FEATURE STORY — March/April 2008

Like a Detective

As chief epidemiologist, Uche Onwuta examines data to help identify health trends that affect Kane County’s nearly 500,000 residents

By Kevin McKeough
Photography by Lloyd DeGrane

It was five o’clock on New Year’s morning when a neighbor knocked on the door of Uche Onwuta’s, MPH ’97, home in Nigeria, asking Onwuta’s mother to help him and his wife give birth to their baby. The 19-year-old Onwuta went with her mother, holding a lamp to light the room and a pair of scissors to cut the umbilical cord as her mother and aunt, both nurses, helped deliver the child.

Looking back on the experience years later, Onwuta realized that the man knew the child’s birth was imminent but wouldn’t take his wife to a hospital because he couldn’t afford to pay for it. “Medical care is not easily accessible to everybody,” she observes. “He knew he could get help from my mother for free, but he didn’t think about the complications that could happen.”

Access to health care and the well-being of mothers and children are a major part of Onwuta’s work as chief epidemiologist for the Kane County Health Department. In that role, she gathers and analyzes data from county health providers to identify health trends and to assess the results of KCHD’s health promotion and intervention efforts.

Onwuta has been “a tremendous asset,” remarks Paul Kuehnert, MS ’91 NURS, KCHD executive director. “She’s tremendously committed to public health and she’s very knowledgeable in her subject areas, particularly epidemiology and data analysis.”

From Nigeria to Chicago

Encompassing the western edge of Chicago suburban sprawl, where farm land is steadily giving way to development, Kane County is far from where Onwuta was born, but her work in public health is literally something she was born into. Her mother was director of the local health department in Onitsha, a commercial center on the Niger River, where Onwuta grew up as the oldest of five children and only daughter in a close-knit, accomplished family. Her grandfather at one time was resident (equivalent of mayor) of Aba, a neighboring city in eastern Nigeria; her great uncle served as a judge on the International Court of Justice in Hague.

Her father was a school superintendent, and Onwuta attended an exclusive high school for top students. During summer breaks, she would accompany her mother, who would travel for hours over bad roads to provide prenatal care to expectant mothers in outlying villages.

“It interested me and puzzled me that, during their pregnancies, these women never had a chance to see a doctor, and that the four tablets of prenatal vitamins they received from my mother were the only ones they got during their pregnancies,” recalls Onwuta as she sits in a basement conference room of a community hospital following a health department staff meeting. The drab setting is made considerably brighter by the almost musical quality of Onwuta’s voice, which still bears a distinctly African tone and cadence, and her gracefully emphatic hand gestures.

While in college, she met her future husband, Emeka Onwuta, a native Nigerian who was attending medical school at the University of Pittsburgh. After earning a BA in microbiology (1987) and an MS in molecular biology (1990) at Nigerian universities, she joined him in Pittsburgh, where she found a job as a university lab researcher but had to overcome doubts about her abilities.

“I got hired at a bachelor’s degree level because they didn’t think Nigerians spoke English,” says Onwuta (whose English is impeccable). “I had to walk in with my thesis and speak to the person hiring me and show [that] I did research and had publications in local journals, all written in English.”

Asked if she has encountered other obstacles due to being African, the normally animated Onwuta grows quiet. “Yeah, I have,” she says softly. “I tell my kids, ‘you have to work a little harder to prove yourself in the society we live in, that everybody’s not treated the same.’ [I want my children] to understand that and know what the expectations are. I’d like to change it, but…” Her voice trails off, and she ends with a shrug of her shoulders.

Onwuta brightens again when she discusses her children. She and her husband have four daughters and two sons, ranging in age from 2 to 16. Onwuta’s parents, who moved to the Chicago area in 2000, look after them while she is at work, and she relishes their clamor for her attention when she returns home. “There’s a lot of noise in my house, but there’s [also] a lot of love,” she says.

"What I love the best is working in the community and making a difference."
     —Uche Onwuta                                 

After moving to the Chicago area in 1992 with her husband (now an anesthesiologist and pain management specialist at Provena Saint Joseph Hospital in Elgin), Onwuta worked as a lab research supervisor in the molecular cardiology lab at Rush-Presbyterian St. Luke’s Medical Center in Chicago. However, she felt limited by the repetition of bench research and, inspired by her mother’s example, decided to redirect her career and enroll in UIC’s School of Public Health.

