Bridging Access:

Across rural America, communities of color may be facing barriers to health care, but they’re also laying the groundwork for a more equitable future. Whether it’s hospitals reopening, a community’s holistic approach to maternal care, or the grassroots work to bring comprehensive  services to immigrants, these stories offer a road map. This story is part of a collaborative reporting effort led by the Institute for Nonprofit News’ Rural News Network, with visual support from CatchLight.  Photo credits: Ariel Cobbert and Aallyah Wright.

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BROWNSVILLE, Tenn. — On a late evening in 1986, sharp pains hit Alma Jean Thomas-Carney’s stomach like lightning.

Days earlier, she’d just returned home to Brownsville, after dancing all weekend at her high school reunion hundreds of miles away in Illinois. Maybe that’s where the pain originated, she thought.

She cried profusely to her husband to take her to a hospital. But not the local Haywood Park Community Hospital, a 62-bed facility built in 1974.

“Please don’t take me up there. Don’t take me up there,” she pleaded. He rushed her to the car and drove to Jackson, Tennessee, nearly 40 miles away.

When she arrived at the hospital in Jackson, she underwent exploratory surgery. They found cysts on her ovaries, a diagnosis she says she wouldn’t have gotten at Haywood Park.

“I didn’t trust I would get the proper care or care that would help me to survive,” she told Capital B.

Years prior, she experienced an unwelcoming environment from white staffers, including doctors, at Haywood Park. Upon entry, she’d walk to the reception desk, only to be ignored or met with unpleasant looks. 

“They acted like you were invisible,” she said. “Whether they were talking or drinking coffee, they kept doing whatever they were doing and didn’t pay attention to you.”

Haywood Park’s reputation deteriorated over the years. Some residents voluntarily drove elsewhere if they could, or went without critical care, which contributed to low patient volume. Many more reasons, such as financial instability, resulted in its ultimate demise.

The hospital closed in 2014, after a long, slow decline. But, the news saddened the community, including Thomas-Carney. “Despite my ill-feelings or experiences I had in that environment … you have indigent people living in Haywood County who need to get to the closest facility available.”

From 1990 to 2020, 334 rural hospitals have closed across 47 states, which disproportionately affect areas with higher populations of Black and Hispanic people. Since 2011, hospital closures have outnumbered new hospital openings. In Brownsville, they’ve been able to do the impossible: reopen a full-service hospital. They’re not the only ones. 

Less than three hours away in the heart of the Mississippi Delta, leaders in Marks reopened their facility in 2021, after a five-year shutdown. In neighboring Georgia, county officials received millions in congressional funding to reopen their hospital in Cuthbert, which closed in 2020. Currently, they’re researching what model is feasible for their town. 

When a rural hospital closes, there’s usually no turning back. Yet, Brownsville became an outlier two years ago and is part of a growing but short list of hospitals in rural counties that have been able to fully reopen. What’s happening in this 68% Black town of 9,700 people is quite uncommon, health experts say. Usually hospitals cut back or reduce services, such as obstetric departments, to keep their doors open. The most recent alternative to prevent closures include the Rural Emergency Hospital designation, a new model established in 2020 that eliminates in-patient beds but keeps an emergency department in order to receive a boost in federal support. At least 29 rural hospitals have converted to rural emergency hospitals, according to Becker’s Hospital Review.

While this is a fix for some, it may not be the most viable for others, experts say. 

“Once you’ve seen one rural community, you’ve seen one rural community; they’re very different. We understand that not every rural hospital that is struggling will benefit or will want to convert to this rural emergency hospital,” said Shannon Wu, senior associate director of payment policy at the American Hospital Association. “We see this as a tool in a toolbox for those that fit their community needs.”

Why the distrust runs deep 

Thomas-Carney lost faith in the local health system long before the establishment of Haywood Park 50 years ago.

As a kid, she witnessed her grandmother lying in a hospital bed in the basement of the Haywood County Memorial Hospital, a 30-bed facility built in 1930 during Jim Crow. Steel pipes followed the linings of the walls. The sounds of steam echoed in her ears.

