Rural Oklahoma Disparities Define UNMC Professor’s Passion for Health Care

Marcia’s Story

Both of my parents were born in small Oklahoma towns — Hennipen (population 214) and Tatums (population 151). They grew up in a town called Duncan, in which Hwy 81 runs right down the middle. Most of my extended family still lives in Duncan, where the company Haliburton is famously headquartered.

Everyone in my family has worked Haliburton in some capacity, and my grandfather retired from there. I used to spend summers in Duncan with both sets of grandparents and the rest of my family after we moved to Omaha. Duncan is slower-paced and unique in its culture, but it is full of family, good home-cooked Southern food and love.

Unfortunately, Duncan also suffers from limited access to health care specialties that many of us take for granted. Being Black can heighten disparity in a town where access is already limited. Sometimes this leads to residents opting for “home remedies” or trying alternative approaches that a close family friend who has bit more medical savvy could offer.

My grandfather, who LOVED to fish, died of metastatic prostate cancer. I never heard him complain. But I wonder — why wasn’t it caught earlier? My grandmother eventually died of chronic kidney failure and diabetes complications in Oklahoma City (about an hour and a half from Duncan). She, too, never complained. But I wonder why she didn’t have access to specialty services closer to home? My other grandmother was prescribed multiple medications for pain and suffered from delirium, which was misdiagnosed as dementia. As a result, she lost her independence. She always said she wanted to go home. It was heart-wrenching. I wonder, why didn’t she have access to a geriatric specialist?

These are just a few of the personal accounts of my family that impacted my desire to earn my PhD and research ways to improve the quality of life for rural older adults. My family, just like many of those in rural communities, is full of love and determination, which has been passed down as a legacy for generations. I love rural health because of its strong spirit that reminds me of where I came from.

Marcia Y. Shade, PhD, BS, RN 
Assistant Professor 
University of Nebraska Medical Center – College of Nursing