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Assessing health in our community required a wide-ranging look at various factors, including disease, physical activity, nutrition, mental health, access to health services, and much more. Our community may be experiencing more health problems than it should because many of our neighbors don’t have access to basic needs like healthy food and healthcare services.

Childhood Trauma

Adverse Childhood Experiences (ACEs) are stressful childhood experiences. They include household experiences like divorce, drug or alcohol use, and incarceration—as well as community experiences like racism. ACEs can have a tremendous impact on lifelong health, and are linked to a range of negative outcomes, including chronic health problems, mental illness, and substance misuse in adulthood.

Local data specific to children is limited. In the state of Nebraska and Iowa, children in higher-income families had lower rates of experiencing two or more ACEs.

We are on par with national averages.

The rates of children experiencing two or more ACEs in Nebraska and Iowa fall in the lower and middle third when compared to other states.

Mental Health

One in three people in our community has experienced symptoms of depression.

Those most frequently impacted by depression include women, adults with lower income, and those who identify as people of color.

The availability of mental health providers is limited in parts of our community.

Douglas County and Nebraska as a whole have lower ratios of mental health providers compared to overall ratios in Sarpy County (Neb.), Pottawattamie County (Iowa), and Iowa. Nebraska ranks in the top half of all states while Iowa is in the bottom 10 states that have the highest ratio of mental health providers to individuals.

Sexually Transmitted Infections

Sexually Transmitted Infections (STIs) are infections passed between people, often through sexual contact, but they may also spread through the sharing of needles, blood transfusions, or from mother to child during birth.

Chlamydia rates in the Omaha-Council Bluffs area grew significantly over the past 20-plus years. Rates of Gonorrhea have also increased but have not grown as fast and have gone through periods of both increase and decline.

Douglas County’s Sexually Transmitted Infection rates are much higher than the national rate.

As of 2021, rates of STIs in Douglas County are higher than the national rate. Pottawattamie and Sarpy Counties are closer to or lower than the state and national rates.

Healthcare Coverage

In our community, 22% of adults living below the poverty line do not have healthcare coverage. Only 4% of individuals with higher incomes do not have healthcare coverage.

When we look at healthcare coverage by race and ethnicity, we see disparities in access to coverage for people of color.

However, we’re doing better than the national average.

Local and national rates of people without healthcare coverage have been declining over the past nine years.


In our community, 39% of adults and 22% of children are considered to be obese.

We see different trends in various parts of our community, but overall, obesity is on the rise. While the methods of identifying obesity are often debated, they give us some indicators of health.

Our obesity rates are higher in some counties than the national average.

Since 2011, the rate of adults who are considered obese has trended upward in the Omaha-Council Bluffs area. Local obesity rates for adults are higher than national rates, based on 2021 data. Childhood obesity rates also are currently higher than the national average.

Access to Healthy Foods

People living below the poverty line are almost four times more likely to have difficulty accessing affordable, healthy foods.

While people at all income levels may experience challenges with access to healthy foods, more than one-third of people whose income places them below the poverty threshold lack access to healthy foods.

The USDA measures access by food deserts—areas (census tracts) where at least 1 in 5 people are living below the poverty line and at least one-third of people are more than a mile from the nearest grocery store.

Multiple ZIP codes in all counties in the Omaha-Council Bluffs area are considered food deserts.


Of people living below the poverty line, 58% worry that their food may run out before they have money to buy more.

Across the community, 20% of residents experience this concern. This rate increases significantly when considering income and race/ethnicity.

Our hunger rate is lower than the national average.

Maternal Health & Birth Outcomes

Fewer babies born in Nebraska and Iowa are low birth weight compared to the average rate for the United States.

However, in Douglas County and Nebraska as a whole, babies born to mothers who identify as Black are more than twice as likely to be low birth weight, compared to babies born to mothers who identify as white.

In Nebraska, for every 1,000 babies born, about five die within the first 12 months of their lives. In Iowa, the rate is approximately four infant deaths per 1,000 births.

In Douglas County as well as the states of Nebraska and Iowa, babies born to mothers who identify as Black die at more than twice the rate of babies born to mothers who identify as white.

In Nebraska, more than 22 mothers per 100,000 live births die from pregnancy or pregnancy-related causes.

In Iowa, more than 18 mothers per 100,000 live births die from these causes. This rate has increased over time in Iowa, Nebraska, and the United States at large.

Health Findings

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