“I just remember looking around, and it didn’t look like nothin’ that I had seen in a book about a hospital,” she explained. 

Thomas-Carney’s grandmother’s experience was not uncommon, as most Southern, white-run hospitals refused to accept Black patients. The few that did placed them “on inferior Black wards, often in the basement, and usually with no separation by disease process,” writes historian Karen Kruse Thomas. 

Kruse Thomas details how prior to World War II, hospitals in the South were racially separate and Black patients mostly went to all-Black hospitals, if they had one. Few and far between, Black hospitals were unaccredited, underequipped, and struggling to remain open. 

In the 1940s, the federal government began to address hospital segregation through the Hospital Survey and Construction Act, known as the Hill-Burton Act. At the time, the South had the highest population of Black folks with the worst rates of morbidity and mortality. In 1938, the surgeon general called the South “the number one health problem in the nation.”

Today, the health disparities can be described the same. 

Black people still experience higher rates of disease, chronic illnesses, and mortality in comparison to their urban counterparts. In Tennessee, Haywood County has higher percentages of adult diabetes, obesity, and overall poor health in comparison to the state and national averages. 

Unfortunately, where you live dictates your health and the type of access you have.

Only recently did a study in the National Library of Medicine distinctly spell out that structural racism — in addition to poverty, education, and environmental conditions — is a major contributor to why such health disparities continue to persist.  

“In rural areas, especially in the South, it is important to understand how institutional policies, such as the Jim Crow laws that segregated hospitals and neighborhoods, led to differences in resource allocation between white populations and nonwhite populations, which may impact healthcare access today,” the study’s authors noted. 

Greta Sanders, a Brownsville resident, recalled how Eva Rawls, a Black registered nurse who worked at Haywood County hospital, was forced to work under the supervision of white women who were licensed practical nurses, even though she was the superior.

That hospital closed in 1974, the same year Haywood Park opened.  

“When [the new owners] found out that a registered nurse was working underneath the LPNs, they were just blown away,” said Sanders, a retired lab technician who worked at Haywood Park. “When the white LPNs had to start working under her supervision …  they did not like it.” 

Advocacy for critical and preventive care isn’t enough

Many residents in Brownsville — the birthplace of the Queen of Rock ‘n’ Roll, Tina Turner — have received life-saving care at the local hospital. 

One of those people: the wife of John Ashworth, a local civil rights activist and historian who co-runs the Dunbar Carver Museum with Thomas-Carney. Some time ago, Ashworth’s wife got stung by a bee. By the time she arrived at Haywood Park, her blood pressure was extremely high. They immediately admitted her and stabilized her.

“I have mixed emotions, but I really think it was a good hospital,” Ashworth said. “I am absolutely convinced that my wife would not be alive today if that hospital had not been there at the time.”

Ashworth believes some deaths could have been prevented had the hospital been open. 

Fed up with the poor health outcomes in his community, William “Bill” Rawls Jr. ran for office. He became the first Black mayor in Brownsville in 2014. Before he could celebrate the win, the hospital closed its doors for good. 

So, he thought.

Rawls set out on a mission to work with Michael Banks, a local attorney, and county officials to bring back the hospital. Like many small towns, the train tracks here still represent a divide, a symbol of racial segregation.

While Banks worked to find quality suitors for the hospital, Rawls started the Healthy Moves Initiative, a health education and preventive care effort. He hosted health fairs, quarterly free wellness screenings, built walking trails and a dog park, and created a farmer’s market. But, it didn’t create the impact he’d hoped for. 

It’s still a work in progress, he says, but the challenge is getting more participation.

Two years after Brownsville lost its hospital, Marks, a small town in the Mississippi Delta, did, too. The closure of the only critical access hospital in Quitman County resulted in the loss of 100 jobs. Similar to Brownsville, limited health care access resulted in longer waits to receive emergency and medical assistance.

Six months later, the Black town of 1,600 people lost its only grocery store.

