Marya Shegog remembers going to her grandfather's Cincinnati house, where she snacked on fruit and vegetables grown on his property. Today, the director of health programs at The Lincy Institute recalls his little corner lot, filled with trees and gardens, as an odd contrast to the urban environment around it. But the memories of eating something she'd seen planted and harvested made an impression on her.
Later, with a biology degree, she settled into a position as a scientist in corporate America. It brought stability and good income, but was far from satisfying. Outside of corporate life, Shegog, ran an inner city program for underserved youth. These children faced myriad issues, including access to good, nutritious food.
"I met kids who never had seen anything grown from the ground," she said. "I'd have 13-year-olds come up to me and say, 'I have high cholesterol.' Other kids would be handed a 2-liter bottle of soda and a big bag of Doritos by their parents and told it better last all week. I thought, 'We have to change this trajectory.'"
In 2002, Shegog went to back school at the University of South Carolina for a master's then doctorate in public health, health promotion, education and behavior. She hoped to learn how to better address both behavioral and structural challenges that result in disease and early death. Now she is exploring the many facets of health disparities in Southern Nevada and collaborating with state, local, and private entities to address and ultimately eradicate them.
Show Me the Data
The Lincy Institute is a research center at UNLV with a goal of leveraging its findings to support local initiatives focusing on health, education, and social services. Attaining federal grant dollars is one mechanism that will help address the challenges. Nevada ranks last among the states in acquiring federal grants for many reasons including, Shegog notes, a lack of available data.
Federal grants proposals must paint an accurate and convincing picture of the region's need for grant support. Making that argument relies heavily on state health, population, and demographic data, which is not readily available in Nevada.
For example, most states release specific risk behavior data for HIV-positive individuals, Nevada does not. Therefore Nevada, specifically Southern Nevada, misses out on various funding opportunities that could reduce the incidence of HIV in our community. Collecting and releasing vital health statistics is a practice Nevada should embrace;the small investment of time and energy will pay off and help support a healthy community, she said.
The Lincy Institute already has examples of how collecting more specific data can lead to improved programs. Shegog partnered with Southern Nevada Strong to create maps, broken down by city quadrants and regions, where elements such as access to grocery stores and fast food restaurants are measured. Coupling this data with the diabetes and obesity rates in the area presents powerful evidence that can be applied to federal grant applications.
In Southern Nevada there are many "food deserts" where there is inadequate access to foods needed to maintain a healthy diet. Vegas Roots, a 4.5-acre community garden northwest of downtown, is now serving one of those deserts. Grocery store chains moved out of the area that was hit hardest by the economic downturn of 2008, making it difficult for residents to access quality food without transportation.
"You and I may not think twice about jumping in the car and driving to a grocery store to get food. But for those who don't have a car, it's a different story," she said.
Identifying Needs
Before Shegog arrived at UNLV in 2012, she began researching the state of Southern Nevada's healthcare infrastructure. A study by UNLV's Brookings Mountain West and SRI -- "Unify, Regionalize, Diversity: An economic Development Agenda for Nevada" -- identified that approximately one-third of the healthcare infrastructure for a region of this size was missing. It found that without a comprehensive, four-year medical education and biotech institution, there is a large deficit of qualified health care providers, little to no drug trials, and a lack of region-specific, health-based innovation and technology. The state's only medical degree-granting institution school, the University of Nevada School of Medicine, is based in Reno. It produces about 50 doctors a year, she noted, enough for a population a quarter the size of Southern Nevada's. Las Vegas is the largest metropolitan statistical area without a medical school.
The Lincy Institute is exploring what impact a four-year, comprehensive medical school in Southern Nevada would have on the economy, including employment, education, and training opportunities. A report will be released by the end of this year. This information can be shared with interested stakeholders including Southern Nevada Strong, a HUD-grant funded program, all local municipalities and education institutions seeking collaborative approaches to economic development and ways to address the healthcare shortage in the region.
In the last decade, despite economic recession, Shegog says about a dozen medical schools have been started around the country. Among them are schools in Phoenix, Charlotte, N.C., and Orlando, Fla., areas with tourism-heavy economies similar to Las Vegas'.
"There are opportunities we have yet to explore. By not capitalizing on our strengths to build the needed healthcare infrastructure, Southern Nevada ranks at the bottom of almost every health index in the United States. This is not a trend that we want to continue.
"Southern Nevada is a great place to live. Current residents as well as future deserve a robust healthcare system. By improving data collection, establishing a comprehensive medical education institution, and expanding research and biotechnology, Southern Nevada will not only diversify the economy but also create a trajectory of health that will move us from the bottom to the top."
