A Day in the Life at UNMC

On the road with Dr. Khan

College of Public Health Dean Ali S. Khan, M.D., M.P.H., near Chimney Rock.
College of Public Health Dean Ali S. Khan, M.D., M.P.H., near Chimney Rock.

By Elizabeth Kumru, UNMC public relations

The new dean of UNMC’s College of Public Health is in love with Nebraska and Nebraska seems to be in love with him.

Just one month into his new position, Ali S. Khan, M.D., M.P.H., began a six-week listening tour of all 24 local and tribal public health departments in the state.

Brandon Grimm, Ph.D., director of public health practice, wasted no time in planning the trip Dr. Khan had envisioned while still in the interview process. The four of us — myself, Drs. Khan & Grimm (who handled most of the driving) and the University of Nebraska Foundation’s Karen Levin, director of development for the Colleges of Medicine and Public Health – were excited as we left. Never before had a dean from the College of Public Health taken a tour of the state like this one. Dr. Grimm, a Nebraska native, often seemed proud to be displaying the beauty of his state to his college’s new dean.

Our “most excellent journey” to western and central Nebraska started with an eight-hour trek to Alliance, punctuated by a drive through the University of Nebraska-Kearney campus and a brief stop at Carhenge, Nebraska’s answer to Stonehenge, built with 38 vintage cars.

In all, Dr. Khan visited eight departments, one critical care hospital and one federally qualified health center, stopping in the communities of Hemingford, Scottsbluff, Gering, North Platte, York, McCook, Holdrege and Burwell. He met with directors, staff, board members and a hospital CEO. He dined with UNMC donors and one prospective student in the unincorporated town of Lisco, population 64, and in a Broken Bow hotel that features the culinary art of a Lebanese chef.

From left, Karen Levin, Dr. Khan and Brandon Grimm, Ph.D., at Carhenge.
From left, Karen Levin, Dr. Khan and Brandon Grimm, Ph.D., at Carhenge.

His easy-going, sincere and energetic style charmed them all.

Dr. Khan spread the message that he was inspired by UNMC Chancellor Jeffrey P. Gold, M.D., and one of his strategic goals of making Nebraska the healthiest state in the nation.

“I call this the ‘Goldilocks state’ because it’s just the right size to get big things done,” he told his hosts. “It’s a microcosm of the country. We have the opportunity to be a model for the nation and the world. It will take a strong public health system partnered with education, business and community. We’re already 11th, so we don’t have far to go.”

See the World-Herald interview with Dr. Khan here.

“America’s Health Rankings,” compiled by the United Health Foundation, places Nebraska 11th on the list of states. Several factors, including the states’ immunization rates, infectious disease numbers, preventable hospitalizations and infant mortality rates, are considered.

Dr. Khan listened to the successes and health challenges each district faced and learned how the College of Public Health faculty, staff and students could collaborate to impact these priorities.

At the first stop, the Panhandle Public Health District in Hemingford, director Kim Engel and her 15-member staff are responsible for the public health of 50,380 people in 10 counties that cover 14,000 square miles. Engel chose Hemingford, population 830, as a base of operation because the “small town makes us think regionally.”

The Panhandle PHD is one of 18 public health districts covering 86 sparsely populated counties that were formed by the Nebraska Health Care Funding Act (LB 692) of 2001 and funded by tobacco settlement funds. All but four districts cover more than one county and three districts do not qualify for state funding.

Engel and her staff spoke about immunizations, clean water, worksite wellness, tobacco-free zones at schools and hospital campuses, health and nutrition education and a myriad of other programs they administer.

Her list of public health challenges foreshadowed those we’d hear across the state:
• Health care access
• Chronic disease management and prevention – diabetes, heart disease and cancer
• Domestic violence/child abuse
• Healthy pregnancy/teen pregnancy prevention

Of course, disease surveillance is constant. Outbreaks of pertussis, or whooping cough, have cropped up in pockets across the state where vaccine rates have dropped. West Nile virus is ever present and mosquito and bird testing is continuous.

The public health professionals we met face another challenge, as well — people generally don’t understand what they do, because the definition of “public health” is so broad. From the first meeting, officials were exploring avenues to better explain the concept of public health. The difficulty of defining public health became clearer after each visit as the team saw the diversity of public health activities at each location.

“Public health is unsustainable as it is set up now and will be unrecognizable in a decade,” Dr. Khan said. “These changes are being driven by the Affordable Care Act (which will fundamentally change health care) coupled with new technology, changes in demographics and populations, and globalization.

“In the U.S., we spend $3.1 trillion on health care. That’s one-sixth of the economy. It’s our version of the cookie monster gobbling up one out of every four state dollars and the crumbs symbolize waste,” he said. “Our health care cost is so much higher than other leading countries in the world, yet we don’t have better public health as a result of that. We can use public health and a community-based approach to make the state and nation healthier.”

The trip allowed Dr. Khan to meeti with some of the state's top public health professionals.
The trip allowed Dr. Khan to meet with some of the state’s top public health professionals.

Prevention is the most efficient and effective way to be healthy, he said. And the public health officials across the state can have a huge impact there, Dr. Khan said, showing people how to “be healthful in your life — with great choices, the ability to exercise and experience positive mental health. “Who doesn’t want to be healthy?”

Officials expressed a desire to collaborate with the College of Public Health to help train health care practitioners, expand research capacity and look for ways to provide field experiences for students.

Dr. Khan announced that this year he is forming the first student outbreak response team, which will provide assistance in an emergency. He also said that adjustments are underway in the master’s program so that students are able to complete the degree in two years.

“I’m out here because I learned a long time ago that public health happens on the local level,” he said. “The best practices and innovations happen here.

“We’re all in this together,” he said. “If we’re going to be the healthiest state in the nation, we have to work together.”

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