NOAH June 2020

Nonprofit Organization U.S. Postage PAID Omaha, Nebraska Permit NO. 454

June 2020

Healthcare in the Shadows

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Healthcare in the Shadows

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Talking to Kids about sex

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Sesame St. COVID-19

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Unraveling The African American Health Disparity: Four Ways Men Can Fight Back Special Edition for Young People and Young Adults, even seniors.

Mark Darby, APRN is a nurse practice partner at NOAH. When he’s not at NOAH, he’s teaching future nurses at UNMC school of Nursing. On the day of my visit a 56 year old woman came in because she had difficulty with her vision. Mark took a brief history and vital signs and then screened her near and far vision. She has no Written by Bonita Pilon Vanderbilt University School of Nursing insurance although she works full time; her income is low and she would likely qualify for expanded Medicaid but The North Omaha Area Health clinic (called Nebraska has refused the expansion. Mark told me that NOAH by everyone in Omaha) may be located in a virtually every NOAH patient would qualify for expanded former nail spa but you can’t get a pedicure there. What Medicaid if it were available. This woman is given a they do offer however, is far more valuable and free: HIV referral to another agency where she can get definitive testing, counseling and referral; screening for diabetes; vision testing and glasses. screening for sexually transmitted infections; and blood pressure checks. People with no insurance and few resources come in for all these services and more. Every kind of request for health and social services can walk through the door at any time. NOAH is like an oasis in the desert: North Omaha is known for its low income, high poverty, high crime, and health disparities.

Healthcare in the Shadows

Ira Combs, a nurse retired from at the University of Nebraska Medical Center, for 4 years scrapes together grants and donations to keep the doors open, hoping to bring small doses of health and hope to the ‘hood’ as he puts it. Ira grew up in this neighborhood and he knows how it operates. He uses his insider understanding to craft creative solutions that entice young people away from the cycles of poverty and violence, toward a more positive future and seniors toward a healthier lifestyle.

NOAH offers 9-week internships for adolescents and young adults interested in health careers. Ira teaches public health classes and instills vision. The participants learn about possibilities and pathways to a different future. Some will become clinic assistants and maybe one or two will make it through nursing or medical school.

All of them grow and learn. In addition to the internship program, NOAH offers a course called CPR in The Hood or Ghetto First Aid. People learn very basic CPR and first aid…..how to save a friend or family member’s life.

He instills in them that they now have an obligation to act once they’ve been trained.

Mark Darby, APRN and Ira Combs, RN --NOAH Healthcare Team

I asked Ira what happens when NOAH picks up signs of serious illness and the patient needs to be seen by a specialist. “Do you have a certain physician group that takes your referrals? ” I wonder. His answer was very straightforward: “We call the ones we know will say yes, and we keep calling until we find the answer we need.”

Perseverance, patience, vision, hope, health promotion…..on a slim budget. These are the hallmarks of NOAH and the foundation for improving health one patient at a time.

Talk to teens about sex and then take action if needed Despite being an advocate for openness around teens and sex, I would also argue that in this country, becoming sexually active isn’t actually the best idea for the majority of young people. We already have far too many teens who lack access to contraception and reproductive health care. We have far too many who are denied accurate information about sex, whether overtly, or as a result not of only of abstinence-only education, but also of parental silence or internet filters that censor basic health-care information., or porn. And we have far too many resulting situations where the sex that teens have is unwanted, unprotected, or deeply unsatisfying.

So what can adults do? One thing is to guide teens toward a decision about whether they are ready for sex in the first place rather than just informing them that they are not. To do that, you can have teens consider questions like: 

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What if having sex ends your relationship?

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Do you know how to reduce health risks?

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Even if you know about them, are you able to access things like condoms, other forms of contraception, and health care?

How do you feel about unintended pregnancy?

Do you know how your partner feels?

Are you feeling pressured into having sex?

Can you let your partner know what you do and don’t like sexually?

