New York, [1:34] and I was collaborating with Les Whitbeck, [1:36] who is a professor in the sociology department, [1:38] very internationally renounced scholar [1:40] in Native American Health, [1:42] and I was a consultant on one of his grants, [1:44] and he invited me out to Nebraska. [1:47] He was retiring. [1:49] They put on the charm and put on the push [1:52] and convinced me[1:53] to relocate here, [1:55] and it’s been a great move. [1:57] Prior to that, [1:58] I had started out as a field researcher in Alaska, [2:03] dealing with substance abuse issues and suicide, [2:06] which is a large problem in northern communities, [2:08] in many Native American communities. [2:10] My frustration with that led me to try to figure out [2:14] some new ways to deal with data collection, [2:18] social relationships, [2:19] and how you document them and those things. [2:22] I was very lucky to find a collaborator [2:24] in a computer scientist named Bilal Khan, [2:27] who became my research partner, as you know.

[2:30] Fascinating guy for sure. [2:32] Yeah. [2:33] Yeah, jack of all trades. [2:35] Amazing intellect, [2:37] and together we started developing some tools [2:39] for data collection that allowed us [2:42] to collect the kinds of data we were doing already, [2:46] but quicker, faster, better, easier. [2:49] That created a lot of research opportunities. [2:52] As you say, we wound up all over the Arctic, [2:54] and then in the Caribbean. [2:56] We were in Vietnam, [2:57] and we’re looking at some collaborations [3:00] with Lusaka Hospital in Zambia right now. [3:04] So UNL [3:06] was looking to replace Dr. Whitbeck when he was retiring, [3:10] and they made me a great offer, a very generous offer. [3:13] We were ready for a move, and my wife’s from the Midwest. [3:16] It made a lot of sense, [3:18] so we were really happy to get here.

[3:19] Well listen, [3:20] you have assembled a very interesting group [3:23] in your REACH research group.

[3:25] Sure, yep. [3:27] So when I came here, I founded the REACH lab, [3:30] which is Research, Evaluation, [3:32] and Analysis For Community Health. [3:34] The website is reach.unl.edu if anyone’s interested. [3:39] So we were doing community-based research [3:43] I think from the very beginning, [3:45] and that was we knew that in order to do good work [3:47] in rural communities, that we had to be in touch. [3:51] That meant getting people involved [3:53] in the research process from beginning to end. [3:56] So we assembled a lab that has all kinds of, [4:00] it has the capacity to do the high-end technical work [4:04] that we do right now. [4:04] We have five full-time programmers, [4:06] but we also have community engagement specialists. [4:09] We have long-time project coordinators [4:11] who have worked in the field [4:13] with Native American communities, [4:14] with Midwestern communities, [4:16] and so, and then very fortunately, [4:18] I was able to convince UNL to reach out [4:21] and bring Bilal Khan, [4:22] my former research worker in New York at here as well, [4:25] so he’s there. [4:26] So we put together a lab [4:28] that is simultaneously a software development lab, [4:32] a community impact lab, [4:34] a theory lab, [4:37] and I just wear different hats everyday, [4:40] and very fortunately, [4:40] we have very smart people in all of those separate areas. [4:44] The real art of my job is just to be the conductor, [4:47] so our post docks right now are a mathematician[4:50] from University of North Carolina, [4:52] an anthropologist from Stanford, [4:54] a sociologist out of Nebraska. [4:58] So my job is to figure out how all those pieces go together.

[5:02] Leadership matters one more time, [5:03] and I hear from your team [5:04] about the quality of your leadership. [5:07] Well listen, speaking of your team, [5:09] you and your team [5:10] have been working [5:11] on a Rural Futures Institute sponsored-project [5:15] that under the title of Minority Health Disparities, [5:19] but let me just say from a community-perspective, [5:23] you’re talking about [5:26] dealing with challenges [5:28] to access to quality healthcare [5:30] for people coming from different cultures, [5:34] different countries, [5:35] overcoming language barriers, [5:36] cultural barriers, all kinds of issues in a community. [5:40] You’ve been conducting that research, [5:42] in one of Nebraska’s legendary rural communities, [5:45] Lexington. Amazing place. [5:46] Out in the heart of Dawson County. [5:49] Talk a little bit about the very unique high-tech, [5:53] high-touch approach that you’ve taken there.