During this time, Velma Benson-Wilson returned to her hometown after 20 years in Jackson, Tennessee. It started as frequent trips to conduct research to write What’s In The Water?, a tribute to her mother. She stayed a bit longer to work as a consultant on cultural tourism for the county, particularly the construction of the Amtrak project and memorializing the history of the Mule Train, which kicked off the late Martin Luther King Jr.’s Poor People’s Campaign.

But, the health crisis and food desert in Marks motivated her to dig deeper. 

Wilson became the Quitman county administrator, the first Black person and female to serve in the position. After she helped close the Amtrak deal in 2018, she turned her focus to the hospital and worked with the county supervisors to find a solution.

After working to save a hospital in Holly Springs, roughly 90 minutes from Marks, Quinten Whitwell, an attorney from Oxford, and Dr. Kenneth Williams, a Black physician, launched Progressive Health Group to keep rural hospitals from closure across the South. 

Five years after the Marks hospital closed in 2016, its Certificate of Need was set to expire. The legal document was required to reopen, establish or construct a health facility.

Whitwell, in quarantine, worked with his team on a plan to get it approved by the state.

Manuel Killebrew, president of the Quitman County Board of Supervisors, said that state Democratic Sen. Robert Jackson passed legislation to help reopen the hospital. Soon after, in 2021, the county supervisors voted to reopen the hospital in partnership with nearby Panola Medical Center in Batesville, Mississippi. The county gave Whitwell’s group a loan, and Citizen Banks of Marks gave a $1 million donation to reopen the facility as Progressive Health of Marks, a critical access hospital. The same year, a local entrepreneur opened a new grocery store across the street from the hospital.

The hospital has a walk-in clinic, emergency room, radiology department, and several other services, such as telehealth, according to Mejilda Spearman, the administrator for the Quitman hospital. They currently have four in-patient beds and are currently renovating their senior care unit. They’ve hired fewer than 50 people. While they’ve seen a steady increase in patients since, they still struggle to get community support. 

But, some residents still aren’t satisfied, Killebrew added.

“There’s still people who gripe, but the hospital here is the closest place to get medical treatment,” he said. “If one of their loved ones were shot or had a heart attack, they get here, and at least they’ll survive.”

A Georgia community gets a second chance

Despite low support in Marks and Brownsville for a hospital, residents in Cuthbert, Georgia, have prayed for more health care options in their predominantly Black community of fewer than 3,100 people.

The Southwest Georgia Regional Hospital in Cuthbert, the county’s only hospital, closed at the height of the COVID-19 pandemic due to increased costs from aging infrastructure and underinsured and uninsured patients. Officials added that the inaction of Medicaid expansion in Georgia also contributed to the closure in Randolph County, which is majority Black. 

Before the hospital closed, some uninsured residents relied on the emergency room for primary care. Now for emergencies or other care, many travel 30 minutes to Eufaula, Alabama, or nearly an hour to Albany, Georgia, said Cuthbert Mayor Bobby Jenkins. 

Minnie Lewis, a retired educator, travels to Albany and Columbus frequently for appointments and would love to eliminate the additional time it takes for roundtrips there.

“In fact, I just had a health scare, but I had to go to have a CT scan there. Then I had to go to Sylvester [Georgia] to a hospital there because they didn’t have enough space there for me for that particular thing,” she said. “I would have had that CT scan right here in Cuthbert, if it was open.”

When the hospital closed, the doctors left, too. Until about a year ago, the town had no doctors, despite Care Connect, an urgent care clinic, opening immediately after the hospital closed in 2020. Jenkins and residents hope the draw of a hospital will bring more jobs, affordable housing, and food options into the town, which is racially divided.

“With the white there and the Black here, you can’t get nothin’ done. We don’t go to church together, but at least we can have some common ground when it comes to the community and for the betterment of all the citizens,” said Cuthbert council member Sandra Willis. 

The hospital is the only issue that they’re united on, she says. The majority Black county commissioners, all-Black city council, and Randolph County Housing Authority have worked together to figure out a solution.