If teens are sexually active, adults can also help them obtain contraceptives and condoms, and set up medical appointments. These actions can be incredibly important since confidential, accessible, and affordable health care is a cornerstone to sexual health for all of us. But for no group is this harder to access than for youth who simply aren’t afforded autonomy in this arena. 

Indeed, though minors in many places legally have the right to confidential health care for things like reproductive health care and STI testing and treatment, actually obtaining this can be next to impossible. This is both the result of the limited number Do you want a committed relationship before of teen clinics offering free or low-cost care, and you have sex? also due to the fact that if teens use their parent’s What if having sex turns out to be different than health insurance, it is likely that a statement will aryou expect? rive in the mail detailing their treatment. Plus, it is How might your feelings about your partner no secret that while it is difficult enough for adults change after you have sex? to obtain services the roadblocks that are put in front of teens who may want to seek reproductive Will you expect more commitment from your services are often nearly insurmountable. partner? What if you don’t get it?

What if your partner wants more commitment from you?

Talking To Your Kids About Sex Talking to your child about sex doesn’t have to be difficult (or embarrassing). Have the conversation early and often. Your home will become a safe and comfortable environment for your child to ask questions.

Your child needs to hear accurate information about sex from you. This includes the basics (vaginal, oral, and anal sex), birth control, sexual assault, sexual molestation, and your family’s moral beliefs. Your child needs to know that he or she can talk with you about sex. They can talk with you about their changing bodies, their feelings, their concerns, and their confusion. You don’t have to know all of the answers to their questions. However, you should be willing to help them find those answers. Help them do the research when you don’t know the answers.

You want to be approachable. You want them to feel comfortable talking with you about sex. Don’t wait until your child asks you about sex before you find the right words. Plan ahead at every age and stage. Be prepared to discuss all kinds of sexual activity as well as same-sex relationships.

younger, they often hear only as much as they need to know.

Elementary school children: Continue to answer your child’s questions about their bodies. Use language they can understand at their grade level. Around 4th or 5th grade, your child’s school will teach students (in stages) about their bodies, puberty, and how it relates to sex and pregnancy. This will prepare your child for the changes coming to his or her body.

Once your child understands puberty, use this new knowledge to continue conversations at home about sex and pregnancy. Again, keep it simple, honest, and accurate.

Middle and high school children: Your child is old enough to use the correct words for sex. Some ‘tweens’ (boys and girls on the verge of turning 13 years old) have sex in middle school. So it’s important to be truthful and accurate. Explain birth control. This does not mean you are giving your permission for your young teen to have sex. It simply educates them about sex. This also is a time to discuss the dangers of having sex at an early age. In addition to pregnancy, tell them that unprotected sex can lead to sexually transmitted disease and other risky behaviors.

Always talk with them about respect. No means no. It does not mean “maybe.”

Path to improved health What and when you tell your child about sex As your young teenager gets older, continue talking depends on a lot of things. Age, for example, is the most with them about sex. Don’t be afraid to share your important guide. family’s moral (or religious) beliefs. Be sure your teenager Preschool children: understands the responsibilities that go along with having Young toddlers will not understand sexual sex (birth control, protected sex). Always remind your intercourse. At this age, it’s important to teach your child child about birth control and sexually transmitted the correct names of their genital parts. For boys, use the diseases. This is also a time to remind your teenager how word penis. For girls, use the word vagina. Your their feelings may be changing. Hormones may make it preschool child may want to know where babies come difficult to resist sexual activity and think clearly. from. Don’t ignore the question. Keep your answers Be specific when discussing vaginal, oral, and anal short and simple. Use language a toddler would understand (for example, tummy vs. uterus). It’s okay if sex. Describe what each is and the risks associated with your child asks you for more information. Don’t worry each. Many children don’t know that unprotected oral and anal sex can lead to sexually transmitted diseases in that you are telling them too much. When they are boys and girls.

This includes: •

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HPV — human papillomavirus (which • can cause genital warts and can lead to • cervical cancer in women).