[5:55] Absolutely. [5:55] So I’ll just back up and say, [5:58] one of the other roles that UNL was looking to fill [6:00] when I came out was [6:01] the Minority Health Disparities Initiative, [6:03] which is something started by Prem Paul, [6:06] the former Vice-Chancellor for Research, [6:08] and is now carried on by Steve Goddard, [6:10] our Vice-Chancellor of Research now. [6:12] This is aimed at trying to do three things, [6:15] which was increase faculty work [6:18] in Minority Health Disparities, [6:20] train the next generation of minority health scholars, [6:24] and to have real impact in communities in Nebraska. [6:28] So I was asked to take over that initiative, [6:31] and that involved taking a group of young faculty, [6:34] many of whom have been hired in the last few years [6:37] from many different departments, psychology, [6:38] educational psychology, nutrition, [6:41] sociology, anthropology. [6:43] Who am I leaving out? [6:45] Computer science, and bring them together. [6:47] So this project was an attempt by us [6:49] to put some of our tools in our community, [6:51] impact people in place, [6:52] and bring a bunch of young research scholars [6:55] into the research fold [6:57] to teach them how to do community-based research, [7:00] and to do that in a way that impacts Nebraska. [7:02] So we put together a proposal around Lexington. [7:06] As you know and as you hinted at, [7:09] Lexington is a community [7:10] that’s undergone a massive demographic shift. [7:12] That makes it unique, but not that unique, right? [7:15] Right. [7:16] I mean this is Crete. [7:17] This is Skylar. [7:18] This is Marshall Town, Iowa. [7:20] This is many places.

[7:21] So that has meant that we have whole new communities [7:25] in the center of very old communities. [7:28] Right. [7:28] And often those new communities [7:31] have very different languages. [7:33] The have very different ideas about what health is, [7:36] about how health matters, [7:38] about how you get health and achieve health. [7:40] They also live in a very different condition. [7:41] Most of them are working in the meat packing industry, [7:44] and so they don’t, [7:46] they’re no similar to each other [7:47] than they are to the folks that they moved in next door to. [7:50] So you have folks from Sudan and Somalia, [7:52] Guatemala, El Salvador. [7:53] You have Corin from Asia. [7:55] What we wanted to do was try and use some of our tools [7:59] to be able to reach those communities [8:01] that don’t show up in most of the ways [8:04] that data is collected. [8:05] So if you do a survey, [8:06] you call people on their phone. [8:07] You find out where they are and you call their home phone. [8:11] We all know that. [8:11] We get called all the time at dinner. [8:13] Most people don’t have a home phone. [8:14] Sure. [8:15] They have a cell phone, [8:16] and their cell phone could be from wherever [8:17] they came in to the country. [8:19] So some of them have a New York area code. [8:21] Many of them are leery of outsiders, [8:24] and so won’t respond to a knock on the door.

[8:27] So what we try to do was to implement a project [8:29] that could reach those people through other survey means. [8:33] The way we do that is we think of human social connections [8:37] as something that looks like the worldwide web. [8:40] We create a research web crawler essentially. [8:44] That is a system of bringing people in[8:47] and getting them to refer other people[8:49] that walks us across the connections of the network. [8:53] In that way, [8:54] we learn a lot about what’s in there. [8:55] But we also have the means [8:57] from the kinds of network technologies [8:59] that we have to estimate out from a sample [9:02] that doesn’t look like a random phone call sample. [9:06] So we can get good rigorous information, [9:07] but we can do it in a way that gets around [9:09] some of the problems associated with people [9:11] not wanting to come in. [9:12] The referral process means that everyone [9:15] who comes into the project had been referred to somebody [9:17] who had already spoken with us. [9:18] They could say, [9:19] they could vouch for our [9:21] intentions and say who we were and explain things. [9:25] I think that that’s[9:26] that high-touch aspect that you’re talking about. [9:29] Yes, absolutely. [9:30] But it combined with this kind of analytic technology [9:33] we get out of the worldwide web, [9:34] that is that high-tech component of people coming in, [9:38] doing network analysis on doing their, [9:40] laying out their networks on a computer, [9:41] being analyzed even on the spot sometimes. [9:45] That of course was something that allowed us [9:48] to do it quickly and easily. [9:50] We did 325 interviews in a process of about three weeks. [9:54] Those interviews were an hour-and-a-half each, [9:56] so if you can imagine our team went full-strength. [10:00] But going back to what we were doing with REACH, [10:02] all those interviews were actually carried out [10:03] by field-trained people from the community. [10:05] So I think that’s a really critical part of it too. [10:08] We bring people in from the community[10:11] from the very start of the project, [10:12] and then they’re involved [10:13] in every aspect of the research process. [10:15] So it has that high-touch component [10:18] carried all the way through. [10:20] So critical. [10:21] Yeah, and you couldn’t do it without the machines. [10:23] Yeah. [10:24] But the machines alone are not enough.

