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Low-income patients find much-needed health care at Hattiesburg free clinic

USM Broadcast Boot Camp Team No. 5: Jermillya Saulsberry, Karsyn Brown, Morgan Grace Brewer, Ashley Sanchez). Team Coach: Joshua Wilson

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They might not be able to do anything about (their condition),” McCullen said. “They can’t afford to even buy a blood pressure cuff … they can’t afford insulin or nutritious food. We also operate a food pantry, so if they come to our food pantry, they might be getting a lot of canned vegetables that could be high in sodium, but they don’t have a choice."
Ann McCullen, executive director of Edwards Street Fellowship Center in Hattiesburg.

    Low-income Mississippians face a variety of health care challenges, and Edwards Street Fellowship Center in Hattiesburg — through its free health care clinic — is helping to meet those needs.

    The clinic is funded by grants from organizations like United Way of Southeast Mississippi and also by private donations. Local health care centers, such as Hattiesburg Clinic and Forrest General Hospital, also provide in-kind donations that help the clinic see about 120 patients per year. Ann McCullen, executive director of the fellowship center, said the clinic has one full-time employee, two part-time nurses, a part-time administrative assistant and “a whole lot of volunteers.”

    “(That includes) the physicians, the lab technicians, other nurses, physical therapists … all sorts of people are coming in and helping,” McCullen said.

    Patients are accepted from Forrest and Lamar counties. They must be uninsured or underinsured, McCullen said, and eligibility is further determined by age — patients must be adults ages 19 or older — and “how much money comes into their house … and what their expenses are.”

    McCullen said clinic patients struggle from a variety of conditions, including diabetes, high blood pressure and high cholesterol.

    “Remember, we love our food in Mississippi, and that shows in our health,” she said.

     She added that patients may know they have these chronic conditions but might not be able to seek treatment due to their incomes. 

      “They might not be able to do anything about (their condition),” McCullen said. “They can’t afford to even buy a blood pressure cuff … they can’t afford insulin or nutritious food. We also operate a food pantry, so if they come to our food pantry, they might be getting a lot of canned vegetables that could be high in sodium, but they don’t have a choice. So, when you are low income, it is just really hard to be compliant when you have chronic conditions.”

      McCullen said their patients struggle with factors beyond just their health.

“Someone in a (low-income) category struggles with transportation (and) paying for safe and adequate housing.          They struggle with everything that’s a basic need. They can’t buy healthy food. They could struggle with their education level. They could be stuck in a minimum-wage job. So, (income) usually leads to difficulty in every aspect of their life,” she said.

      The clinic also helps patients who are struggling with their mental health. McCullen said there is a clear correlation between mental health issues and income.

      “We now do a depression assessment on every patient every time they are here, and we can do referrals for free mental health counseling for our most depressed patients,” she said.

She said the clinic is making a solid difference in the counties it serves, but the needs are always great. McCullen said her staff — and the clinic’s many volunteers — are moving Forrest and Lamar counties in a “positive direction.”

      "There are just all sorts of unique ways that people are making a difference,” she said.

      For more information on the clinic, visit edwardsstreetfellowship.org or call 601-255-5077. Eligibility screenings are held from 9-11 a.m. on the first and second Tuesdays of each month at 1919 Edwards Street in Hattiesburg.

USM dean says college can help health disparities
through recruiting and training future pros

USM Broadcast Boot Camp  team: Michelle Xie, Jeremiah McCarty and Makenna Kemp. Story coach: Huey Turlich

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Health is a primary need for all folks, and we all deserve access to high-quality healthcare. However, we don’t always have access to high-quality healthcare and that changes based on where people live because in the rural setting, they may not have access to that and they may not be able to come to other settings to get that."
USM Dean Lachel Story

         Mississippi stands out for not only its rich cultural heritage, but also for its significant health disparities between whites and African-Americans, rich and poor, and other demographics.

         The healthcare situation in Mississippi has been an ongoing battle and professionals all over are fighting to combat these disparities.

        These disparities include factors that range from race, gender, age, social economic standing, and geographic locations. These issues come in many forms and involve access to care, health outcomes, and overall well-being of its population. According to the annual Mississippi Health Disparities and Inequities Report, published by the state Department of Health, state residents have a life expectancy 3.1 years less than the rest fo the nation. Further, health outcomes for African-American residents are worse across nearly all categories than for whites.

      Dr. Lachel Story, dean of Nursing and Health Professions at the University of Southern Mississippi, said  access and quality healthcare should not be a racial issue.

      "Health is a primary need for all folks," she said, "and we all deserve access to high-quality healthcare. However, we don’t always have access to high-quality healthcare and that changes based on where people live because in the rural setting, they may not have access to that and they may not be able to come to other settings to get that.” 

       She said that in Mississippi, residents often face challenges such as long travel distances to healthcare facilities and shortage of healthcare providers. This lack of access can lead to delayed diagnoses and poorer health outcomes. The cause of healthcare disparities in Mississippi are caused by various reasons, such as gender, race, sexual orientation, as well as socio-economic statuses. However, Story said the programs in her college are well aware of the health disparities issue, and they can help through recruiting future health professionals and by making students aware of the issues.

