Mississippi Today
Q&A: Harvard Chan’s Program Leadership weighs in on improving Mississippi’s public health
Reporter Pam Dankins spoke with Jocelyn Chu, director of the community engaged learning fellowships program at Harvard University, and Bizu Gelaye, program director for the Mississippi Delta Partnership in Public Health program at Harvard University, about the importance of Harvard T.H. Chan School of Public Health initiatives and its efforts to influence positive public health outcomes in the Mississippi Delta.
Through the Mississippi Delta Partnership in Public Health and the Winokur, Jr. Fellowship in Public Health for the Mississippi Delta, Harvard Chan’s faculty, staff and students have partnered with community-based and nonprofit organizations in Mississippi.
Several Harvard Chan students have worked closely in recent years with the Children’s Foundation of Mississippi, where they researched and helped draft a Blueprint for Improving the Future of Mississippi’s Children designed to offer suggestions to policy makers on how to make the biggest impact on the state’s children. Students also worked with Baby University, a free eight-week parenting course for Delta families with children under three years old.
Chu and Gelaye’s work focuses on fellowships that enable Harvard Chan School graduate schools to do field work in the Delta and working with local leaders on public health issues.
This Q&A has been edited for length and clarity.
Pam Dankins: How did Harvard Chan begin to form partnerships between its students and public health organizations in Mississippi?
Bizu Gelaye: I think Dean Williams was featured the last time in a Q&A, where she mentioned the long history that the school has with Mississippi partners. About five years ago, the school leadership decided to have a more comprehensive approach and to engage with collaborators in Mississippi in various forms. So both Jocelyn, myself and another faculty member had an opportunity to travel to Clarksdale to attend the Delta Regional Forum (an assembly aimed at engaging practitioners and scholars to work alongside Delta Region partners and learn about population health from each other).
After we came back, this idea of Mississippi Delta Partnership in Public Health was created, which has three large components, the first one being research collaboration. Not for Harvard faculty members to come and research on topics that interest them, but something that is beneficial, urgent, and priorities for folks in Mississippi and for our faculty members to add value to existing work that’s already happening in the Delta.
The second one is around mentoring and providing opportunities, particularly for pipeline programs. We haven’t had a sustained engagement, so the goal was to try and partner with existing programs. There was the Delta Summer Institute that provides training opportunities to students from around the Delta (to have) firsthand real applied experience of what it means to work with the community, on community engagement and different activities, but public health was not included. We felt this could be a nice opportunity for students from Mississippi to be part of a public health training that also provides them with sustained mentoring throughout their careers. And the last part is providing opportunities for our students who are really engaged in meaningful community-engaged learning activities. So it’s within those three broad opportunities or initiatives that we decided to create this partnership. And this Blueprint (for Improving the Future of Mississippi’s Children) is just one of the components.
Jocelyn Chu: Just to build upon what Bizu mentioned. It is a pretty comprehensive approach that it’s not just for students. It is thinking about engagement of faculty, engagement of students who are undergraduates or/and graduates who are in Mississippi or in the region. The work with the Children’s Foundation started through a conversation with its executive director, Linda Southward. When she was up in Boston back in November of 2019, and it just happened that we were sitting around a table and she talked about her organization and I said, “do you think you’d need any (Harvard public health) students to come alongside and work with you?” We found ourselves in the middle of a pandemic in the summer of 2020, so there were two students that started working with Linda and putting together what she called the first Blueprint for Children’s Health in Mississippi.
Dankins: Chu, you mentioned in a blog on the school’s site about how there’s this need to kind of shift our narratives when we go to different locations in Mississippi. So, what is Harvard Chan’s approach to reduce stigma and discrimination in healthcare settings, especially against marginalized populations?
Chu: That’s a really good question.