They’ve been able to get the attention of their state and federal officials. After four years, they have a plan.

Earlier this year, U.S. Rep. Sanford Bishop and Sens. John Ossoff and Raphael Warnock requested congressional earmarks to develop and reopen Southwest Regional. They secured more $4 million from the USDA Community Facilities Program and more than $2 million from HUD for the Randolph County Hospital Authority to move forward, according to a spokesperson in Bishop’s office.

There’s no date for when a hospital, or some version of it, will be reopened in Cuthbert. Will critical access, rural emergency hospital, or freestanding emergency department work best? County officials contracted with a third-party to conduct a feasibility study to decide what route to go with the hospital.

“What we hope is to have an emergency room so we can get ‘em stabilized,” State Rep. Gerald Greene said in a phone call. “We’re hoping this is going to work, but we’ll have some [inpatient] rooms. That’s our plan.” 

‘True systemic change is a grassroots effort’

In Brownsville, it took six years to find a solution. In attorney Banks’ eyes, it was all “pure luck.”

On a recent tour of the hospital, Banks — who is now CEO of Haywood County Community Hospital — pointed out a bed that displayed colorful LED lights with symbols, advanced technology that checks oxygen levels, weight, and heart rates.

“If a [patient] gets too close to the edge, the alarm goes off. So, the nurse at night – rather than waking someone up – they can come out and look at those lights.”

He credits Braden Health, the hospital management group that took over the hospital. As counsel for Haywood County, Banks would take prospective buyers on “a tour with a flashlight” because the building was boarded up. None of the deals panned out — until 2020 when they met Dr. Beau Braden, an emergency medicine specialist and co-founder of Braden Health. The county officials agreed that Braden Health could take if they improved the property and ran the facility as a full service hospital. 

Two years later, they reopened Haywood Park Community Hospital, under a new name: Haywood County Community Hospital. They downsized to nine in-patient rooms and have a staff of 80 employees, all from Brownsville or neighboring communities.

In addition to an emergency room, they have an urgent care walk-in clinic, pharmacy, mammography, ultrasound, and radiology department. Despite the new infrastructure and quality, Banks averages about five patients a day, and about 25 patients in the ER. But, there have been times when they’ve had to send patients to other facilities because they are full, he said.

Residents stop by often for the handprint ceramic tile wall in the main entrance of the hospital. In the 1990s and early 2000s, kids in Brownsville painted these tiles. Many people come back to find their handprint. They built a conference room so local organizations can meet. They also eat at Annie Mae’s Cafe, a soul food restaurant in the hospital named after Tina Turner and run by two local cooks who lost their restaurant during the pandemic. 

Banks, the mayor and residents, are optimistic about the hospital’s future. In fact, they’re planning to expand, adding things like a physical therapy section. They expect more traffic, especially with the opening of Ford’s Blue Oval mega facility.

“Ever since we opened the inpatient side, we’re breaking even. We’re profitable and growing more every month,” Banks said. “Even if Brownsville stayed the size it was, we’d be fine.”

Staying on top of the accounting, rural health-related policies and regulations, and making sure insurance providers pay is the key to being sustainable, Banks says. 

Beyond federal dollars, there’s a need to expand Medicaid, increase Medicare payments, and incentivize health care professionals to work in rural areas, rural health experts say. They also advocate for health equity, specifically on better pay systems for rural hospitals and ensuring those investments focus on communities that have “faced historical and contemporary challenges of racism.”

Ultimately, everyone has to work together — government officials, local agencies and the residents.

“People are dying. Not because the hospital is there or not there. It’s because we’ve not taken control. We’re accepting a lesser quality of life and a shorter life expectancy,” Rawls said. “True systemic change is a grassroots effort, but you will need people from the top pushing legislation that’s going to allow rural hospitals to survive or reopen.”

The post Healing a Dark Past: The Long Road to Reopening Hospitals in the Rural South appeared first on Capital B News.

Patrick Braxton is overwhelmed with gratitude.