• HIV/AIDS.

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Genital herpes.

Syphilis.

Viral hepatitis.

Pubic lice (the slang term is crabs).

Gonorrhea.

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Chlamydia.

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Trichomoniasis, and more.

As puberty begins, it is normal for your child to start to feel a variety of physical urges. Be calm and patient if your child talks to you about same-sex relationships. If you disagree for moral or religious reasons, love your child unconditionally. Remember, they may be fearful of your response. Make it easy for them to continue the conversation by not reacting angrily.

child by practicing what another child might say and how your child should respond.

Give your child a code word to signal that they need help getting out of a situation that could lead to pressure to have sex.

Continue to set curfews and know where your child is. Avoid letting your child be alone with a partner. Don’t be embarrassed to check with other parents to make sure there will be adult supervision at their home. Be a good example of respect in your own adult relationship.

Talk to your child about healthy and unhealthy relationships. Unhealthy relationships involve pressure, physical abuse, rape, or sexual molestation.

You want to have your child’s full attention when Questions to ask your doctor talking about sex. However, a TV show or movie might If I suspect my child is having sex, should I be a natural starting point for a conversation. Talk to your child about sex and love. Teach them that hormones can confront him or her? confuse sex and love. Hormones make it difficult to tell Should I provide birth control for my child as a if their feelings are love or just the desire for sex. precaution or just tell them about it?

Another good opportunity for a discussion about Can being overprotective push my child into having sex is between your child and his or her doctor. Your sex before he or she is ready? child’s next checkup will give them a chance to have a Should my daughter’s routine exam include a confidential and nonjudgmental conversation about sex. pregnancy test?

It might make it easier for your child to ask questions, Are there signs that indicate my child is having sex? too. No matter how old your child is, always listen to their If my child is interested in a same-sex relationship, questions and opinions. should I take him or her to a doctor who works with that Things to consider population?

Don’t judge your child’s opinions about sex. However, don’t ignore the facts. Present the facts about unsafe sex The most important thing to remember is sometimes the hardest to accept is that YOUR child is growing up into and sex before you think your child is ready. an adult Talk to your child about how to handle pressure to Resources Healthfinder.gov: Talk to Your Kids About have sex from friends or a partner. Role play with your Sex

Health Care In Omaha 1

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4. Catholic Health Initiative

1. The hospital for kids

7. If you smoke you could get this

2. Community Health Center in North Omaha

11. What we need to breath

3. Leading cause of cancer death

12. The only free clinic in Nebraska

5. COVID-19

13. Abbreviation for Blood Pressure

6. What you would take for a headache

14. What we do to get a heart started

8. University Nebraska Medical Center

15. Community Health Center in South Omaha

9. What organ can you take out and not worry and not replace it?

16. Leading cause of death in African American

10. What was the name of hospital that Creighton supported

17. What is the name of UNMC's clinic North Omaha

NOAH paper is compiled and distributed by North Omaha Area Health Inc. Questions or comments please write the Editor Shanta Roberts at 5620 Ames Ave Omaha Nebraska 68104, or email noahclinic@cox.net or call 402-933-0737