I think we’ve been talking a lot about shifting the narrative. After the first time we visited Clarksdale, and then we debriefed, we said there is something in what we experienced and the people that we met. There’s something there that we can learn from and learn more about. Oftentimes, I think in any institution, especially elite institutions, there’s an idea that we go and help or rescue. I want to bring back to school and to campus and into classrooms the idea that we hold a dominant story, a dominant narrative, but it’s an incomplete narrative. It’ll take, what I call proximity or going into the community and immersing ourselves. That’s why our fellowships bring students to a location, and they’re required to stay there for a six to eight week range.
There are many parts to a place. It is knowing and accepting that there is going to be complexity and contradictions that we will find. Now coming back and being in person, we’re hoping to be able to organize a series of conversations at the Chan School by bringing in speakers. We want to also have our students who were in Mississippi over the summer share their work. We have to continue having that exchange and continue to bring rural health and rural health equity into conversation at the school. I think we tread carefully and slowly and make sure that we are working alongside others and coming together as conveners and facilitators of conversations and learning.
Dankins: Right now we are focusing on adults, but how do you take those tools and practices and transfer that knowledge down to younger children in that age range of 0-18?
Gelaye: The more you generate evidence and you try to show that those are effective, I think the more people are going to be able to appreciate and say that okay, this works in this setting. We have to generate evidence but also change how we communicate the evidence. We have to bring the communication in ways where people can understand it, where people live, pray and eat. We have to use the tools of social media that young people are more likely to understand than our outdated means of communication, which is publishing in high-tier academic journals that nobody reads.
Chu: When you mentioned this, Pamela, I was just thinking about the young people that we got to interact with when we went to Clarksdale. I think it is putting the power and determination, sort of self determination, into the hands of young people. I think change is sort of shifting that power over to young people. They determine their future and invest in the communities that they are familiar with or that is their home, and they have the right to say something about it. Those projects that the Delta scholars embark on have lots of great potential, and they want to see change in so many different areas that determine health.
Dankins: Gelaye, what data through your research have you found that emphasizes why studying children, age 0-18 in Mississippi, health is important? Can you state them?
Gelaye: That’s a great question.
I don’t want to say just “children’s health” because I think when we say maternal and child health, the two are related to each other because pre-pregnancy health determines pregnancy outcomes and child health. A child who is born preterm, their long-term health outcomes is predestined, so to speak. It’s pre-programmed. A person who is born too early, which is often one of the biggest problems that we see in many counties in the Delta, which have the highest rates of preterm birth, will develop long-term complications in adulthood, including neurodevelopmental, cardiovascular outcomes, premature mortality, and all the health outcomes one can think of.
There are some incredible organizations that do a great job in Mississippi. One that I have recently learned, and I really appreciate their work, is MomMe. They provide postpartum services and mental health services in Mississippi. I think trying to capitalize on those initiatives supporting mothers better will, in turn, support the children. We have research that comes out of the Center on the Developing Child at Harvard University that the first 1,000 days are really critical for brain and health development of a child. They’re set up for life based on what is provided in those sensitive or critical periods in the first five years. By just looking at one aspect, we may not necessarily be able to appreciate the complexities that exist in the living environment, in the ecosystem that affect both maternal and child health.
Dankins: Are there any future initiatives or research projects in the making to continue Harvard Chan’s efforts in improving public health?
Chu: Hopefully, we’re going to be hosting some conversation seminars in the fall that include our students that were in the field or in Mississippi for the summer and bringing in some speakers. In November, we’re hosting the undergrad Delta scholars (undergraduate students who a committee of community partners and respective academic institutions selects from schools across the US to participate in a summer program of research and projects in Mississippi) that are coming up to Boston which will be another chance to bring the work into the school community.
Gelaye: With research, one is Jackson State University as a lead institution in collaboration with the Mississippi State Department of Health, Harvard and a few other collaborators that are about to get funding from the National Institute of Child Health and Development (NICHD) trying to create a center of excellence for maternal health research. So we’re looking forward to participating in that effort and hopefully engaging students from Mississippi as well as students from Harvard to take part in that.