He’s been juggling a yearslong legal battle to serve as the lawful mayor of his hometown, Newbern, Alabama. After years of harassment, his rural town enters a new chapter: Its first Black mayor will finally get to serve. 

Braxton will be reinstated as mayor of Newbern, according to a proposed settlement reached on June 21. The settlement awaits the signature of U.S. District Judge Kristi K. DuBose. After 60 years of no elections, residents will get to exercise their right to vote. The town has also pledged to hold regular municipal elections beginning in 2025.

In nearly a year since Capital B was among the first to report on Braxton’s fight, he has garnered support locally and nationally.

On a recent morning in May, he traveled nearly three hours from his hometown to Mobile for a preliminary injunction hearing, asking the courts to demand the town hold regular elections in November.

When he and his council members arrived, they were met by a busload of more than 30 residents who also traveled nearly three hours to showcase their support.

In 2020, Braxton became the first Black mayor in Newbern and experienced harassment and intimidation for doing so. However, the previous majority-white town council blocked him from the post.

He and his council filed a federal civil rights lawsuit against them in 2022 for conspiring to deny his civil rights and position because of his race, challenging the racially discriminatory voting and electoral practices in Newbern in the process, Capital B previously reported. 

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Read More: A Black Man Was Elected Mayor in Rural Alabama, but the White Town Leaders Won’t Let Him Serve

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For at least 60 years, there’s been no elections in this 80% Black town of fewer than 200 people, which Braxton’s attorneys argued is a violation of Section 2 of the Voting Rights Act and due process under the Fourteenth Amendment. The Act provides an avenue to challenge states and jurisdictions using racially discriminatory voting policies.

Since 2020, when Braxton ran for mayor, he says some white residents have moved away.

Though the court denied the request to hold an election in November, Braxton didn’t feel defeated. In fact, he felt optimistic.

“I knew I was gonna be able to serve again, you know,” he told Capital B in a phone call last week. “It’s just how long it was gonna take for us to get some kind of resolution first for this.”

This week, that long overdue resolution came.

When he received the news that he’d get reinstated, Braxton shared it with his pastor, who exclaimed, “Finally. It’s been a long time coming. You know if you pray, change will come.”

This win in Newbern is important because it shows citizens nationwide can still use the courts to be heard, despite the attacks on the Voting Rights Act, said Morenike Fajana, co-counsel on the case and senior counsel at the NAACP Legal Defense & Educational Fund Inc. 

“It’s important just to highlight Mayor Braxton’s tenacity, and the fact that this is a four-year battle that he’s had to fight in different courts and at different levels — and now finally, a court is going to say, ‘Yes, we agree. You were wronged. And you were the mayor,’” Fajana told Capital B. “I think that is very inspirational and important. And it’s also very sobering, just the amount of work that it takes and time that it takes to have your rights vindicated.” 

Setbacks, frustration, and the will to keep fighting

For the past few years, it’s been a heap of long nights and early mornings for Braxton, a volunteer firefighter for years.

Not only was he locked out of the town hall and forced to fight fires alone, but he was also followed by a drone and denied access to the town’s mail and financial accounts, he told Capital B last year. Rather than concede, Haywood “Woody” Stokes III, the former white mayor, and his council members reappointed themselves to their positions after ordering a special election that no one knew about. 

“It hurt my heart because I couldn’t do what I wanted to do,” Braxton said. “We had some plans to do some work in Newbern. … It might not have been the time for us to do it.”

The setback didn’t stop him, he said. He’s hosted several community events for the youth and the town’s elders. Two months ago, he used his personal funds to feed more than 125 people at his church, First Baptist. This week, he helped plan a Fun Day Out, a type of summer reading program, at the local library. 

He’s also been working overtime to build a racially diverse city council amid the lawsuit. He wakes up early in the morning, knocking on doors and “running down people” to talk to him. In 2020, no white person seemed interested. 

That has changed. 

He will submit his list of interim council members to Alabama Gov. Kay Ivey for confirmation. If the governor does not affirm the positions, she must notify the Hale County probate judge to declare a special election, which Braxton will administer, the settlement states.

