Catch Up With Chuck | Episode 4

Rural Futures Institute Author

11/15/2017 Added

16 Plays

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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.”

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[00:00:01.079]Listen.
[00:00:01.958]Welcome back to Catch Up With Chuck,
[00:00:03.880]this periodic broadcast
[00:00:05.829]from the Rural Futures Institute
[00:00:07.758]at the University of Nebraska.
[00:00:09.611]I'm Chuck Schroeder.
[00:00:10.600]I'm the Executive Director of the Rural Futures Institute,
[00:00:13.811]and today we're gonna talk about
[00:00:15.571]some very innovative research
[00:00:17.651]into some of the most difficult challenges
[00:00:20.021]facing rural communities,
[00:00:21.741]and the impact of that research on rural Nebraskans.
[00:00:25.829]I'm delighted today to be joined
[00:00:27.560]by a good colleague here at UNL
[00:00:30.309]that I very much enjoyed getting to know
[00:00:32.381]over the last year, Dr. Kirk Dombrowski.
[00:00:35.011]Kirk is the John Bruhn Professor of Sociology at UNL,
[00:00:39.909]but I think it's important to know
[00:00:41.319]that he's an internationally respected scholar
[00:00:44.360]whose worked from Nebraska to Alaska to Puerto Rico,
[00:00:47.941]and all kinds of other places around the globe
[00:00:50.789]really going face-to-face with rural issues
[00:00:54.041]ranging from opiod addiction
[00:00:56.591]to minority health disparities among other things.
[00:00:58.772]In that role, I think it's important for you to know
[00:01:02.306]as a colleague here at the Rural Futures Institute,
[00:01:05.855]Kirk works across a number of fields,
[00:01:08.596]that include sociology,
[00:01:09.935]but also anthropology, psychology,
[00:01:12.404]political economy,
[00:01:14.084]and there are
[00:01:14.917]maybe some others. Nutrition.
[00:01:15.750]Nutrition.
[00:01:16.626]Hang out with artists a little bit.
[00:01:18.775]I even hang out with artists.
[00:01:19.924]Yeah.
[00:01:20.757]So anyway, Kirk, why don't you give us a little snapshot
[00:01:24.503]of your background and your work at UNL.
[00:01:26.567]Sure, I'm happy to.
[00:01:28.010]Prior to coming to UNL,
[00:01:30.004]I was in New York City as a researcher
[00:01:33.157]at The City University of New York,
[00:01:34.738]and I was collaborating with Les Whitbeck,
[00:01:36.526]who is a professor in the sociology department,
[00:01:38.328]very internationally renounced scholar
[00:01:40.568]in Native American Health,
[00:01:42.037]and I was a consultant on one of his grants,
[00:01:44.997]and he invited me out to Nebraska.
[00:01:47.698]He was retiring.
[00:01:49.351]They put on the charm and put on the push
[00:01:52.239]and convinced me
[00:01:53.669]to relocate here,
[00:01:55.295]and it's been a great move.
[00:01:57.783]Prior to that,
[00:01:58.969]I had started out as a field researcher in Alaska,
[00:02:03.995]dealing with substance abuse issues and suicide,
[00:02:06.424]which is a large problem in northern communities,
[00:02:08.373]in many Native American communities.
[00:02:10.597]My frustration with that led me to try to figure out
[00:02:14.834]some new ways to deal with data collection,
[00:02:18.540]social relationships,
[00:02:19.540]and how you document them and those things.
[00:02:22.775]I was very lucky to find a collaborator
[00:02:24.814]in a computer scientist named Bilal Khan,
[00:02:27.480]who became my research partner, as you know.
[00:02:30.989]Fascinating guy for sure.
[00:02:32.974]Yeah.
[00:02:33.807]Yeah, jack of all trades.
[00:02:35.185]Amazing intellect,
[00:02:37.612]and together we started developing some tools
[00:02:39.265]for data collection that allowed us
[00:02:42.105]to collect the kinds of data we were doing already,
[00:02:46.043]but quicker, faster, better, easier.
[00:02:49.555]That created a lot of research opportunities.
[00:02:52.372]As you say, we wound up all over the Arctic,
[00:02:54.988]and then in the Caribbean.
