In the 1960s, health care across the Mississippi Delta was sparse and much of it was segregated. 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 launched a movement of their own to address the care disparity.
“Mississippi was Third World and was so bad and so separated,” said Dr. Robert Smith. “The community health center movement was the conduit for physicians all over this country who believed that all people have a right to health care.”
In 1967, Smith helped start Delta Health Center, the country’s first rural community health center. They put the clinic in Mound Bayou, a small town in the heart of the Delta, in northwestern Mississippi. The center became a national model and is now one of nearly 1,400 such clinics across the country. These clinics, called federally qualified health centers, are a key resource in Mississippi, Louisiana and Alabama, where about 2 in 5 people live in rural areas. Throughout the U.S., about 1 in 5 people live in rural areas.
The COVID-19 pandemic has only exacerbated the challenges facing rural health care, such as lack of broadband internet access and limited public transportation. For much of the vaccine rollout, those barriers have made it difficult for providers, like community health centers, to get shots into the arms of their patients.
“I just assumed that [the vaccine] would flow like water, but we really had to pry open the door to get access to it,” said Smith, who still practices family medicine in Mississippi.
Mound Bayou was founded by formerly enslaved people, many of whom became farmers.
The once-thriving downtown was home to some of the first Black-owned businesses in the state. Today the town is dotted with shuttered or rundown banks, hotels and gas stations.
Mitch Williams grew up on a Mound Bayou farm in the 1930s and ’40s and spent long days working the soil.
“If you would cut yourself, they wouldn’t put no sutures in, no stitches in it. You wrapped it up and kept going,” Williams said.
When Delta Health Center started operations in 1967, it was explicitly for all residents of all races — and free to those who needed financial help.
Williams, 85, was one of its first patients.
“They were seeing patients in the local churches. They had mobile units. I had never seen that kind of comprehensive care,” he said.
Residents really needed it. In the 1960s, many people in Mound Bayou and the surrounding area didn’t have clean drinking water or indoor plumbing.
At the time, the 12,000 Black residents of northern Bolivar County, which includes Mound Bayou, faced unemployment rates as high as 75% and lived on a median annual income of just $900 (around $7,500 in today’s dollars), according to a congressional report. The infant mortality rate was close to 60 for every 1,000 live births — four times the rate for affluent Americans.