Our son was confused (and still is) about the fact that it's a bad word when he says it, but a cool, fun word when others do (in videos, music, on the basketball court, and on the I am dating a man who wants street). my 7 year old daughter and me He said the word in school and hurt a classmate's feelings. to move into his home. He has 2 He felt terrible, apologized for the offense, and the two kids, 11, and 13. He has a became very good friends for the rest of the school year. horrible relationship with his ex- The entire neighborhood found out about it and painted him wife. They fight instead of talk. (and us) as racists. My husband and I are steadfast liberals They share the custody and raising our children to treat everyone with respect and parenting of their children. The schedule is very erratic, dignity. depending on her work schedule. No one knows where the children will be staying from week to week. He is happy with Signed…..Upset Family this situation because he gets to see his kids. The children, Upset Family: Your son seems to have learned from his mistake. however, have no stability or responsibilities. Their grades Let’s ponder yours. You should not tell a child with “limited are horrible, D’s, and F’s. My daughter has weekly social understanding” to “find clean versions” of songs with commitments with her father and our lives are scheduled and stable. I think living there would be very chaotic for us. lyrics featuring racial epithets. Your job is to teach and to lead, He says he cannot change the situation, and really wants me not to instruct your child to lead himself. to live with him, but I don’t think I could manage… Please He gathered from watching various (obviously inappropriate) help! media at home that saying the “n-word” was cool. As parents, you know that it is NOT cool. Once you became aware of this Sincerely, happening in your own household, your job was to educate, explain and teach him to empathize. Does your son walk around Confused….. school using curse words that he has likely heard, either at home or through media? I gather not. And that’s because he has Hi Ms. Confused, absorbed the concept that some words are “adult” or “hurtful.”

There is no issue here.

You would be nuts to Hi Shanta D., move your daughter into a chaotic, unscheduled environment, and double nuts to move your daughter into someone’s life I’m so glad you started this column. I am planning to marry without the benefit of marriage. So, don’t do it. the man of my dreams this August. Although his parents are This man has a chaotic life, failing children, a nasty relationship wonderful, I'm a little concerned about the role that they still with his ex, all swirling about him and he wants another family play in his life...particularly his mother. She still does my to move in? He has too much on his plate as is. fiancé's laundry, cooks his lunches daily, and cleans his You are having an excellent preview of your future with this man: house. What do you think? chaotic. This living arrangement does not sound like a good fit Thank you for your kind words about my page. Please spread the for you or your daughter. It is not fair to your daughter to be word, that would be awesome. I would be concerned too. Have placed in such chaos. you talked to your fiancé about what he expects from you when you are both married? A man who has his mother perform these Dear Shanta D., mundane daily tasks often will expect his wife to step in, or even worse, continue to have his mother do them. Find out what your Last summer, my 10-year-old son learned a racial epithet future might look like now!!! (the "n word") from listening to his favorite music and watching his favorite basketball videos.

TREAT EACHOTHER WITH RESPECT AND LIVE When we discovered that he had been listening to music with LIFE ON YOUR TERMS. UNTIL NEXT TIME that word, we asked him to find clean versions. Although he EVERYONE!!! is 10, he has the social maturity of a younger child.

Dear Shanta D.,

“North Omaha Area Health in the community, for the community” This resource is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $4,024,409 with 0 percent financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government. For more information, please visit HRSA.gov.

Community Response to COVID-19 Food Banks (Gardens, Pantries, Creating

Storehouses) - Locals made a “COVID-19 Food Today” Facebook page with daily updates on food locations.

No More Empty Pots Pick up Feeding Our Neighbors meals Friday 8a – 10a, or Saturday Noon – 2:00p at Cups Café at Florence (8501 N. 30th St.) Deliveries occur on Fridays and can be scheduled w/ Emily at communityharvest@nmepomaha.org. Register for meals here by Tuesday of each week.

No More Empty Pots CSA (Community Supported Agriculture) - 6 Weeks of local produce, available for distribution beginning April 30. SNAP participants can qualify.

Register: nmepomaha.org/communityharvest-meals SNAP Online - April 1, NE DHHS has launched a pilot program for online purchasing and delivery of groceries purchased with Supplemental Nutrition Assistance Program (SNAP). Amazon and Walmart are the only qualified retailers that will be able to handle SNAP purchases online in Nebraska. Walmart and Amazon are able to deliver statewide.

Nebraska is extending SNAP recertification process by 6 months and the family EBT will be raised to the maximum allotment for April and May. The state is also waiving some requirements for individuals and interviews for recertifications.

SNAP recipients will be issued emergency supplemental allotments to Supplemental Nutrition Assistance Program (SNAP) recipients who receive benefits for the month of May on June 6.