[00:02:56.217]We were in Vietnam,
[00:02:57.834]and we're looking at some collaborations
[00:03:00.716]with Lusaka Hospital in Zambia right now.
[00:03:04.988]So UNL
[00:03:06.111]was looking to replace Dr. Whitbeck when he was retiring,
[00:03:10.121]and they made me a great offer, a very generous offer.
[00:03:13.231]We were ready for a move, and my wife's from the Midwest.
[00:03:16.758]It made a lot of sense,
[00:03:18.296]so we were really happy to get here.
[00:03:19.768]Well listen,
[00:03:20.601]you have assembled a very interesting group
[00:03:23.862]in your REACH research group.
[00:03:25.782]Sure, yep.
[00:03:27.448]So when I came here, I founded the REACH lab,
[00:03:30.321]which is Research, Evaluation,
[00:03:32.209]and Analysis For Community Health.
[00:03:34.231]The website is reach.unl.edu if anyone's interested.
[00:03:39.626]So we were doing community-based research
[00:03:43.473]I think from the very beginning,
[00:03:45.332]and that was we knew that in order to do good work
[00:03:47.921]in rural communities, that we had to be in touch.
[00:03:51.143]That meant getting people involved
[00:03:53.913]in the research process from beginning to end.
[00:03:56.369]So we assembled a lab that has all kinds of,
[00:04:00.415]it has the capacity to do the high-end technical work
[00:04:04.005]that we do right now.
[00:04:04.838]We have five full-time programmers,
[00:04:06.405]but we also have community engagement specialists.
[00:04:09.306]We have long-time project coordinators
[00:04:11.906]who have worked in the field
[00:04:13.497]with Native American communities,
[00:04:14.412]with Midwestern communities,
[00:04:16.533]and so, and then very fortunately,
[00:04:18.470]I was able to convince UNL to reach out
[00:04:21.202]and bring Bilal Khan,
[00:04:22.390]my former research worker in New York at here as well,
[00:04:25.093]so he's there.
[00:04:26.026]So we put together a lab
[00:04:28.032]that is simultaneously a software development lab,
[00:04:32.024]a community impact lab,
[00:04:34.181]a theory lab,
[00:04:37.461]and I just wear different hats everyday,
[00:04:40.162]and very fortunately,
[00:04:40.995]we have very smart people in all of those separate areas.
[00:04:44.301]The real art of my job is just to be the conductor,
[00:04:47.790]so our post docks right now are a mathematician
[00:04:50.613]from University of North Carolina,
[00:04:52.470]an anthropologist from Stanford,
[00:04:54.232]a sociologist out of Nebraska.
[00:04:58.072]So my job is to figure out how all those pieces go together.
[00:05:02.271]Leadership matters one more time,
[00:05:03.392]and I hear from your team
[00:05:04.901]about the quality of your leadership.
[00:05:07.421]Well listen, speaking of your team,
[00:05:09.461]you and your team
[00:05:10.340]have been working
[00:05:11.498]on a Rural Futures Institute sponsored-project
[00:05:15.402]that under the title of Minority Health Disparities,
[00:05:19.232]but let me just say from a community-perspective,
[00:05:23.552]you're talking about
[00:05:26.252]dealing with challenges
[00:05:28.809]to access to quality healthcare
[00:05:30.827]for people coming from different cultures,
[00:05:34.139]different countries,
[00:05:35.187]overcoming language barriers,
[00:05:36.956]cultural barriers, all kinds of issues in a community.
[00:05:40.838]You've been conducting that research,
[00:05:42.638]in one of Nebraska's legendary rural communities,
[00:05:45.604]Lexington. Amazing place.
[00:05:46.905]Out in the heart of Dawson County.
[00:05:49.414]Talk a little bit about the very unique high-tech,
[00:05:53.046]high-touch approach that you've taken there.
[00:05:55.038]Absolutely.
[00:05:55.871]So I'll just back up and say,
[00:05:58.175]one of the other roles that UNL was looking to fill
[00:06:00.987]when I came out was
[00:06:01.854]the Minority Health Disparities Initiative,
[00:06:03.446]which is something started by Prem Paul,
[00:06:06.592]the former Vice-Chancellor for Research,
[00:06:08.451]and is now carried on by Steve Goddard,
[00:06:10.251]our Vice-Chancellor of Research now.
