A Cambio de Colores in the Midwest

Cambio.  What is cambio?  Well, it’s a change.  Colores.  Well, that means colors.  Why are we talking about a change of colors?  Because our Midwestern communities are changing in many respects and  we are witnesses to demographic shifts.

  • Nebraska has some of the country’s fastest growing communities of color, and our Hispanic/Latino population has nearly doubled since the 2000 U.S. Census.
  • Currently, almost 10% of Nebraska’s population is of Hispanic/Latino descent (U.S. Census Bureau, 2013 population estimate), and it is predicted that the number of Hispanic/Latinos in the state will more than triple by the year 2050 due to not just to migration/immigration, but also natural change.
  • According to the Pew Hispanic Trust, approximately 2.4% of Nebraska’s population is unauthorized.

This week, I’m at the Cambio de Colores Conference, which serves as a unique venue to share, learn, discuss, and identify critical areas where the development of information and promising practices will facilitate the successful transition of newcomers into communities large and small.  I believe that being able to integrate newcomers into the fabric of our communities is going to be imperative for the growth and prosperity of the state.  A hostile reception to newcomers and immigrants  will not move communities forward.  In fact, hostile receiving communities:

  • Contribute to the reduction in public safety by increasing fear of police making individuals less likely to contact law enforcement (Ford Foundation, Insecure Communities, 2013)
  • Decrease physical and mental health status by increasing stress levels and feelings of isolation
  • Perpetuate cycles of inequality

According to the Ford Foundation, “A growing number of aggressive local measures attempting to restrict every aspect of life, including housing, education and employment, push immigrants into a marginalized existence.”  Educating receiving communities on the economic benefits of immigration and the reality of globalization may help in dispelling the myths and stereotypes related with immigration.  We need to work together to build strong, vibrant healthy communities for all.

Did you know that there are already 62 cities in the U.S. that have Latino majority populations “Pueblos” as J.S. Onesimo Sandoval labels them, and there are 397 burgeoning pueblos within the next 5-15 years.

What are the characteristics of successful pueblos?  What are these communities doing right that other communities can learn from in terms of integrating newcomers?   How can we work across differences in color, ethnicity, socioeconomic status, religion, sexual orientation, and other divides to create communities of promise for all?



Study Seeks to Improve Lives for Migrant Farmworkers in Nebraska

Aida Olivas, with the Nebraska Migrant Education Program, introduces the study team to a group of migrant workers.

Aida Olivas, with the Nebraska Migrant Education Program, introduces the study team to a group of migrant workers.

Here’s the link to the recent article published about the Migrant Farmworker Health Study in Nebraska: http://www.unmc.edu/news.cfm?match=15233

This study was conducted over the summer of 2013 by my team and I throughout five central Nebraska counties.  We surveyed 200 Latino migrant farmworkers about their health status, stress, substance use, and depression.  This pilot study was funded by the Central States Center for Agricultural Safety & Health (CS-CASH).

We are now in the dissemination phase where we want to share the findings with other stakeholders and brainstorm together about how we can improve lives for migrant farmworkers in our state.

Symposium on Small Towns 2014: Co-Creating Our Future

MN farmThis week I have the opportunity to participate in the the Symposium on Small Towns in Morris, Minnesota.  It was about a five hour drive up here, and I spent most of my time looking at the farms and the land.  I caught myself thinking about rural life and the significance of place in our lives.

During today’s sessions there was a strong focus on rewriting the rural narrative.  There is so much negative press out there about rural communities and that they are losing population, closing schools and hospitals, and that main streets dying; however, people’s experience limits what they can see.  Rural communities are changing, not dying.  Obviously, there is an impact of globalization and economies of scale, but most are not unincorporating and closing shop.  Thanks to Ben Winchester from the Center for Community Vitality and Randy Cantrell from University of Nebraska Extension, I learned that these are stereotypes and myths that exist.  Facts are that rural population in shear numbers has increased although the percentage of people living in rural areas has decreased from 26% to 19%.  In essence, we need to change our own narratives from a deficit-based approach to an asset-based approach…instead of the focus on the “brain drain” we should focus on the “brain gain” whereby there is an in-migration of 30-49 year olds into rural areas because of quality of life factors.  Additionally, there is in-migration to small towns from immigrants.  So newcomers are making there way into small towns.