Food Bank of the Heartland Complete Pantry List (As of Tuesday, March 31, children must be present to receive

meals. FBH has to make this change to adhere to federal regulations for child feeding sites.)

Food Bank of the Heartland Backpack program Backpacks will be filled with 5 breakfast, 5 lunches and 10 milks Completely KIDS: 2566 St. Mary's Ave, Weekly on Fridays starting March 20, 4 to 6 p.m.

Metropolitan Community College: Food pantry available for students at North and South campuses. MCC ePantry request form, ePantry@mccneb.edu, or call 531-6222875.

Together Omaha: 812 S 24th St, Monday-Thursday 12-2pm, Friday 12-2 pm Pantry boxes will be distributed from the dock located at the backside of the parking lot. Staff will fill out the USDA waiver form to eliminate personal contact.

Project Hope Food Pantry: 6201 North 60th Street, Call for hours: (402) 452-7649 St. Vincent De Paul Food Pantry: 2101 Leavenworth Street, Call for hours: (402) 341-1689 Omaha Public Schools - Meals: OPS Teacher Administrative Center, 3215 Cuming St, Call for hours/information: (531) 299-0220 Monday, March 23 at 11 a.m., OPS will provide grab-and-go packages with several meals inside for students.

Youth Emergency Services Outreach Center: 2679 Farnam Street, 402-345-5187, 1-3pm Monday-Friday Youth will be able to get boxed or sacked meals. Outreach staff will assist youth not available at those times by appointment.

Westbrook Elementary and Westside Middle School: 8:30am-1pm, For any family who shows up at these sites, we will provide every child (age 0-21) in that household 5-days worth of meals to include breakfast and lunch. Director of Student Services Robert Aranda at aranda.robert@westside66.net

Unraveling The African American Health Disparity: Four Ways Men Can Fight Back Information from HuffPost and NOAH Clinic

When it comes to health, your race and gender can be a factor in

how long you live. This is especially true for the 21.5 million African American men who live in the U.S. Categorically, African American men are the unhealthiest of all Americans. Threats that disproportionately affect all men like heart disease, stroke and cancer are impacting African American men earlier in their lives, resulting in more complications and more serious problems down the line, including higher mortality rates.

Already men are at a disadvantage when it comes to life expectancy.

Women outlive men by five years, and white men outlive African American men by another five years. Why the disparity?

Genetics and family history play a role, but lifestyle and lack of preventative care are far greater contributors. June is National Men’s Health Month – the perfect catalyst to start a discussion about why African American males are not as healthy as the rest of the population.

Here are four shocking statistics to get your attention, along with manageable solutions to help change the tide.

What you can do. Meet with your provider to assess your lifestyle, family history and cancer risks. Roughly 20 percent of cancers could be avoided through healthy nutrition, exercise and weight loss. Cigarette smoking is the number one risk factor for lung cancer, so if you smoke, quit. Beyond prevention, screenings are key to early detection and better outcomes. Because African Americans are more likely to develop prostate cancer, begin screening at age 40. For colorectal cancer, schedule screenings beginning at age 50. Thanks to better prevention and early detection, the mortality gap for African Americans with cancer is shrinking.

3. Approximately 2.7 million African Americans have diabetes — and

at least one-third of them don’t know it. African Americans are 80 percent more likely to be diagnosed with diabetes and more than four times as likely to be diagnosed with end-stage renal disease. We are also significantly more likely to suffer from blindness, kidney disease and amputations because of the condition. Shockingly, African Americans today have a 50 percent chance of developing type 2 diabetes in their lifetime.

What you can do. The good news is diabetes is treatable and preventable. Eating a healthier diet, getting regular exercise and losing extra weight can go a long way in reversing diabetes symptoms. If you are the one out of every three adults who has prediabetes, there is a 90 percent chance you have no idea.

Getting regular medical checkups can reduce your diabetes risk by 60 percent.

4. Nearly 40 percent

of African-American men are obese, and nearly 70 percent of Americans are overweight.