[00:06:12.849]This is aimed at trying to do three things,
[00:06:15.775]which was increase faculty work
[00:06:18.358]in Minority Health Disparities,
[00:06:20.698]train the next generation of minority health scholars,
[00:06:24.269]and to have real impact in communities in Nebraska.
[00:06:28.349]So I was asked to take over that initiative,
[00:06:31.698]and that involved taking a group of young faculty,
[00:06:34.370]many of whom have been hired in the last few years
[00:06:37.149]from many different departments, psychology,
[00:06:38.730]educational psychology, nutrition,
[00:06:41.229]sociology, anthropology.
[00:06:43.427]Who am I leaving out?
[00:06:45.156]Computer science, and bring them together.
[00:06:47.743]So this project was an attempt by us
[00:06:49.452]to put some of our tools in our community,
[00:06:51.732]impact people in place,
[00:06:52.941]and bring a bunch of young research scholars
[00:06:55.759]into the research fold
[00:06:57.979]to teach them how to do community-based research,
[00:07:00.110]and to do that in a way that impacts Nebraska.
[00:07:02.350]So we put together a proposal around Lexington.
[00:07:06.178]As you know and as you hinted at,
[00:07:09.059]Lexington is a community
[00:07:10.350]that's undergone a massive demographic shift.
[00:07:12.848]That makes it unique, but not that unique, right?
[00:07:15.801]Right.
[00:07:16.782]I mean this is Crete.
[00:07:17.889]This is Skylar.
[00:07:18.742]This is Marshall Town, Iowa.
[00:07:20.126]This is many places.
[00:07:21.726]So that has meant that we have whole new communities
[00:07:25.699]in the center of very old communities.
[00:07:28.013]Right.
[00:07:28.846]And often those new communities
[00:07:31.618]have very different languages.
[00:07:33.329]The have very different ideas about what health is,
[00:07:36.641]about how health matters,
[00:07:38.178]about how you get health and achieve health.
[00:07:40.311]They also live in a very different condition.
[00:07:41.841]Most of them are working in the meat packing industry,
[00:07:44.949]and so they don't,
[00:07:46.721]they're no similar to each other
[00:07:47.791]than they are to the folks that they moved in next door to.
[00:07:50.401]So you have folks from Sudan and Somalia,
[00:07:52.489]Guatemala, El Salvador.
[00:07:53.721]You have Corin from Asia.
[00:07:55.689]What we wanted to do was try and use some of our tools
[00:07:59.529]to be able to reach those communities
[00:08:01.689]that don't show up in most of the ways
[00:08:04.100]that data is collected.
[00:08:05.548]So if you do a survey,
[00:08:06.678]you call people on their phone.
[00:08:07.838]You find out where they are and you call their home phone.
[00:08:11.078]We all know that.
[00:08:11.911]We get called all the time at dinner.
[00:08:13.569]Most people don't have a home phone.
[00:08:14.995]Sure.
[00:08:15.828]They have a cell phone,
[00:08:16.661]and their cell phone could be from wherever
[00:08:17.972]they came in to the country.
[00:08:19.084]So some of them have a New York area code.
[00:08:21.501]Many of them are leery of outsiders,
[00:08:24.678]and so won't respond to a knock on the door.
[00:08:27.358]So what we try to do was to implement a project
[00:08:29.998]that could reach those people through other survey means.
[00:08:33.158]The way we do that is we think of human social connections
[00:08:37.625]as something that looks like the worldwide web.
[00:08:40.838]We create a research web crawler essentially.
[00:08:44.206]That is a system of bringing people in
[00:08:47.259]and getting them to refer other people
[00:08:49.070]that walks us across the connections of the network.
[00:08:53.179]In that way,
[00:08:54.012]we learn a lot about what's in there.
[00:08:55.527]But we also have the means
[00:08:57.527]from the kinds of network technologies
[00:08:59.270]that we have to estimate out from a sample
[00:09:02.678]that doesn't look like a random phone call sample.