A “newcomer” is defined as someone who has lived in a community less than five years.  Here’s some interesting facts about “newcomers” in Nebraska:

  • 40% have bachelor’s degrees
  • 48% have household incomes of over $50K
  • 43% of children
  • They are generally leaving their career and are underemployed in the new community, yet quality of life is more important.
  • 60% say that they will be living there five years from now and the more communities are friendly and trusting the more people want to stay.
  • Newcomers want to live in a place that has vision and where they can see an opportunity to participate and co-create that future.

Leadership and capacity-building is an important issue to highlight.  We need a strategy in order to grow what we need.  Little did I realize, but in Nebraska, there are 27.7 people for every elected or non-profit leadership position.  That means that there is a great opportunity to serve and build this vision for a stronger state, whereas in other places there are fewer of these types of opportunities.  In fact, in urban areas there are 144 people for every position.  How do you harness that opportunity?  We need to rethink our engagement strategy and find ways to bring non-traditional partners to the table.  Instead of doing things “to” or “for” people, we need to do things “with” people and engage them in re-imagining what could be.

Moving forward we need to hear an authentic voice about community assets and build relationships to strengthen the niche, promote the assets, build social capital, and connect the community.  This is a promising way to develop lasting community change that both honors the history, tradition, and people of the area and also allows for new voices, ideas, and visions to be heard.

SOURCE: Small Towns Symposium, 2014: Ben Wichester & Randy Cantrell, Rewriting the Rural Narrative; Craig Schroeder, Discussing the Youth Voice.

Promising Practices Conference 2014

I’m in Washington DC this week for the the Promising Practices Conference, which is a conference all about healthy living and tobacco-free lifestyles.  Check out my posts from the Break Free Alliance blog!

DAY 1:

Blog #1: Moving From Promise to Practice 

Blog #2: New Frontiers in Tobacco Control: Lessons from a Frontier State


Development of Innovative Strategies to Reach the Lesbian, Gay, Bisexual, and Transgender (LGBT) Community in Tobacco Control

Acting Surgeon General, Rear Admiral (RADM) Boris D. Lushniak, M.D., M.P.H.

Acting Surgeon General, Rear Admiral (RADM) Boris D. Lushniak, M.D., M.P.H.








DAY 2: Coming Soon!

Experience in Self-Reflection

This weekend I had the opportunity to participate in a seminar on place, culture, home, and identity in New Mexico. I was one of about 15 people who joined the conversation.

We learned much about ourselves and how culture and identity are impacted by place. I struggled with how to explain what I learned and how I feel, but below I will highlight some of the key reflections I’m taking home:

1. Life is in all forms. Your ability to eliminate the distance between you and anything else brings greater harmony and allows relationships to flourish.
2. Identity and life transitions are deeply affected by place and space.
3. Sharing a story is so often not valued but it is immensely important to understanding any other person. Not only are you sharing in the words for that instant, but in fact you are sharing in their experience.
4. We should strive for more intentional conversations. Instead of shying away from difficult and important topics, we should embrace the opportunity and learn to see the world through another’s eyes.
5. We share a common humanity and are all connected through a lifeblood provided by the universe.
6. Nothing is perfect. Nothing is permanent. And nothing is ever finished.
7. “Being face to face, you cannot see the face. You must step back to see.” (Russian proverb)
8. We find our own meaning in everything we see, feel, hear, say, and experience. We are the authors of our lives, and meanings and interpretations can change as we change or reflect.
9. We are all only a path of greater understanding. It’s a journey, not a destination. It might be slow and tough, but there’s no parking along the way.


The many deep, intentional conversations, the beauty of nature, and open mindfulness shaped this experience of a wonderful, peaceful place. I can’t wait for next time!

Tobacco Control Prevention and Outreach Program is Working in Nebraska

Throughout the last twelve years, we have been working hard in Nebraska to reduce tobacco use, exposure to secondhand smoke, and tobacco-related disparities as well as to promote health throughout communities. In Omaha, a number of groups, organizations, and individuals are working together through MOTAC, the Metro Omaha Tobacco Action Coalition.

