Document Type

Capstone Experience

Graduation Date

12-2025

Degree Name

Master of Public Health

Department

Health Promotion

First Committee Member

Chad Abresch, PhD

Second Committee Member

Carol Gilbert, PhD, MS

Third Committee Member

Nicole Kolm-Valdivia, PhD, CHES, MPH

Abstract

Douglas County, including the city of Omaha, covers 339.6 square miles along the border of the Missouri River in Nebraska with a population of 517,110 (https://www.douglascounty-ne.gov/) and is one of seven large urban counties in the state. There are approximately 8,000 infants born in Douglas County annually (Nebraska Vital Statistics Birth Dashboard). The Douglas County Health Department (DCHD), established in 1854, is one of the oldest county health departments in the state and manages multiple public health projects annually. In 2024-2025, a renewed focus for DCHD has been its infant mortality rate (IMR). In 2024, 44 infant mortalities occurred in Douglas County based on death certificates filed in Vital Statistics that year (Douglas County Health Department, 2025). Based on 8,039 births occurring in Douglas County in 2024 that gives a provisional infant mortality rate of 5.5 per 1,000 live births (Nebraska Vital Statistics Birth Dashboard, 2025). From 1999-2002 the IMR was as high as 7.74 per 1,000 live births (CDC Wonder Database, 2025). From 2003 to 2006 the IMR improved, but the rate for Black infants remained much higher at 13.8 compared to non-Hispanic whites at 4.9 per 1,000 live births (Figure 1) (Douglas County Health Department, 2025). Local collaborative efforts were put in place during this time that improved both the overall IMR and especially the IMR for Black infants. Unfortunately, a clear and consistent racial disparity in IMR has remained and appears to be widening since 2015.

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