[00:09:06.099]So we can get good rigorous information,
[00:09:07.870]but we can do it in a way that gets around
[00:09:09.369]some of the problems associated with people
[00:09:11.438]not wanting to come in.
[00:09:12.447]The referral process means that everyone
[00:09:15.078]who comes into the project had been referred to somebody
[00:09:17.539]who had already spoken with us.
[00:09:18.499]They could say,
[00:09:19.339]they could vouch for our
[00:09:21.022]intentions and say who we were and explain things.
[00:09:25.917]I think that that's
[00:09:26.845]that high-touch aspect that you're talking about.
[00:09:29.117]Yes, absolutely.
[00:09:30.226]But it combined with this kind of analytic technology
[00:09:33.106]we get out of the worldwide web,
[00:09:34.734]that is that high-tech component of people coming in,
[00:09:38.082]doing network analysis on doing their,
[00:09:40.381]laying out their networks on a computer,
[00:09:41.850]being analyzed even on the spot sometimes.
[00:09:45.682]That of course was something that allowed us
[00:09:48.659]to do it quickly and easily.
[00:09:50.032]We did 325 interviews in a process of about three weeks.
[00:09:54.299]Those interviews were an hour-and-a-half each,
[00:09:56.042]so if you can imagine our team went full-strength.
[00:10:00.082]But going back to what we were doing with REACH,
[00:10:02.501]all those interviews were actually carried out
[00:10:03.821]by field-trained people from the community.
[00:10:05.740]So I think that's a really critical part of it too.
[00:10:08.679]We bring people in from the community
[00:10:11.367]from the very start of the project,
[00:10:12.900]and then they're involved
[00:10:13.733]in every aspect of the research process.
[00:10:15.760]So it has that high-touch component
[00:10:18.937]carried all the way through.
[00:10:20.396]So critical.
[00:10:21.284]Yeah, and you couldn't do it without the machines.
[00:10:23.196]Yeah.
[00:10:24.029]But the machines alone are not enough.
[00:10:25.068]Listen.
[00:10:25.901]Here's,
[00:10:27.177]here's what I find fascinating about your work.
[00:10:30.606]We know that we have viewers
[00:10:32.966]who look at
[00:10:35.082]sophisticated university research,
[00:10:37.620]which certainly you and your team conduct.
[00:10:40.271]They think of that as being
[00:10:42.260]years of data collection,
[00:10:44.130]then drawn back to the lab Yes.
[00:10:46.351]for tedious analysis perhaps,
[00:10:48.262](laughs)
[00:10:49.095]resulting in-- Can I tell you how tedious?
[00:10:51.214]Sometimes.
[00:10:52.047]That goes on a shelf
[00:10:53.534]that may be of principal interest to other scholars.
[00:10:55.702]Yes.
[00:10:56.809]Your work has impact,
[00:10:58.529]and it has impact very quickly.
[00:11:00.799]I just can't tell you what it meant to me
[00:11:03.628]to go to Lexington here a couple of weeks ago,
[00:11:06.169]and be at that community gathering,
[00:11:08.285]Yeah.
[00:11:09.123]At the Dawson County Historic Home Museum,
[00:11:12.587]and to hear Somali,
[00:11:15.490]grandfather, Yeah.
[00:11:17.699]And youth,
[00:11:18.659]Hispanic, as well as Anglos from the community
[00:11:22.244]talking about
[00:11:23.811]how this project has already
[00:11:27.082]bridged those gaps.
[00:11:28.704]The Hispanic woman who had moved away
[00:11:31.874]because of what she felt were community attitudes
[00:11:35.173]that she just couldn't live with,
[00:11:37.384]has moved back to the community
[00:11:39.074]because she sees this change going on.
[00:11:41.864]Talk just a little bit
[00:11:43.264]about how you drive. Magic.
[00:11:45.887](laughs)
[00:11:46.720]Well there is a bit of that but,
[00:11:48.514]I think it's incredible. Sure.
[00:11:54.005]Again the key thing
[00:11:55.765]is having people involved from the very beginning,
[00:11:58.484]letting some of their interests drive,
[00:12:00.296]and most of the time,
[00:12:01.203]entirely their interest drive the research questions.