The other activity that we’re trying to do in the Delta is work with community health centers like the Aaron E. Henry Community Health Center in Coahoma County. Through an initiative called The Right! From the Start (R!FTS) led by Sannie Snell, a social worker and public health advocate who has done great work in neonatal intensive care unit (NICU) babies. Snell is trying to really expand on addressing maternal health by working from the grassroots. The idea is if we can work with the policy and higher level with the Health Department but also with community health centers at the grassroots level, then we’re able to make a difference in addressing the burden of maternal morbidity and mortality.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
On this day in 1972
Nov. 16, 1972
A law enforcement officer shot and killed two students at Southern University in Baton Rouge after weeks of protests over inadequate services.
When the students marched on University President Leon Netterville’s office, Louisiana Gov. Edwin Edwards sent scores of police officers in to break up the demonstrations. A still-unidentified officer shot and killed two 20-year-old students, Leonard Brown and Denver Smith, who weren’t among the protesters. No one was ever prosecuted in their slayings.
They have since been awarded posthumous degrees, and the university’s Smith-Brown Memorial Union bears their names. Stanley Nelson’s documentary, “Tell Them We Are Rising: The Story of Black Colleges and Universities,” featured a 10-minute segment on the killings.
“They were exercising their constitutional rights. And they get killed for it,” former student Michael Cato said. “Nobody sent their child to school to die.”
In 2022, Louisiana State University Cold Case Project reporters, utilizing nearly 2,700 pages of previously undisclosed documents, recreated the day of the shootings and showed how the FBI narrowed its search to several sheriff’s deputies but could not prove which one fired the fatal shot. The four-part series prompted Louisiana Gov. John Bel Edwards to apologize to the families of the victims on behalf of the state.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Gloster residents protest Drax’s new permit request
GLOSTER — Drax, the United Kingdom-based wood pellet producer that’s violated air pollution limits in Mississippi multiple times, is asking the state to raise the amount of emissions it’s allowed to release from its facility in Gloster.
In September, the state fined Drax $225,000 for releasing 50% over the permitted limit of HAPs, or Hazardous Air Pollutants, from its facility Amite BioEnergy. In a pending permit application that it submitted to the Mississippi Department of Environmental Quality in 2022, the company is seeking to transition from a “minor source” of HAPs to a “major source.”
A “major source” permit would remove the limit over the facility’s total HAP emissions, but it would apply a new limit over the rate at which Drax could release the pollutants.
This year’s fine was its second penalty for violating Mississippi law around air pollution limits. In 2020, the state fined the company $2.5 million for releasing over three times the legal threshold of Volatile Organic Compounds, or VOCs, one of the largest such fines in state history. Drax underestimated its VOC releases since the facility opened in 2016, but didn’t realize it until 2018. The facility didn’t come into compliance until 2021.
The Environmental Protection Agency lists a variety of potential health impacts from exposure to HAPs, including damage to the immune system and respiratory issues. VOCs can also cause breathing problems, as well as eye, nose and throat irritation, according to the American Lung Association.
For years since Drax’s violations became public, nearby residents have attributed health issues to living near the facility. During a public hearing on Drax’s permit request Thursday in Gloster, attendees reiterated those concerns.
“We all experience headaches every day,” resident Christie Harvey said about her and her grandchildren. Harvey said she has asthma too, and her doctor was “baffled” by her symptoms. “Each week I have to take (my grandchildren) to the clinic for upper respiratory issues … It’s not fair that we have to go through this. Drax needs to lower the pollution as much as possible.”
Part of the public outcry is the proximity of people’s homes to the plant, which is within a mile of Gloster’s downtown.
“The wood pellet plant in Lucedale is situated in an industrial park outside of town,” Andrew Whitehurst of Healthy Gulf, an environmental group dedicated to protecting the Gulf of Mexico’s natural resources, said at the meeting. “The wood pellet plant that (Enviva is) trying to put in Bond will be situated north and west of the downtown area. Not like this when it’s right smack in the middle (of the city). It’s totally inappropriate. People can’t take it, they don’t deserve it.”
In a statement to Mississippi Today, Drax said it prioritizes the public health and environment in Gloster, adding that the permit modification is a part of standard business practice.
