MARYA SHEGOG is the director of health programs at UNLV’s Lincy Institute. She specializes in identifying health disparities within communities, figuring out why they exist and correcting them. Here she tells us what Southern Nevada needs most.
What are we lacking?
I’ve been looking at a number of factors, especially health disparities, which is my area of interest. One thing is the shortage of medical providers in the area. I try to discern what that means. Is it that we don’t have enough doctors in the area? And specific specialties, or is it not enough general practitioners? Or a combination of both? The doctors we do have, are they actively practicing or are they retired? Where can you find accurate records of that? I’ve found it very difficult to find accurate and timely data.
Is this problem specific to Nevada?
Because of the Affordable Care Act, there is a predicted expectation that we will fall short in general practitioners. Finding the data in usable forms, I’ve found to be a Nevada-specific problem. Anything that’s statewide you can get because it’s available on national databases, but when you’re looking for regional-specific data, I’ve found it to be very difficult.
Why is that?
I think there’s a fragmented system for data collection. Not every system reports to one place or in one way. That’s challenge No. 1. There are some things maybe you can find by asking social services. But other things, maybe only St. Rose really collected. I’ve spent a great amount of time trying to find information, but a lot of times it seems like they don’t know.
What happens to your research?
The Lincy Institute is creating a database that will be searchable and available for people to request and receive data. In the future, let’s say there’s someone who will be writing a grant, looking at HIV/AIDS in Southern Nevada. You can get national data, you can get some on state levels, but in a best-case scenario we’d be able to provide data on who was tested, if they were tested by social services or by the HIV-testing clinic, and the data would be clean so you don’t have any HIPAA-type infractions, but you’d be able to identify down to the ZIP code or Census level, such as this is who was found negative, this is who was found positive, these are the risk factors identified. We could provide them that data, and they could analyze it any way they saw fit. The database will have measures of health, education and social services.
What have your other findings been? You mention a shortage of doctors. Is there anything else we need?
For the area this size, I don’t think we have enough federally qualified health-care centers, or FQHCs. FQHC are health-care centers that have to meet parameters as far as who they see, the mix, if you will, of how many people they see that are uninsured or underinsured, Medicaid or Medicare, it’s a specific mix. There are two in town: Nevada Health Centers and First Med. Nevada Health Centers has a number of locations in the area and in the north, as well, but there’s still more need than there are centers.
What would a healthy number be for a city our size?
First Med is only one site. Nevada Health Centers has four or five. Twenty or 30 would be much more appropriate for our size. It’s also a revenue stream. Compared to California, we received less than a 10th of the money.
Why aren’t we good at tapping into federal funding?
It’s a number of things. One, it goes back to data, because we can’t fill in those blanks sometimes. Two, there is a general fear. Anecdotally, what I’ve heard, there are strings of funding you have to fill out papers for. People don’t apply because they’re concerned that if they get this money but don’t qualify the next year, there will be full-time positions that will go away. There’s also a sense of autonomy. Before the economic crisis, Nevada was like, “We don’t need it, we’re good.” Now there’s more of a feeling that we qualify, so we should have it. Four, there are times when the people don’t understand what’s being asked for, so they don’t fill out the forms. And when I say leaving money at the table, we’re not talking about thousands, we’re talking about millions.
What’s the most important thing to know about health disparities in Southern Nevada?
Health disparities are present, but they’re not insurmountable. Through collaboration between and community effort and research, a lot of these health disparities can be eradicated or reduced.