With roots in civil rights, neighborhood well being facilities push for fairness within the pandemic

In the 1960s, health care in the Mississippi Delta was sparse and much of it disconnected. Some hospitals were dedicated to black patients, but they often struggled to stay afloat. At the height of the civil rights movement, young black doctors started their own movement to tackle inequality in care.

“Mississippi was in the developing world and was so bad and so separated,” said Dr. Robert Smith. “The community health centers movement has been the conduit for doctors across the country who believed that everyone has a right to health care.”

In 1967, Smith helped set up the Delta Health Center, the country’s first rural health center. They built the clinic in Mound Bayou, a small town in the heart of the Delta in northwest Mississippi. The center became a national model and is now one of nearly 1,400 such clinics across the country. These clinics, known as federally qualified health centers, are a vital resource in Mississippi, Louisiana, and Alabama, where approximately 2 in 5 people live in rural areas. About one in five people in the United States lives in rural areas.

The COVID-19 pandemic has only exacerbated the challenges faced by rural healthcare providers, such as lack of broadband internet access and limited public transportation. For much of the vaccine rollout, these barriers have made it difficult for providers such as community health centers to shoot their patients in the arms.

“I just accepted that [the vaccine] would flow like water, but we really had to break the door open to get in, ”said Smith, who is still a general practitioner in Mississippi.

Mound Bayou was founded by formerly enslaved people, many of whom became farmers.

The once thriving downtown area was home to some of the first black-owned businesses in the state. Today the city is littered with rundown or rundown banks, hotels and gas stations.

Mitch Williams grew up on a mound bayou farm in the 1930s and 40s and spent many days working the soil.

“If you cut yourself, you wouldn’t put any seams, no stitches. You packed it up and carried on, ”Williams said.

When the Delta Health Center opened in 1967, it was specifically intended for all residents of all races – and free of charge for those in need of financial assistance.

Williams, 85, was one of the first patients.

“They visited patients in the local churches. They had mobile units. I had never experienced such comprehensive support, ”he says.

The residents really needed it. In the 1960s, many people in Mound Bayou and the surrounding area did not have clean drinking water or house plumbing.

At the time, the 12,000 black residents of northern Bolivar County, which includes Mound Bayou, faced an unemployment rate of up to 75% and lived on an average annual income of just $ 900, according to a congressional report in today’s US dollars). The infant mortality rate was nearly 60 per 1,000 live births – four times that of wealthy Americans.

Delta Health Center staff helped people insulate their homes. They built outhouse toilets and provided them with food, and sometimes even drove to the patients’ homes to take care of them when someone did not have transportation. Staff believed these factors also influenced health outcomes.

Williams, who later worked for Delta Health, said he wasn’t sure where the community would be today if the center didn’t exist.

“It’s terrifying to think about,” he said.

Half a century later, the Delta Health Center continues to provide accessible and affordable care in and around Mound Bayou.

Black southerners still face health barriers. In April 2020, at the start of the pandemic, nearly half of all COVID deaths in Alabama and over 70% in Louisiana and Mississippi were from black residents.

Last month’s public health data showed that black residents of these states were consistently more likely to die from COVID than residents of other races.

“We have many chronic health conditions here, especially in the Mississippi Delta, that lead to higher rates of complications and deaths from COVID,” said Nadia Bethley, a clinical psychologist at the center. “It was hard.”

The Delta Health Center has grown over the decades, from a few supporters in Mound Bayou to a chain of 18 clinics in five counties. We have succeeded in vaccinating over 5,500 people against COVID. The majority were black.

“We don’t have the National Guard standing in line out here running our side. It’s the people who work here, ”said Bethley.

The Mississippi Department of Health announced that it has been giving priority to health centers since it was launched. However, Delta Health CEO John Fairman said the center only received a few hundred doses a week in January and February. The offer became more constant in early March, center officials said.

“Many states would be much further ahead if they had used community health centers from the start,” said Fairman. Fairman said his center has had success with vaccination because of its longstanding relationships with local communities.

“Take advantage of the infrastructure that is already in place and has the trust of the community,” Fairman said.

That was the purpose of the health center movement in the first place, Smith said. He said states that have been slow to use health centers in adopting vaccines have made a mistake that has made it difficult to control COVID in the most vulnerable communities.

Smith called the slow spread of vaccines in rural health centers “an example of systemic racism that is ongoing”.

A Mississippi Department of Health spokesman said it was “obliged to provide vaccines to rural areas, but given the rural nature of Mississippi, this is a real challenge”.

Alan Morgan, CEO of the National Rural Health Association, said that early allocation of low doses to rural health clinics and community health centers “will cost lives.”

“With hospital stays and mortality rates much higher in rural communities, these states need to focus on the hot spots, which in many cases are these small towns,” Morgan said of the vaccination effort in Mississippi, Louisiana and Alabama.

A report by KFF found that people of color made up the majority of people vaccinated in community health centers and that the centers appear to vaccinate people at a rate similar to or higher than their proportion of the population. (The KHN newsroom that contributed to this story is an editorially independent program of the KFF.)

The report added that “greater involvement of health centers in federal, state and local vaccination efforts” could be a useful step in “advancing equality on a larger scale”.

Equitable access to health care in rural communities is necessary to reach the most vulnerable populations and is just as important during this global health crisis as it was in the 1960s, according to Smith.

“If health care improves for black people, it will improve for all Americans,” said Smith.

This story comes from a partnership that includes NPR, KHN, and the three broadcasters that make up the Gulf States newsroom: Mississippi Public Broadcasting; WBHM in Birmingham, Alabama; and WWNO in New Orleans.