We have had a number of successes including:

  • Tobacco product placement law to put all tobacco products behind the counter
  • Smoke-free air law for Nebraska
  • Increased smoke-free housing options including working towards smoke-free apartments
  • Tobacco-free campus policies for all major hospital systems – Alegent, Creighton, Methodist, and UNMC
  • Tobacco-free grounds organizational policies
  • Outreach to communities that experience a disproportionate burden of tobacco including Latinos, LGBT individuals, and African-Americans

UNMC Center for Reducing Health Disparities, Tobacco Outreach Team:
Ariss Rogel Mendoza, Antonia Correa, and Athena Ramos

Today, we got to meet up with Dr. Scout, the Director of the LGBT Network for Health Equity. We had a great conversation about some of the things that are working with our program. Dr. Scout will be spending the next few days with us teaching us about best practices in tobacco control, outreach to priority populations, and much more.

Here’s a link to Dr. Scout’s recent blog about what’s going on here locally: http://lgbthealthequity.wordpress.com/2013/04/15/nebraska-travelogue-smokeless-diva-drag-pageant/

Lots of work is being done in communities across the state to make our state more healthy and safe for everyone!

Agricultural Medicine Course Opened My Eyes

Wow! I just spent the last week or so emerged in learning about agricultural and medicine through an agricultural medicine course at UNMC.  This course opened my eyes to some of the dangers related with this industry.  Agricultural medicine is an interdisciplinary study in occupational and environmental health within the agricultural community.  Agriculture is the most dangerous industry/occupation in the world.

I guess, like many other people, I never realized or never really thought about the occupational and environmental hazards of production agriculture before I learned about this class.  Now, I have a much better understanding and appreciation for what really goes into producing the food that we share on our table everyday.  I want to share some of the basics here:

  • There are many health issues related with production agriculture including hearing loss, chemical exposures, animal exposures, skin diseases, vibration injuries, respiratory diseases, musculoskeletal issues, exposure to extreme weather, and of course, injuries occurring from equipment especially tractors.  Many agricultural injuries, diseases, and fatalities could be prevented.  There is a need for a comprehensive approach to farm safety.
  • There are about 540 deaths per/year in the United States equating to a fatality rate of about 30 deaths/100,000 workers.  This is higher than any other industry including construction and manufacturing.
  • There are groups that are at a higher risk for injury on the farm including children, older adults, farm workers, and anabaptist groups.  Some of the reasons for this include the lack of childcare facilities near agricultural centers, unsafe play areas, use of older farm equipment, lack of adequate personal protective equipment, potential limited English proficiency, and adherence to traditional ways of working the land.
  • Contrary to popular belief, not all farming is regulated.  In fact, family farms are not subject to OSHA regulations. Only farms that have 11 or more hired workers/employees are subject to OSHA regulations.
  • The 3 E’s of safety are Engineering, Enforcement, and Education; however, the most effective way to prevent some of these injuries and exposures is to engineer them out of the farm and the equipment.

Here are some links if you want to learn more:

Performing Arts Medicine Association (PAMA) Conference 2011

PAMA welcomes attendees for the 2011 Annual Conference

Today and for the next few days, I have the opportunity to attend and participate in the Performing Arts Medicine Association (PAMA)’s annual conference held in Snowmass Village, Colorado.  Day one – complete.  And WOW! so much information that I learned.

So many times, we don’t think of the arts as professions and/or workplaces.  We treat them as hobbies.  Did you know that according to a recent student by Dr. Bronwen Ackermann in Australia as part of the Sound Practice Project, 84% of musicians surveyed reported pain or injury that interfered with their performance?  If these people were working in a factory, it would be shut down because of hazardous conditions.

Today, we also learned about the stress disease connection from Dr. Gabor Mate.  He is the author of a number of books including “When the Body Says No: Exploring the Stress-Disease Connection.”  He emphasized that we need to look at people as parts of their environments and as not just a body, but a body and a mind.  Health is very much related to our social and emotional lives.  So often in Western medicine, we have forgotten this fact and tend to treat symptoms in a silo rather than in a holistic approach.  Dr. Mate described how we develop our personality as children as a defense mechanism for the situations and environments in which we live.  He provided relevant case studies and also described anger.  Anger is a powerful emotion; however, we can have healthy anger that is more or less a boundary defense that is in the moment and very specific or we can have unhealthy anger that is based on past experiences.  One thing is clear that self-expression through the arts is needed; and furthermore, self-expression must translate through all parts of a person’s life.

Today, we also heard from the Dancer Wellness Project (www.dancerwellnessproject.com).  This is a very interesting collaboration of organizations using technology to build profiles for and of dancers to help promote dancer health and wellness.

