OneWorld is a community health center that provides quality care to their patients,

focusing on those who are underserved. OneWorld is just that- a world of services packaged into

one program. There seemingly is nothing that the center does not assist patients with- from

pediatrics to geriatrics, OneWorld has their patients covered. They have programs to teach

parents and children about healthy eating as well as help immigrant parents learn English. Their

locations are picked based off convenience for their patients, but even then, it is quite remarkable

the thought they put into location. For example, although West Omaha is considered a more

socioeconomically stable community, OneWorld has placed a location there because they

understand that those who are in West Omaha may not be willing to venture to other parts of

Omaha for their care. The population that this program targets is one of diversity and of

hardship, encompassing seven percent of Omahas population. The patients of OneWorld face

many challenges in their daily lives, one of which includes psychosocial hardships.

A large portion of those that OneWorld provides services to are those who are of low

socioeconomic status. The strain that one faces while living in poverty are far too many to list,

but all contribute to a need for specialized healthcare for these patients. OneWorld utilizes a

sliding scale payment system, such that patients provide paystubs and the cost of their visit is

then calculated based off their ability to pay. For some, the cost of a visit can be $35. And for

some, the decision to spend $35 for an annual checkup is difficult when that money could be put

towards providing food for the family. Once a patient can spend the money to take an

appointment, that appointment must be utilized effectively, in case the patient is unable to make

a follow up appointment in a desired timeframe.

One way that OneWorld effectively uses appointments is by doing quick psychiatric

screenings during annual appointments. There is a stigma associated with psychiatric conditions,
and some patients are unwilling to seek treatment because of that stigma. By doing these mental

health interventions during annual appointments, they can screen and provide as much help as

some patients are able or willing to get. Depression is a serious condition that can impair many

aspects of a patients life, including education and jobs. Should interventions not be done

regarding depression in this community, there can be a perpetuating cycle of depression and

poverty.1 Mental health problems, such as depression and schizophrenia, can be debilitating to a

patient and render them incapable of holding a job. This then leads to an economic load that

could be reduced should proper treatment be given.

Physicians could play a role in further destigmatizing mental health problems by talking

to patients during visits. Physicians can also advocate for further health insurance coverage and

speak to their local government officials. The more patients that are on Medicaid, the less out of

pocket fees the center has. There are also many other benefits for patients to have insurance, but

that is one benefit for OneWorld. I was shocked to learn the limited eligibility for Medicaid in

Nebraska. Another thing physicians can do is to reach out to as many adolescents as possible and

ensure they are taught regarding safe sex and contraception. Douglas County has higher rates of

STDs compared to other regions of the United States.2 It was brought up at the meeting that

some high schools would allow for talks regarding STDs, but not about contraception. It is

essential for adolescents to know all options available to them regarding safe sex.

Our site visit comprised of a simple presentation. When I sat down, I was ready to learn

about small undertakings that the center does for their community. I could not have been more

incorrect- I was blown away by OneWorlds comprehensive care for their patients. This center

provides for their patients in every way imaginable. From the actual inpatient healthcare to

making sure that patients know how to cook proper meals and speak English, One World does it
all. Community health centers provide care to their community in so many aspects, they are a

one stop shop for the community.3 OneWorld even provides dental care for their patients, and

has buses that go to schools to dental care to students. Though we only had the presentation to

learn about the center, I learned so much and was inspired by the center. I dont know how to say

this in a way that makes it clear that my amazement by this center is sincere. I am in awe of how

a center started by two Creighton medical students has somehow managed to become an entire

world for a community that needs something exactly like this. I have seen organizations that do

their best to provide some form of care to underserved populations, which is still something

needed. What amazed me about OneWorld is that they provide care that is comparable, or even

above, what a person with a higher socioeconomic status would receive. They provide

competitive salaries to their employees to ensure that the quality of care is good. At OneWorld,

income does not prevent a patient from getting quality care.

References:

1.Bouvette-Turcot, Andre-Anne, et al. "The joint contribution of maternal history of early

adversity and adulthood depression to socioeconomic status and potential relevance for offspring
development." Journal of affective disorders 207 (2017): 26-31.

2.Glissmann, Bob. "Chlamydia Rates in Douglas County at an All-time High." Omaha.com. Live
Well Nebraska, 18 Feb. 2015. Web. 18 Apr. 2017.

3. Adashi, Eli, MD, Jack Geiger, MD, and Michael Fine, MD. "Health Care Reform and Primary
Care - The Growing Importance of the Community Health Center NEJM." New England
Journal of Medicine. N.p., 28 Apr. 2010. Web. 10 Apr. 2017.