The Mississippi Delta, famous as the birthplace of the blues, also played a pivotal role in America’s healthcare history. In 1965, following the Freedom Summer of 1964, pioneering physicians and organizers inspired by the civil rights movement established the nation’s first rural Community Health Center in the Delta. Tufts-Delta Health Center became a model for improving healthcare in areas overlooked by mainstream medicine. And 60 years after Freedom Summer, in the fall of 2024, medical residents from Boston visited Mississippi to explore the legacy of civil rights activism, the influence of physicians as advocates, and the transformative impact of Community Health Centers on marginalized communities.
Dr. Cheryl R. Clark organized the Mississippi trip to provide residents in her “Leadership for Health Equity Pathway” program an opportunity to learn how structural changes can lead to more equitable healthcare. Clark is a physician researcher at Brigham and Women’s Hospital in Boston and executive director and senior vice president of the Institute for Health Equity Research Evaluation and Policy for the Massachusetts League of Community Health Centers.
Clark believes physicians who are going to practice medicine in settings like Community Health Centers should know the unique history of health center origins–this moment when the struggle for civil rights joined the cause of making healthcare a human right for all. Dr Clark explains:
It’s important, particularly for physicians who are going to practice medicine in health centers, to know this history. And to make sure that, as they embrace systemic change or systemic practices that support diverse populations, that they have this history so they can advance health equity as a part of their careers.
Dr. Cheryl R. Clark
Freedom Summer exposed physicians to glaring racial health disparities
In 1964, the effort to register African American residents of the South to vote culminated in Freedom Summer, with volunteers from around the country traveling to Mississippi and other southern states.
Fannie Lou Hamer, a civil rights leader born down the road from the health center, played a big part in organizing the hundreds of college students, Black and white, who answered the call to register voters. Clark and her students visited the Hamer memorial in Ruleville, MS. They also stopped at the nearby construction site of the future cancer center named after Hamer, who learned too late that she had stage 4 cancer.
Freddie White-Johnson, president of the Fannie Lou Hamer Cancer Center, founded the center to provide much-needed screening and treatment for cancer in the area, especially as Black women and Black men in the Delta face a disproportionately high risk of cancer.
From voting rights to equity in healthcare
Physicians from out of state also joined Freedom Summer, recruited by Dr. Robert Smith. They provided free healthcare to the volunteers, becoming the “medical arm of the civil rights movement.” While tending to the students and other activists, they saw first-hand the disparities in the healthcare system in the state, where Black Mississippians had limited access to care and received only substandard care when it was available.
After Freedom Summer, a group of these physicians, including Smith and Dr. Jack Geiger, convened to plan their next steps. They decided to prioritize the creation of neighborhood health centers, later known as Community Health Centers. Guided by Geiger’s belief in operating “with people, not for people,” these centers combined clinical care with public health initiatives and a patient-governed board. The centers would address not only medical needs but also the environmental, economic, and social drivers of health.
Geiger took the proposal to the federal government in Washington, DC, and secured funding for two demonstration projects, one in Boston and one in the South.
Later Geiger described the ambitious goals of the Community Health Center model in a documentary: “We have been able to enter and to do things under the general umbrella of health that would have been much harder to do if we’d said we were here for economic development or for social change per se.”
Mound Bayou selected as the location for the first rural health center
With assistance from Dr. John Hatch, a public health professional and community organizer working with Geiger, they selected Mound Bayou, MS, as the site for the southern health center.
After learning the history of Mound Bayou, it’s no surprise that it was chosen for the site of the first health center. Founded by formerly enslaved people, at one point Mound Bayou was the biggest all-Black town in America and became a haven from the racism of the Jim Crow South. It was a place where Black families and businesses could thrive.
The group of future doctors from Boston spent time learning about the town’s rich history at the Mound Bayou Museum of African American History and Culture. The small building houses an extensive collection of artifacts documenting the tremendous progress and prosperity the town achieved – a hospital, high-grade cotton production – despite the racism and white supremacy that threw up obstacles at every turn.
One of the residents behind the museum is 95-year-old former vice-mayor of Mound Bayou, Hermon Johnson, Sr., who was instrumental in locating the land for the Delta Health Center clinic. Johnson’s sons Hermon, Jr., and Darryl serve as the well-informed and engaging tour guides at the museum.
Hurdles to becoming the first rural health center
During their visit to the Mound Bayou Museum, Clark’s students learned the story behind the original name of the health center, the Tufts-Delta Health Center. The Mississippi governor and entire congressional delegation opposed the idea of building a health center in Mound Bayou (or anywhere in the state). The only way to prevent the governor from vetoing the federal funds needed to operate the health center was to align with a university, which was protected from the governor’s veto. Geiger’s colleague, Dr. Count Gibson of Tufts University, offered to sponsor the health center, along with the one in Boston.
When the Tufts-Delta Health Center finally opened, Hatch and Geiger quickly realized that environmental issues and nutrition were some of their patients’ biggest problems. In keeping with their commitment to improve the wellbeing of the entire community, they hired an environmental engineer to address the community’s need for clean water, building latrines and digging wells. Hatch started a farm co-op. And Geiger became famous for writing prescriptions for food, an early practitioner of the now-trendy “food as medicine” approach.
As described in the health center’s own history exhibit:
The right to health care was essentially an extension of the civil rights movement. The staff at the Center knew that so much more could be accomplished under the umbrella of ‘health care’ as opposed to ‘social change,’ but social change is what was needed to help in any lasting way.
Delta Health Center expanding to meet the growing needs of the community
Now known as the Delta Health Center, the organization has developed into a gleaming, modern facility with an ever-expanding roster of programs and services. With 17 clinics in the region, the health center offers a host of services, including physical therapy, wellness services, behavioral health, ob-gyn care, pediatric services, diabetes management, a pharmacy, and more.
One of the central features of the Community Health Center model is that the majority of the health center board members must be patients. Visiting the Mound Bayou Museum offers an acute reminder of how radical a notion this kind of community-directed healthcare was in a part of the country that viewed Black autonomy as a threat to the established order.
The Delta Health Center’s resilience and ongoing success highlight its vital role in both healthcare and community empowerment. Founded during a time of intense scrutiny and resistance toward initiatives aimed at uplifting African American communities, its thriving presence today is a testament to its adaptability and impact.
And the day before the internal medicine residents from Boston students visited, the health center held a voter registration drive, part of a robust civic engagement program the health center operates all year long.