Out in the Rural: A Mississippi Health Center and Its War on Poverty

New Book Chronicles and Celebrates the History of the Nation’s First Rural Community Health Center in the Mississippi Delta

In Out in the Rural: A Mississippi Health Center and Its War on Poverty, historian Dr. Thomas J. Ward Jr., professor and chair of the History Department at Spring Hill College (Mobile, Alabama) explores the origins of the community health center movement through the story of the Tufts-Delta Health Center in Mound Bayou, Mississippi. Pioneering activists Dr. H. Jack Geiger, Dr. John W. Hatch, Dr. L.C. Dorsey, Dr. Andrew B. James, and others founded the center in 1966 to improve health and health care for the region’s rural poor, the majority of whom were black sharecroppers and their families who had lived without any medical resources for generations. Dr. Ward explains how these activists, working with grant funds secured by Tufts University from the federal Office of Economic Opportunity, led “a radical assault on both the medical and the social status quo.” Where other works on the health center movement have focused primarily on community health centers in a broader context, Ward instead meticulously documents all the work that went into starting America’s first rural community health center and details how the center, deep in Bolivar County, helped set the blueprint for those that followed.

The center’s founders were deeply concerned with how the social determinants of health - reflected in entrenched poverty, malnutrition, few educational opportunities, poor sanitation, and inadequate housing - affected the community. Building on Dr. Geiger’s experience in South Africa during his training, they sought to create a comprehensive center that would provide much more than just basic medical services. To do this, they needed to understand the issues that the community members themselves found the most pressing. In an interview with Publishers Weekly Dr. Ward describes how Dr. Hatch, recruited away from a job in Boston, came to Mississippi with Geiger and worked to set up local health associations to understand the priorities of the area’s residents. By listening to the community members’ concerns, Hatch learned that the main issues facing the community were the lack of food and a need for elder care.

Indeed, as they learned that hunger was widespread and malnutrition rampant, Dr. Geiger and Dr. Hatch decided that “wherever we saw [malnourished] children...we would provide them with food...by writing them a prescription for food.” They made a deal with ten grocery stores in northern Bolivar County, which in turn filled the food “prescriptions” and billed the health center for reimbursement. When the center attempted to recoup these costs as pharmacy expenses under its grant, it was initially rebuffed, but Dr. Geiger countered, “the last time we looked in the book for specific therapy for malnutrition, it was food.” A farm co-op was set up part of the health center’s core programs. To help advocate for the needs of elderly community members, they established the position of Coordinator of Services to the Elderly and hired a local woman, Pearlie B. Robinson, or “Miss Pearlie B.” who became an important activist.   

With this deliberate, locally focused, problem solving approach, the founding team created a health center that “challenged the racial, social, and class systems of Mississippi with its mission to empower the poor and dispossessed through community engagement.” The Tufts-Delta Health Center began to make inroads, gaining the trust of the community and improving the quality of life for local residents.  Fifty years later, what is now known as the Delta Health Center operates six locations and in 2014  opened a state-of-the-art flagship site in Mound Bayou, named in honor of Dr. H. Jack Geiger.

Alongside the Delta Health Center, more than 1,400 community health centers today provide comprehensive care at nearly 10,000 sites across the county. Moreover, at each site, the groundbreaking model established at Mound Bayou and its sister health center in Dorchester endures. Out in the Rural is important not only for what it tells us about the past, but for what it suggests for the future – a continued need to focus on equity, local needs and community engagement as the cornerstone for improved health.