[10:25] Listen. [10:25] Here’s, [10:27] here’s what I find fascinating about your work. [10:30] We know that we have viewers [10:32] who look at [10:35] sophisticated university research, [10:37] which certainly you and your team conduct. [10:40] They think of that as being [10:42] years of data collection, [10:44] then drawn back to the lab Yes. [10:46] for tedious analysis perhaps, [10:48] (laughs) [10:49] resulting in– Can I tell you how tedious?[10:51] Sometimes. [10:52] That goes on a shelf [10:53] that may be of principal interest to other scholars. [10:55] Yes. [10:56] Your work has impact, [10:58] and it has impact very quickly. [11:00] I just can’t tell you what it meant to me [11:03] to go to Lexington here a couple of weeks ago, [11:06] and be at that community gathering, [11:08] Yeah. [11:09] At the Dawson County Historic Home Museum, [11:12] and to hear Somali, [11:15] grandfather, Yeah. [11:17] And youth, [11:18] Hispanic, as well as Anglos from the community [11:22] talking about [11:23] how this project has already [11:27] bridged those gaps. [11:28] The Hispanic woman who had moved away [11:31] because of what she felt were community attitudes [11:35] that she just couldn’t live with, [11:37] has moved back to the community [11:39] because she sees this change going on. [11:41] Talk just a little bit [11:43] about how you drive. Magic. [11:45] (laughs)

[11:46] Well there is a bit of that but, [11:48] I think it’s incredible. Sure. [11:54] Again the key thing [11:55] is having people involved from the very beginning, [11:58] letting some of their interests drive, [12:00] and most of the time, [12:01] entirely their interest drive the research questions. [12:03] I think that was a critical part of what we did. [12:05] So I did mention before, [12:07] prior to the survey, [12:08] we did a large Photo Voice Project [12:10] where we actually gave people cameras. [12:12] Oh, yes, yes. [12:13] And they went out and took pictures of things [12:15] that were important to them, [12:16] more things they thought [12:17] people didn’t know about their community, [12:19] or aspects of their life that are probably not seen, [12:23] that they think almost are boring. [12:25] Then we bring them in, [12:25] sit around a table, [12:26] and they talk to us about what’s going on there. [12:28] We formed our research questions out of that. [12:30] So by the time we got to actually [12:32] going into the field and doing research, [12:34] it was already being driven by their kinds of, [12:38] by the community’s input. [12:39] That was a big diversity of questions, [12:41] so our job as researchers was to try and make that[12:44] into a rigorous format, [12:46] so that we could get data [12:47] that we thought was really actionable data. [12:50] Rigorous actionable data. [12:51] Because the rigor matters. [12:53] Sure, absolutely. [12:53] But it started with the questions there, [12:56] and they conducted the research, [12:58] and so they’re itching for the results. [13:00] That’s one of the nice things about that process. [13:03] If you begin with the community’s interest, [13:06] they’re waiting for it to come back. [13:07] Yeah. [13:08] They took real ownership. [13:09] Yes, that was obvious. [13:10] I think it often surprises people how much [13:13] their kinds of questions and worries and concerns [13:17] are actually perfectly legitimate research questions. [13:21] That’s a fault of the university [13:22] that we haven’t made that more clear, [13:25] that there are really actionable questions out there. [13:27] Sure.

[13:28] Listen, we should tell our viewers [13:30] that one of the cool things about this project [13:33] is that it is resulting in a very interesting exhibit [13:37] called Looking Past Skin Common Threads. [13:40] It’s going to be [13:42] actually a centerpiece [13:45] of exhibitions at the Nebraska History Museum. [13:48] I believe starting in January? [13:49] January, [13:50] January 5th I think is the public opening. [13:52] It’s opened right now out at the Dawson County. [13:55] Folks oughta be looking for that [13:57] and to be able to come and see real time, [14:00] the results of your project. [14:02] Yeah, it’ll be really exciting. [14:04] There’s two certain major exhibits. [14:07] Yeah, it’s a relationship with Sheldon, [14:08] did you not form for the development?

