Mapping out the good life: Using geographical analysis of a county-wide survey to understand and address health disparities in Omaha, Nebraska

Home to nearly 23% of Nebraska’s population, the city of Omaha has transformed in recent years as it has become a hub of immigration, refugee resettlement, and rural-urban migration.  Locals divide the city by affluence east and west of 72^nd Street and by race north and south of Dodge Street.  The purpose of this study is to determine the veracity of these divisions and to explore their implications for health and health care access. In the summer of 2013, the Center for Reducing Health Disparities at the University of Nebraska Medical Center conducted a population-based phone survey of 1,503 English- and Spanish-speaking adults living in Douglas County.  Responses were categorized by zip code to compare four distinct areas of Omaha across five domains: socio-demographic characteristics, health status and behaviors, access to health care, sources of health information, and knowledge and perception of health reform.  The four areas of Omaha differ significantly in every domain.  Results of this study indicate that West Omaha is more affluent, less racially diverse, and has higher access to health care; East Omaha is lower income and has a more positive perception of health reform; Northeast Omaha is more racially diverse and has the highest rates of diagnosed chronic disease; and Southeast Omaha has the lowest rates of English proficiency, health coverage, and access to health care.  Public health partners and stakeholders in Omaha can use outcomes of this study to improve the focus and effectiveness of localized and city-wide efforts.