One of those people: his “ride or die” Janice Quarles, a Newbern native and plaintiff who volunteered to serve on Braxton’s council in 2020.

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Read More: How Some States Are Responding to the Worst Attack on Voting Rights in Decades

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The most stressful part of this journey for Quarles has been finding adequate legal representation and a listening ear to hear their concerns. 

“It seemed as if we weren’t moving. It seemed to me as if we weren’t being heard,” Quarles said. “By being from such a small little town, I kind of felt like we weren’t getting enough attention. But eventually, we kept pushing and got into the courts.”

With the recent news, she is beyond “elated” and hopeful it will bring together the community across racial lines.

“We don’t do a lot of integrating. We don’t do too many things together. But I just feel that it’s gonna be a change because sometimes it has to work on both sides,” Quarles said. “I’m just filled with joy because … there always comes a time for change — everywhere in every country, every state, every city. And now the time has come for us here in Newbern.”

While this chapter is closed, the fight is not over, Braxton said. He’s hoping his journey will inspire others.

“Like I told the pastor, I’m not fighting for myself,” Braxton said. “I’m fighting for all the younger generations coming up behind me. They can do the same thing and be successful in this town. You don’t have to move away from your hometown just to accomplish something. We finally got the door open for me, so y’all can come in. I don’t want to hold this seat forever.”

The post After Years of Litigation, First Black Mayor in Rural Alabama Town Gets to Serve appeared first on Capital B News.

Ben Brubaker, a row crop farmer on Comer Road, said this summer’s prolonged heat and drought have substantially impacted his day-to-day operations.

“We’ve been having to run irrigation pretty much around the clock to just try to stay ahead of the heat and lack of rain,” he said. “What’s called (our) dry land, basically the land that doesn’t have irrigation, has just been withering up to nothing, essentially.”

There has been a concerted effort by the Trump and Biden presidential campaigns to woo the Black vote during recent efforts in metro Atlanta, other Georgia cities.

The Current is an inclusive nonprofit, non-partisan news organization providing in-depth watchdog journalism for Savannah and Coastal Georgia’s communities.

Voter turnout is highest when a future president is on a November ballot and is consistently lower for all other elections. 

The Current is an inclusive nonprofit, non-partisan news organization providing in-depth watchdog journalism for Savannah and Coastal Georgia’s communities.

Marquitrice Mangham never imagined that she’d open a grocery store in her hometown of Webb, Mississippi. 

She left in the 1990s after high school. But in 2016, she inherited her family’s farm, splitting her time between the majority-Black town of fewer than 500 people in the rural Delta and her current home in Atlanta.

Webb had changed considerably and was regressing, she said. Businesses had closed, and the housing situation got worse — but the food desert still had a Dollar General. Like many counties across the Delta region, Tallahatchie County, where Webb is, is situated in a food desert. Though the town has had the Dollar General since 2009, it only provided frozen and processed foods. Here, the residents never had a grocery store, forcing many to travel more than 20 miles to the nearest one.

Mangham, a military veteran and planning expert, saw a solution. In October 2022, she opened Farmacy Marketplace, a 2,500-square-foot neighborhood grocery store that sells fresh foods and meats sourced mostly from local farmers. Instead of the traditional for-profit store, she used a different model: her nonprofit, In Her Shoes, works at the intersection of farming and food access. 

Mangham is one of many Black entrepreneurs nationwide working to improve health outcomes and food accessibility in rural communities or Black neighborhoods. And as hundreds of dollar stores are closing, more Black entrepreneurs are opening grocery stores anyway — whether it’s Neighborhood Grocery in Detroit, All-In Grocers in Waterloo, Iowa, or Sherman Park Grocery in Milwaukee. 

Research shows that when dollar stores show up in communities — particularly areas that are low-income, rural, and Black — it results in grocery store closure, job loss, and declining sales. From 2000 to 2019, grocery stores experienced a nearly 6% decrease in sales, 4% decline in employment and 2% increase in grocery stores closing. The outcomes are three times larger in rural areas than urban areas, according to new research released by the United States Department of Agriculture Economic Research Service. These negative impacts waned after five years in urban areas. In rural areas, however, the effects continued.