[14:09] Yep. [14:10] We’re now working with Sharon Kennedy [14:13] at the Historical Museum. [14:14] That will be two exhibits. [14:16] That will be up and they’ll be addressing [14:19] in some ways that original Photo Voice Project [14:23] and more about the kind of health results that we found, [14:26] but it’s an art piece as well. [14:28] I think that that’s really critical for giving people [14:31] opportunities to engage the work that we do emotionally, [14:35] as well as intellectually, aesthetically, [14:38] and with some real connection. [14:41] I think art does that in some ways [14:43] in ways that we can only envy in science.

[14:45] Well I, [14:46] for folks who think [14:47] you’re a buttoned-up old college professor, [14:50] I will always hold a memory of walking [14:52] into the museum and here’s Kirk doing posters and… [14:56] Hand cook and bottle washer. [14:58] (laughs)[14:58] Absolutely. [14:59] I knew you were a true believer [15:01] in what we were getting ready to tell. [15:04] Well listen Kirk, [15:04] I just want you to know [15:05] the Rural Futures Institute is so proud [15:07] to be associated with you and your very eclectic gang [15:11] of researchers and difference makers, [15:14] but you know we believe this is the path [15:17] to impact for rural people.

[15:19] Connecting people in the community who have said, [15:22] we’re not okay with where we are. [15:24] We think we know where we wanna go. [15:26] We want to make it better, [15:28] connecting them with people like you and your team, [15:30] who can come in and help them. Yeah. [15:32] With such sophisticated tools to grapple [15:35] with those very difficult issues, [15:37] but in as we’ve described, [15:39] a very high-tech Sure. [15:41] high-touch approach that we think is central [15:44] to the way we do things in Rural Futures Institute. [15:46] Thanks. [15:47] Anything else you wanna add about your work?

[15:50] Well, I think you hit it right on the head. [15:52] I think that folks in rural communities [15:55] are rightfully weary about the intentions and questions [15:58] of people who come from the outside. [15:59] That high-touch question is really critical. [16:02] Our rural people have always been tech-oriented. [16:06] I mean, rural doctors are everywhere. [16:08] Very true. [16:09] Their whole process of rural production [16:11] is a trial and error process, [16:12] and people are very comfortable with the concept [16:15] that their world can change by new tools and new equipment. [16:19] So we’ve actually found that that can work really well. [16:21] I know that partly because I’m from a small town, [16:24] even though I came here from New York City. [16:25] (laughs) [16:26] I grew up in a place a lot of people have heard of, [16:28] but don’t know is a small town [16:29] called Nantucket, Massachusetts. [16:31] Oh yeah, sure. [16:32] Which is an island of 8,000 people [16:33] with three ferries a day. [16:35] If you think you’re in the middle of nowhere, [16:37] try being 17 miles out in the ocean. [16:39] (laughs) [16:40] So I understand the perspective that says, [16:42] we worry about why people will be coming in [16:44] and asking a lot of questions, [16:45] but I also recognize that people [16:47] are really interested and engaged in the kinds of, [16:51] and in experimental ways, [16:52] about how they can make their lives better, [16:54] and I think actually rural people are more adept [16:56] at that than urban people in my experience. [16:59] Thank you for the opportunity.

[17:01] Well, we are proud of the work that you’re doing [17:03] on behalf of the University of Nebraska, [17:05] and certainly on behalf of rural people everywhere. [17:07] Well listen, [17:08] we want you to stay in touch [17:09] with the Rural Futures Institute. [17:10] Look at our newly redesigned website. [17:13] It’s a lot of fun, [17:15] and know that in weeks ahead, [17:16] we’ll be coming back with another episode [17:19] of Catch Up With Chuck [17:21] looking at rural people, [17:22] rural places, innovators, [17:23] thinkers, doers, [17:25] artists, and others [17:26] who are helping to make rural places [17:28] a legitimate best choice for worthwhile living. [17:30] Thanks for being with us.

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