The afternoon was spent discussing neuroscience and neurorehabilitation using music from Dr. Gottfried Schlaug.  He showcased through neuroimaging how making music changes brains and their structure.  For artists/musicians, a combination of both mental and physical practice is much more effective than just physical practice alone.  He described  motor imagery and the benefits of using such techniques including: facilitating learning, preventing injury, making practice opportunity any time, and making practice possible even after one has sustained an injury.  He also provided an overview of melodic intonation therapy and auditory-motor mapping training.  All of these types of interventions that Dr. Schlaug discussed have rehabilitation usages that can improve lives for people who have had strokes, children with autism, and many others.  He closed by saying that therapeutic effects seem to last when changes are made in the brain.

The Cuba and the Arts Crew 2011

This day was packed full of information.  I’m excited for tomorrow’s lectures, and now preparing for our panel presentation on Saturday about our recent trip to Cuba to work with health in the arts.  Good to see part of the Cuba Crew 2011: Dave Hinkamp, Mary Burns, Charlie Barrett, and Marc Brodsky!

SIIC 2010 – Training Updates #1

Below are some notes and reflections on the first two days of the course that I am taking with Jack Condon and Nagesh Rao – Facilitating Intercultural Discovery – as well as some other evening sessions that I have attended.

Intercultural skills are becoming more and more necessary in all facets of our lives; however, we are instinctively more drawn to people who are similar to us so finding ways to allow and challenge ourselves to reach out of our comfort zone is going to be imperative to our future success.  Any job is most likely intercultural regardless of the title.  Global leaders in any field: (1) are “watchers;” (2) care about stakeholders and pulling them together to resolve issues; and (3) know when culture matters and when it does not.  As Elmer Dixon said, “Is it a difference that makes a difference?”

Every day we make assumptions and create our own explanations to stimuli based on our experiences and our social conditioning.  “We see things not as they are, but as we are.”  We need to work together to create a space that enables more than one story, more than one perspective, and more than one explanation.

As any corporation, and diversity is a major initiative; therefore, learning how to understand, manage, develop, and retain diverse talent is a must.  In its most basic form, there are four circles of culture: personality, primary considerations (things that you cannot change easily and are recognizable by others), secondary considerations (things that you can control about yourself and others wouldn’t necessarily know), and organizational considerations.  These four circles and all of their components affect us in both personal and professionals ways including how we work together and what we value.  Furthermore, many of the characteristics that are important to people are not readily identifiable to others (ie. they are not primary considerations).  Therefore, we must invite conversations with others in order to understand more fully.

Questions are a useful tool for facilitating intercultural discovery; however, it has been well documented that the person who is asking the questions sets the agenda and has the power.  There is also power in silence.  So not only must we learn how to ask questions, but also how to listen and listen with our whole self.

Objects can also be a forum to mediate conversation between people of different cultures.  The process of naming objects can make us blind by failing to see the possibilities of the particular object and opening our minds to potential uses or explanations.

Play is an important part of intercultural discovery.  A state of play allows you to explore what is possible.  According to Stuart Brown, “Play is more than fun.”  Play facilitates creativity, not only in children, but also in adults.  “Creativity is as important as literacy,” said Sir Kenneth Robinson.  One cannot be creative and try something new unless that person is prepared to be wrong.   Educational systems from across the world have created hierarchy across subject material where STEM subjects such as math or science are valued more highly than arts, music, drama, or dance.  Intelligence comes in many forms.  It is dynamic, interactive, and highly varied; however, our educational system focuses almost solely on educating our left brain.  There is a great video that we watched that discussed these ideas: http://www.ted.com/talks/lang/eng/ken_robinson_says_schools_kill_creativity.html.

We must work to ensure accurate understanding and allow space for educating, developing, and empowering people.  As Edward T. Hall said, “Perception is what you intend to do about something.”  We need to create our network of others and understand what they can bring to the table: Are they connectors?  Are they mavens?  Or salespeople?  Can they bring us closer to where we want to go?  As Malcolm Gladwell as articulated in The Tipping Point, many people have many more connections and ties with others, but those ties are weaker than they have been in the past.  Now we may have 500 friends (weak ties) on Facebook, and have only a few (strong ties) friends in “real life.”  Even though these ties are not as strong as before, it allows us to know many more people and connect at different levels across the globe creating a strong force that we can harness and use to our advantage.

Intercultural discovery is not a one-day workshop.  It is a life-long commitment to learning, growing, and developing ourselves as a human being because after all this is about US.  It is not about you or anyone else, this is an introspective process based on our experiences and learning.