“When we first began operations, some of our original permits were not fit for purpose,” spokesperson Michelli Martin said via e-mail. “We are now working to acquire the appropriate permits for our operating output and to improve our compliance. Within these permits the requirements may change based on engineering data and industry standards. This permit modification is part of our ongoing plan to provide MDEQ with the most accurate data. Drax fully supports the resolution of our permitting request and looks forward to working with MDEQ to finalize the details.”
While researchers, including from Brown University, are studying the health symptoms of residents near the wood pellet plant, there is no proven connection between the facility’s emissions and those symptoms.
Erica Walker, a Jackson native who teaches epidemiology at Brown and who’s leading the study, spoke to Mississippi Today earlier this year. Regardless of the cause and effect, she said, the decision to put the plant near disadvantaged communities with poor health outcomes is concerning.
“We want to make sure we aren’t additionally burdening already burdened communities,” Walker said.
About 1,300 people live in the city, according to Census data, and 39% live below the poverty line.
Moreover, Gloster residents often have to travel hours, to cities such as McComb and Baton Rouge, to find the nearest medical specialist. Amite County, where Gloster is, has a higher rate of uninsured residents than the rest of the state, according to County Health Rankings, and the ratio of residents to primary care physicians is over three times greater in the county than Mississippi as a whole.
As part of its application, Drax is seeking a Title V permit under the Clean Air Act, which the EPA requires for major sources of air pollutants. This gives the EPA the opportunity to review Drax’s application and public comments submitted with it. The public can submit comments on the application until Nov. 26, and can do so through MDEQ’s website.
The Mississippi Environmental Quality Permit Board, which is made up of officials from several state agencies, will then decide whether or not to grant the new permits. A full overview of the process and Drax’s application is available online.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
Mississippi Today
Mississippi receives ‘F’ rating on preterm birth rate
Mississippi received an F grade for its rate of preterm births in 2023 – those occurring before 37 weeks gestation – from the 2024 March of Dimes report card.
Mississippi’s preterm birth rate was 15%, the worst in the country. Any state with a rate greater than 11.5% also received an F. The U.S. average was 10.4%.
Preterm births in Mississippi have risen steadily over the last decade, increasingly nearly 2% since 2013. In Jackson, the state capital, nearly one in five babies are born preterm, according to the report.
“As a clinician, I know the profound impact that comprehensive prenatal care has on pregnancy outcomes for both mom and baby,” Dr. Amanda P. Williams, interim chief medical officer at March of Dimes, said in a press release. “Yet, too many families, especially those from our most vulnerable communities, are not receiving the support they need to ensure healthy pregnancies and births. The health of mom and baby are intricately intertwined. If we can address chronic health conditions and help ensure all moms have access to quality prenatal care, we can help every family get the best possible start.”
In addition to inadequate prenatal care, factors such as smoking, hypertension, diabetes and unhealthy weight can cause people to be more likely to have a preterm birth.
The report highlighted several other metrics, including infant mortality – in which Mississippi continues to lead the nation.
In 2022, 316 babies in the state died before their first birthday. Among babies born to Black mothers, the infant mortality rate is 1.3 times higher.
The state’s maternal mortality rate of 39.1 per 100,000 live births is nearly double the national average of 23.2.
Mississippi has yet to expand Medicaid – one of only 10 states not to do so – and tens of thousands of working Mississippians remain without health insurance. It also has not implemented paid family leave, doula reimbursement by Medicaid, or supportive midwifery policies – all of which March of Dimes says are critical to improving and sustaining infant and maternal health care.
The Legislature passed a law last session that would make timely prenatal care easier for expectant mothers, but more than four months after the law was supposed to go into effect, pregnant women still can’t access the temporary coverage.
“March of Dimes is committed to advocating for policies that make healthcare more accessible like Medicaid expansion, addressing the root causes of disparities, and increasing awareness of impactful solutions like our Low Dose, Big Benefits campaign, which supports families and communities to take proactive steps toward healthy pregnancies,” Cindy Rahman, March of Dimes interim president and CEO, said in a press release.
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
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