[00:12:03.955]I think that was a critical part of what we did.
[00:12:05.835]So I did mention before,
[00:12:07.785]prior to the survey,
[00:12:08.839]we did a large Photo Voice Project
[00:12:10.777]where we actually gave people cameras.
[00:12:12.930]Oh, yes, yes.
[00:12:13.909]And they went out and took pictures of things
[00:12:15.540]that were important to them,
[00:12:16.520]more things they thought
[00:12:17.488]people didn't know about their community,
[00:12:19.258]or aspects of their life that are probably not seen,
[00:12:23.174]that they think almost are boring.
[00:12:25.067]Then we bring them in,
[00:12:25.900]sit around a table,
[00:12:26.733]and they talk to us about what's going on there.
[00:12:28.787]We formed our research questions out of that.
[00:12:30.845]So by the time we got to actually
[00:12:32.677]going into the field and doing research,
[00:12:34.723]it was already being driven by their kinds of,
[00:12:38.132]by the community's input.
[00:12:39.214]That was a big diversity of questions,
[00:12:41.323]so our job as researchers was to try and make that
[00:12:44.555]into a rigorous format,
[00:12:46.092]so that we could get data
[00:12:47.252]that we thought was really actionable data.
[00:12:50.134]Rigorous actionable data.
[00:12:51.523]Because the rigor matters.
[00:12:53.035]Sure, absolutely.
[00:12:53.868]But it started with the questions there,
[00:12:56.812]and they conducted the research,
[00:12:58.545]and so they're itching for the results.
[00:13:00.763]That's one of the nice things about that process.
[00:13:03.963]If you begin with the community's interest,
[00:13:06.435]they're waiting for it to come back.
[00:13:07.905]Yeah.
[00:13:08.738]They took real ownership.
[00:13:09.571]Yes, that was obvious.
[00:13:10.404]I think it often surprises people how much
[00:13:13.894]their kinds of questions and worries and concerns
[00:13:17.665]are actually perfectly legitimate research questions.
[00:13:21.155]That's a fault of the university
[00:13:22.643]that we haven't made that more clear,
[00:13:25.174]that there are really actionable questions out there.
[00:13:27.643]Sure.
[00:13:28.476]Listen, we should tell our viewers
[00:13:30.523]that one of the cool things about this project
[00:13:33.652]is that it is resulting in a very interesting exhibit
[00:13:37.373]called Looking Past Skin Common Threads.
[00:13:40.529]It's going to be
[00:13:42.760]actually a centerpiece
[00:13:45.449]of exhibitions at the Nebraska History Museum.
[00:13:48.216]I believe starting in January?
[00:13:49.938]January,
[00:13:50.776]January 5th I think is the public opening.
[00:13:52.047]It's opened right now out at the Dawson County.
[00:13:55.389]Folks oughta be looking for that
[00:13:57.570]and to be able to come and see real time,
[00:14:00.450]the results of your project.
[00:14:02.821]Yeah, it'll be really exciting.
[00:14:04.859]There's two certain major exhibits.
[00:14:07.341]Yeah, it's a relationship with Sheldon,
[00:14:08.419]did you not form for the development?
[00:14:09.471]Yep.
[00:14:10.304]We're not working with Sharon Kennedy
[00:14:13.311]at the Historical Museum.
[00:14:14.911]That will be two exhibits.
[00:14:16.231]That will be up and they'll be addressing
[00:14:19.473]in some ways that original Photo Voice Project
[00:14:23.269]and more about the kind of health results that we found,
[00:14:26.348]but it's an art piece as well.
[00:14:28.439]I think that that's really critical for giving people
[00:14:31.449]opportunities to engage the work that we do emotionally,
[00:14:35.159]as well as intellectually, aesthetically,
[00:14:38.940]and with some real connection.
[00:14:41.500]I think art does that in some ways
[00:14:43.129]in ways that we can only envy in science.
[00:14:45.837]Well I,
[00:14:46.670]for folks who think
[00:14:47.948]you're a buttoned-up old college professor,
[00:14:50.469]I will always hold a memory of walking
[00:14:52.898]into the museum and here's Kirk doing posters and...