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Read More: The Movement to Stop Dollar Stores from Suffocating Black Communities

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Back in Webb, only a few weeks before Farmacy opened its doors, the Dollar General caught fire and closed down, which served as an opportunity for Mangham to offer household items in the store, too. The dollar store has since reopened.

Opening a grocery store isn’t the only, or best, solution to address the root causes of food insecurity, she said. Affordability, transportation, and lack of education create additional barriers to healthy lifestyles. Mangham is looking to do more: drive a mobile produce truck to other towns and provide financial incentives to encourage families to buy more fruits and vegetables, through programs such as Double Up Food Bucks. It allows people who receive SNAP benefits to earn up to $20 a day when they buy fruits and vegetables.

But what does it really take to open a local grocery store? 

Capital B wanted to understand more about the challenges, the benefits beyond Mangham’s community, and her plans for the future. The conversation has been lightly edited for length and clarity.

Capital B: Why a grocery store? How did you get into this work?

Marquitrice Mangham: There was only one grocery store in the whole county, and that was 15 to 17 miles away from most residents in the county, and some even farther. In Her Shoes, we work closely with farmers and help them to grow their business or at least sustain their business over time. One of the biggest ways to help them is to access markets. We work with farmers who are growing but not able to reach those populations that need it … because the populations are sparsely populated, everything is stretched out over 600 square miles. They’re throwing their hard-earned food away because it’s rotting, meeting its shelf life prior to them actually being able to sell it or reach people who want to buy it. The grocery store was the answer to a number of things.

Why a nonprofit model?

We decided to do it under the In Her Shoes Inc. umbrella or do it as a part of our nonprofit because over time, we felt that it would be more sustainable. There are a lot of resources out there to help address food access. There’s a lot of resources out there to help farmers, so we felt by doing it as a nonprofit, if the sales were short or [there were] issues with trying to maintain over time, there were other programs or resources that would help us to be able to sustain the store longer. Fortunately for us, we’ve been able to sustain ourselves even though there is a dollar store in the community.

What are some of the challenges or startup costs you’ve experienced since opening?

We bought the brick-and-mortar store a year or so prior. We applied for a grant to buy the equipment to do some renovations and upgrades to the mechanicals. It took us maybe four or five months to make the renovations and upgrades.

Most of these wholesale vendors require you to order a minimum amount each week, and if you’re not selling it you can’t buy it — having to order $10,000 or $20,000 a week just to maintain your vendor. That alone would shut down a lot of smaller community grocery stores. Just the overhead outside of that is fairly steep when you’re talking about refrigeration and coolers, electricity and other things. So the price tag not only starts up, but the ongoing or monthly price can get pretty extensive. You’re looking at your small, independent store, so you’re not getting your products at the price that a chain retailer gets. 

Not only are you having to buy more, but you’re having to sell at a higher price because you don’t get the discounts. You don’t have the amount of sales volume that the Family Dollar or the Dollar Generals have, and they’re buying in bulk for hundreds of stores at a time. There are a lot of challenges that we saw in the beginning. 

As far as variety, we have a national wholesale distributor, and we partner with them. They helped us out a lot with relaxing some of their standards to be able to allow us to partner with them and supply our grocery store. For us, the best outlet was to basically open under the nonprofit and do it as economically as possible. 

What should people take into account before going on this journey? Are there alternatives to a grocery store?

After opening Farmacy Marketplace, I’m getting quite a few requests from other local governments and other entities to help build a grocery store in their community. I’m doing the research to see if it’s doable, and if it’s economically feasible over time. Every community is just not able to support a standalone grocery store over time, not as a business. It may be more sustainable as a nonprofit. 

