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Doctor says state can improve from ‘We’re No. 11!’ in health

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America’s Health Rankings 2013 list 
Minnesota3rd
Colorado8th
Nebraska11th
Wyoming17th
Iowa18th
South Dakota22nd
Kansas27th
Missouri39th
Source: United Health Foundation

Posted: Wednesday, August 13, 2014 1:00 am

Before you move past the three-month-old debate between “Nebraska ... the good life” and “Nebraska Nice,” you might consider “Nebraska, the Healthiest State in the Nation.”

Dr. Ali Khan isn’t proposing a replacement slogan. Instead, the new dean of the College of Public Health at the University of Nebraska Medical Center wants Nebraskans to think about what they can do to have a “good life.”

To that end, Khan, 51, has been talking to Nebraskans about how to improve the state’s health indicators since he started work here July 1. Last week, he traveled to western and central Nebraska, visiting health department officials from Gering and Hemingford to McCook, Holdrege and Burwell. He sought to learn what health concerns they were dealing with and what the university could do to help them.

Khan plans to visit all 24 local health departments in the state over six weeks.

So far, he said, his travels have cemented the idea that becoming a healthier state “is a collaborative approach that will require everyone in the system to think about health and health care a little differently.”

Nebraska is 11th (and Iowa 18th) among the states on the “America’s Health Rankings” list compiled by the United Health Foundation. For its annual rankings, the group considers several factors, including the states’ immunization rates, infectious disease numbers, preventable hospitalizations and infant mortality rates.

The ability to measure such factors allows Khan, a former administrator with the U.S. Centers for Disease Control and Prevention, and others to target problem areas and build on successes.

Making Nebraska the healthiest state is one of UNMC Chancellor Jeffrey Gold’s strategic goals for the university. Khan, who wants to achieve that goal in the next five years, said that type of thinking attracted him to the job.

Improvements can be made, and Khan goes down the list: One in five adults in Nebraska — more than 260,000 people — smokes. Physical activity among adults is decreasing, while the obesity rate is increasing. The percentage of Nebraska children living in poverty is up. Immunization coverage is down.

“I think, collectively, we can look at this and say, ‘What would it take for us to work on these issues within the state and get us to the healthiest state?’ ” Khan said.

Nebraska, he said, is a “Goldilocks” state — just the right size to get big things done.

The health-related issues in rural areas are similar to those in the state’s urban areas, Khan said. They include a lack of ready access to health care, chronic disease and underserved populations. Geography, he said, is a big challenge for some of the state’s health departments, which serve up to 10 sparsely populated counties.

Khan said the officials he met with want to collaborate with the College of Public Health to help train their health care practitioners, expand their research capacity and look for ways to provide field experiences for students.

Khan grew up in Brooklyn, New York, went to medical school and completed a joint residency in internal medicine and pediatrics before joining the CDC. A former assistant surgeon general, he worked at the CDC in Atlanta for 23 years before moving to Omaha. He and his wife, Kris, have 21-year-old triplets in college.

The work he was doing at the CDC was challenging and enjoyable, Khan said. But he said he thought that public health practitioners could be doing more to help people.

“I think public health has fundamentally changed with the Affordable Care Act, with technology, changes in demographics, changes in populations, globalization,” he said. “We can do much better in the States. Our cost of health care is so much higher than other leading countries in the world, and we don’t have better health as a function of that.”

Being healthy, he said, is different from not being sick. “Being healthful in your life — with great choices, the ability to exercise, good mental health ... I want a healthful life. I want people to thrive.”

Adi Pour, Douglas County health director, said she thinks that striving to make Nebraska the healthiest state is “a perfect goal.”

“We definitely in public health have a role and the college can have a role, and that is in educating individuals about quitting smoking, about binge drinking,” Pour said.

Khan said communicating the economic and societal benefits of improved health is easier today because of social media, which allow public health officials to target messages to specific groups. He noted that people’s health status isn’t linked only to what they’re doing with their doctor.

That probably represents 10 percent to 15 percent of what it takes to be healthy, Khan said. “We need to worry about what are those social determinants of health. Do you live in a violence-free environment? A drug-free environment? Are there sidewalks? Bike paths? Smoke-free laws?

“I don’t have immediate solutions for these things. I do know that we have the talented staff here that would like to work on these issues.”

Contact the writer: 402-444-1109, bob.glissmann@owh.com, twitter.com/bobglissmann

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