Obesity contributes to health 1. Nearly half of all conditions that disproportionAfrican American men have ately affect African Amerisome form of cardiovascucans, such as type 2 diabetes, lar disease. Heart disease is heart disease, stroke and certhe single biggest killer globtain types of cancer. Obesity-related conditions are the second leading cause ally, and, not surprisingly, the leading cause of death among African American of preventable deaths, yet many African Americans live with this risk factor men. Not only are African American men more prone to heart disease, they their whole lives. are also twice as likely to die prematurely as a result.

What you can do. For some who are struggling with weight problems, What you can do. Visit your health provider as soon as possible to adopting a healthier lifestyle that incorporates exercise and better nutrition assess your risk. High blood pressure, high cholesterol, diabetes, smoking, can tip the scales in your favor. For those who suffer with obesity, the Ameriobesity and lack of exercise are the most dangerous factors. These conditions can Heart Association recommends a medically supervised weight loss proare all manageable, but to treat them, you must know you have them. The gram that involves eating fewer calories, exercising for 30 minutes most days good news is, with better prevention, half of heart disease deaths can be and learning skills to change unhealthy behaviors. Your provider can help you avoided. devise a plan that is right for you.

2. African American men have the highest cancer death rate of any African American men seem to have an uphill battle when it comes to racial/ethnic group in the U.S. Prostate cancer is the most common cancer maintaining good health, but it’s far from impossible. Understanding risk facaffecting African American men, followed by lung and colorectal. Overall the tors for the most threatening medical conditions and actively engaging in precancer death rate for African Americans is 25 percent higher, and African ventive care has proven to improve health outcomes, and we are seeing a American men are more than two times as likely to die from prostate and col- gradual shift in African American health as a result. The overall death rate for orectal cancer. Despite their high risks, nearly half of African American men African Americans fell 25 percent between 1999 and 2015, and this trend will do not have a provider they see regularly, which helps explain why they are continue as more men understand their health risks and take proactive steps more likely to be first diagnosed with advanced-stage cancer. to live healthier lives. In honor of National Men’s Health Month, take stock of your health today and make changes that could literally save your life.

The Bureau of Labor Statistics (BLS) expects the healthcare field to create more new jobs than any other field. The BLS forecasts a 33% employment growth for the healthcare and social assistance industry from 2010 to 2020, providing 5.7 million new jobs. The BLS forecasts continued demand for healthcare workers at all education levels

ARE YOU TIRED OF YOUR CURRENT JOB??? READY FOR A CAREER??

Jobs in the health care industry are abundant, and many of them don't require medical school or advanced degrees. That means you can quickly build a good career for which there will be high demand for years to come. The thriving healthcare field offers some of the best career opportunities in the United States. If you're seeking a personally and financially rewarding occupation, consider the healthcare industry.

As a well-paid healthcare professional, you'll work with caring coworkers to improve people's lives.

Salaries of nonsupervisory employees in most healthcare fields are higher than the average pay for all private industry. Plus, you have more than 80 healthcare occupations to choose from and many healthcare occupations only require a two-year degree or a certificate.

Check out what NOAH has to offer……..

A Medication Aide is a great start or a great finish for a healthcare career.

In this position you would, dispense medications, take vital signs like blood pressure, temperature and a pulse, perform glucose testing, wear scrubs of course, perform dressing changes on wounds and many other things. Sometimes life doesn’t permit you to commit to a two or four-year plan as a college student, yet you want to change your current situation. Medication Aide is not a long course, actually only 4 hours a day for 2 weeks or a 2 weekends class......... starting pay $14-$16. NOAH also has partners in the community that are ready to hire you right after you’re finished NOAH offers this course at a very low cost and payment plans available. Classes start in June and will continue throughout the summer.

Other classes offered, CPR, First Aide, Phlebotomy, Change your current situation and you will change your life…….

Tuesday and Thursday 12-6 PM Saturday noon to 4:00 PM