Onwuta felt a glowing sense of freedom while at UIC, despite juggling school, a research assistantship and family. “Just being there was such a happy feeling. I was floating,” she recalls. “I have always loved being a student. When I was on campus, everything else was put on hold. This was school time.”

Onwuta is particularly grateful for the opportunity to study with public health practitioners such as Bernard Turnock, MD ’73—former director of the Illinois Department of Public Health, who taught her community health course—and for the quantitative skills she gained from her studies.

Reflecting her appreciation for her UIC education, Onwuta is a board member and past president (2005-07) of the School of Public Health Alumni Association. “I felt I needed to give back to the students,” she explains. Onwuta was recently honored with the 2008 UIAA Constituent Leadership Award for her outstanding effort on behalf of the SPH Alumni Board.

Using data to initiate new programs

Shortly after receiving her MPH degree, Onwuta joined KCHP in 1998 as a planner. As chief epidemiologist since 2003, she compiles and assesses data about births, deaths, rates of disease, demographics and other relevant matters to create a statistical portrait of the health of Kane County’s half million residents.

Being an epidemiologist is “like being a detective,” relates Onwuta. “There’s a problem, and you want to know why it happened, what’s different about it [and if] it’s something we need to focus on.”

In addition to guiding the work of her own department, Onwuta responds to data requests from hospitals, health centers, schools and students. Her work is particularly important in helping KCHD and other health-related organizations prepare proposals for grant funding, such as the $2 million federal grant the county received for programs that assist uninsured and under-insured residents with the cost of prescription drugs. Health care providers also use her data when seeking government approval of facility expansions and other changes in service.

“We’ve been able to secure funding in part because we’re basing it on data that is accurate, assessed and crunched to support these initiatives,” says Ed Hunter, chaplain and vice president of mission services at Provena Mercy Hospital in Aurora and Provena St. Joseph Hospital in Elgin. “Without data that is accurate and verifiable and translatable, it’s not going to happen.

“Uche understands numbers and the value of statistics, but she sees beyond the numbers to the potential outcomes and their benefit to the community,” he adds.

Investigating high infant mortality rates

For much of the past three years, Onwuta’s work has focused on completing the Illinois Project for Local Assessment of Needs documentation, which the state of Illinois requires health departments to prepare every five years. She coordinated the work of about 50 community leaders—including businesspeople, school representatives and CEOs of area hospitals—who developed goals and intervention strategies in response to the most pressing health needs identified by her data.

Having completed a previous IPLAN for Kane County, Onwuta has already seen her work help bring about changes in the public health system. The previous plan, for example, identified access to primary care for Medicaid and uninsured residents as a priority. “We didn’t have a community health center then,” she explains. “By the time we started this next IPLAN cycle, we had five community health centers,” which are located in Aurora (three), Elgin and Carpentersville. The plan also emphasized child abuse interventions—and now the county has a nurse home-visitation program to respond to abuse.

Two priorities identified in the new IPLAN for Kane County are to reduce the number of black infants who are born with low birth weight (defined as weighing less than five pounds, eight ounces) by 20 percent, and to reduce the mortality rate of black infants by 20 percent. “Our rates have been consistently higher than Illinois rates for African Americans,” says Onwuta.  For example, the 1997-2001 rate of infant mortality for African Americans in Kane County was 20.1 per 1,000 live births. By comparison, the Illinois infant mortality rate for African Americans for the same period was 16.1.

Onwuta relies on her data to yield insights into the problem. “I’m looking at fetal deaths and infant deaths and trying to find what aspects of deaths are related to maternal health characteristics, which is likely the case if it’s related to the prenatal period [five months before and one month after birth],” she explains. “If it’s after the first 28 days of birth, it’s possibly something that relates to the child’s health. Therefore, I’m looking at the birth weight, which would indicate whether or not the death is related to the mother’s health. If we can narrow down the issues, then we can [focus] our interventions.”