[00:14:56.517]Hand cook and bottle washer.
[00:14:58.010](laughs)
[00:14:58.843]Absolutely.
[00:14:59.676]I knew you were a true believer
[00:15:01.652]in what we were getting ready to tell.
[00:15:04.148]Well listen Kirk,
[00:15:04.981]I just want you to know
[00:15:05.814]the Rural Futures Institute is so proud
[00:15:07.618]to be associated with you and your very eclectic gang
[00:15:11.330]of researchers and difference makers,
[00:15:14.071]but you know we believe this is the path
[00:15:17.119]to impact for rural people.
[00:15:19.489]Connecting people in the community who have said,
[00:15:22.969]we're not okay with where we are.
[00:15:24.687]We think we know where we wanna go.
[00:15:26.608]We want to make it better,
[00:15:28.048]connecting them with people like you and your team,
[00:15:30.431]who can come in and help them. Yeah.
[00:15:32.727]With such sophisticated tools to grapple
[00:15:35.100]with those very difficult issues,
[00:15:37.631]but in as we've described,
[00:15:39.719]a very high-tech Sure.
[00:15:41.409]high-touch approach that we think is central
[00:15:44.119]to the way we do things in Rural Futures Institute.
[00:15:46.340]Thanks.
[00:15:47.239]Anything else you wanna add about your work?
[00:15:50.279]Well, I think you hit it right on the head.
[00:15:52.509]I think that folks in rural communities
[00:15:55.503]are rightfully weary about the intentions and questions
[00:15:58.361]of people who come from the outside.
[00:15:59.863]That high-touch question is really critical.
[00:16:02.732]Our rural people have always been tech-oriented.
[00:16:06.612]I mean, rural doctors are everywhere.
[00:16:08.507]Very true.
[00:16:09.961]Their whole process of rural production
[00:16:11.649]is a trial and error process,
[00:16:12.918]and people are very comfortable with the concept
[00:16:15.489]that their world can change by new tools and new equipment.
[00:16:19.040]So we've actually found that that can work really well.
[00:16:21.421]I know that partly because I'm from a small town,
[00:16:24.000]even though I came here from New York City.
[00:16:25.672](laughs)
[00:16:26.505]I grew up in a place a lot of people have heard of,
[00:16:28.000]but don't know is a small town
[00:16:29.691]called Nantucket, Massachusetts.
[00:16:31.120]Oh yeah, sure.
[00:16:32.101]Which is an island of 8,000 people
[00:16:33.849]with three ferries a day.
[00:16:35.301]If you think you're in the middle of nowhere,
[00:16:37.137]try being 17 miles out in the ocean.
[00:16:39.358](laughs)
[00:16:40.191]So I understand the perspective that says,
[00:16:42.468]we worry about why people will be coming in
[00:16:44.455]and asking a lot of questions,
[00:16:45.678]but I also recognize that people
[00:16:47.358]are really interested and engaged in the kinds of,
[00:16:51.023]and in experimental ways,
[00:16:52.498]about how they can make their lives better,
[00:16:54.230]and I think actually rural people are more adept
[00:16:56.400]at that than urban people in my experience.
[00:16:59.470]Thank you for the opportunity.
[00:17:01.507]Well, we are proud of the work that you're doing
[00:17:03.530]on behalf of the University of Nebraska,
[00:17:05.238]and certainly on behalf of rural people everywhere.
[00:17:07.358]Well listen,
[00:17:08.191]we want you to stay in touch
[00:17:09.110]with the Rural Futures Institute.
[00:17:10.702]Look at our newly redesigned website.
[00:17:13.680]It's a lot of fun,
[00:17:15.142]and know that in weeks ahead,
[00:17:16.910]we'll be coming back with another episode
[00:17:19.200]of Catch Up With Chuck
[00:17:21.080]looking at rural people,
[00:17:22.359]rural places, innovators,
[00:17:23.980]thinkers, doers,
[00:17:25.030]artists, and others
[00:17:26.144]who are helping to make rural places
[00:17:28.239]a legitimate best choice for worthwhile living.
[00:17:30.438]Thanks for being with us.

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Catch Up With Chuck | Episode 4

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