Most elderly people, most people, are going to go to the local pharmacy. You could partner with a local pharmacist to offer a food display for fresh fruits and vegetables. That’s one of the reasons why we’re called Farmacy Marketplace because it’s good, healthy food options that promote good health. Rather than building a brick-and-mortar building, look at those retailers that people visit that are already in place that you may be able to partner with. 

We looked at gas stations and other stores that are existing that we may be able to partner with and make some upgrades to their electrical and plumbing to offer what I call fresh food kiosks, and in those outlets they already have the consumers that are visiting out of necessity or easy access. Why not put a refrigerated display case with fresh fruits and vegetables and some meat options?

Try and address the issue with what’s there, meet people where they are, and build up to that. The idea isn’t to just have a brick-and-mortar. The idea isn’t to just build a grocery store. The idea or the hope is to provide fresh food access in whatever form that might be.

The post Dollar Stores Force Local Grocery Stores to Close. This Woman Opened One Anyway. appeared first on Capital B News.

After a sharp rise in the number of women dying in childbirth, which was likely due to the COVID-19 pandemic, new data shows that the mortality rate is returning to pre-coronavirus levels and the racial disparities in who’s most likely to die remain. 

The rate for 2022 was 22.3 deaths per 100,000 live births, a significant dip from the surge in 2021 that hit 32.9, according to the report, published Thursday by the CDC’s National Center for Health Statistics. For Black women, the rate decreased the most among racial groups, lowering from 69.9 to 49.5. 

Still, the numbers are concerning experts who say, despite the decline, the U.S. maternal mortality rate is far worse than other high-income countries. 

“We’re leveling back out to where we were, which is still abysmal,” said Jennie Joseph, a British-trained midwife and founder of Commonsense Childbirth Inc. According to the report, 817 women died due to maternal health causes in 2022, compared with 1,205 in 2021, 861 in 2020, 754 in 2019 and 658 in 2018.

Without another year of data, it’s hard to draw any conclusions about whether 2022’s dip truly indicates a nationwide trend toward a steady decline in the number of deaths per year. It is possible, experts say, that some of the practices being put in place — like greater use of midwives and doulas and increased awareness about systemic racism — could be starting to scratch the surface of widespread impact. But, most experts speculate that the trends in the last few years are COVID-related, and that we’re now starting to see a return to the rates that persisted before the virus devastated communities across the country. 

Without another year of data to show the true, long-term trajectory of the maternal mortality rate, officials are hesitant to make assumptions and worry that this slight dip could convince folks that the crisis is less dire than it is. More years of data will offer more context and reveal additional patterns.

“I’m hoping 2021 is the worst we will see,” said Dr. Ndidiamaka Amutah-Onukagha, the founder and director of the MOTHER Lab at Tufts University, whose mission is to eliminate the racial disparities Black women face in childbirth. There’s a lot that will be affecting the statistics we see in the years to come, she said, from the 2022 U.S. Supreme Court decision that reversed the constitutional right to an abortion to rural hospital closures and OB-GYN shortages. 

Black women remain at least three times as likely to die due to pregnancy related causes compared to white women.

Nationwide trends are hard to pin down, said Tiffany Green, an associate professor at the University of Wisconsin-Madison focused on population health and obstetrics and gynecology. Conditions vary so much from state to state and the data tends to be relatively small. But what we know, she said, is that heart-related issues are the main cause of death related to pregnancy, childbirth, and postpartum. 

“There needs to be a big shift in how we talk about this,” said Green. A lot more focus should be on how we address preeclampsia and other disorders affecting the heart. Other top causes include mental health-related issues, like depression and substance use. By effectively addressing those underlying causes, we could see a significant reduction in deaths, she said.

For now, many experts are continuing to research and provide care for the families they work with without drawing too many conclusions about the most recently released data. 

“We don’t know until the next set of numbers come out,” said Joseph, the midwife. Still, “this death is preventable no matter which way we count them.”

The post The Maternal Mortality Rate Dipped For Black Women. The Reason Is Complicated. appeared first on Capital B News.

A feasibility study underway will help decide the new model for the facility. Randolph County lost its only hospital in 2020 after decades of it being in operation.

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