     "The vision of the admission office is to increase the health of our state. Our priorities are always around that, and it may look like academic programs. We provide services through the children’s centers, the speech and hearing clinic, and we also run the gulf port health center on the coast.” She says. The College of Nursing and Health Professions is the beacon of hope for combatting the health disparities issue by providing services all throughout Mississippi. They aim to create a more equitable healthcare landscape where all residents have opportunities to receive quality medical care.

     The full report ono the state's health disparities is available here. For more information, you can visit https://msdh.ms.gov/msdhsite/_static/resources/6414.pdf to learn more about the health disparities issue in Mississippi. If you have any questions regarding your health, please contact your provider. Healthcare is crucial for maintaining an individual’s well-being and addressing health concerns properly regardless of their background of socioeconomic status. Ensuring access to healthcare remains a cornerstone today, but thankfully we have organizations and the College of Nursing and Health Professions to combat these issues.

African-American men suffer worst disparities

USM Broadcast Boot Camp team: Daniela Madamidola, Mary Riddle, Jordon Bratcher, Taylor Makiyal Story coach: 

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There’s a couple of different reasons. First of all, African Americans have different socio-economic barriers. Maybe they don’t have the money and resources as other people to go to get the doctor. So that affects it. So when you’re preventing diseases, we have worse outcomes."
Nurse practitioner Andrea McGill

    Factors affecting the African American community's health outcomes range from economic issues to trust issues with the medical establishment.

     Healthcare can be an issue for people due to problems with any financial or social barriers coming with these health issues. We reach out to a professional who gives in-depth information about health disparities in the community. 

      Andrea McGill, a family nurse practitioner with Harriet House, an assisted living facility in Sumrall, Mississippi, said health issues hit the African American community the hardest.

      “There’s a couple of different reasons. First of all, African Americans have different socio-economic barriers. Maybe they don’t have the money and resources as other people to go to get the doctor. So that affects it. So when you’re preventing diseases, we have worse outcomes,” said McGill. 

      COVID gave some difficulty to where it was a lot harder by harming the economy and multiple jobs. One of the factors she mentioned is a lack of trust in the medical system due to systemic racism. There could be a lack of affordable and accessible produce, especially in rural areas where it introduces weight problems. Also, genetics could play a part as well.

    “There's always a little bit of a genetic factor, but I think the biggest thing is back to the socio-economic structures that we're having right now, with inflation, so food cost is high,” said McGill. 

    McGill also said the lack of information being placed out in the public for African Americans and men about getting the help they need for their health.

    Yet, the issues tend to circle back to money, she said. “I would say financial is a big one. And I also say mental health plays an effect on this issue,” McGill said. 

     McGill said individuals taking charge of their own health is important to overcoming disparities in health outcomes. The Harriet House strives to serve all who inquire, she said.

   “The biggest thing is that you need to go and have your checkups. At least you need to go in and have your screenings and your checkups … sometimes it's better if you know somebody,” said McGill. 

   The Harriet House was created to enhance functional independence in community living. To find more information about the Harriet house contact 769-307-6150 or their website 

Rural residents struggle with healthcare access

Broadcast Boot Camp team: Erian Powell, Briunna Davis, Airia Burton, and Sosuke Inoue. Story coach: Jason Beverly.
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The further we go into rural areas in Mississippi, the more that availability of healthcare drastically disappears."
Dr. Vickie Reed, associate director of health programs at USM

   According to the Mississippi State Department of Health, residents living in rural counties have a  higher  prevalence of health disparities than those living in urban counties.

      Residents living in rural areas are more likely to have chronic illnesses, such as high blood pressure, heart disease, and diabetes. They lack access to the appropriate treatment and transportation due to it being too costly, or because healthcare facilities are too far. 

      “The further we go into rural areas in Mississippi, the more that availability of healthcare drastically disappears,” said Dr. Vickie Reed, associate director of health programs at the University of Southern Mississippi.

      Although complex, some health experts argue that the issue can often times be categorized.

     “The reason health disparities impact those in rural areas can be classified as three-fold,” said Amanda Mitcham, director of managed care and special projects at Southeast Mississippi Rural Health Initiative (SEMRHI). “For the most part, people in rural areas don’t have easy access to medical care. It’s no fault of their own. But another major reason is based on finances. Many times, those rural areas are poor farming communities. And if it’s not a life-threatening injury or sickness, some folks in those areas are unwilling to make the financial sacrifices to get that medical care that they actually need.”

      Mitcham emphasized the third piece of the puzzle is probably the most impactful, and it deals with health literacy. 

      “One major health disparity that SEMRHI has identified in our communities is how people view healthcare,” she said. “They think that they only need to see a provider when they are feeling ill. This mindset hinders the health of our communities. For many chronic diseases, catching the disease before a person starts showing bothersome symptoms means a much better prognosis. So, when a patient comes in, we remind them that SEMRHI wants to not only help them get healthy, but also keep them healthy. In order to do this, patients must come in to be seen regularly—not just when they run out of medication or are feeling ill. ​So, we have to change that. And a major health literacy campaign needs to happen to try to get the word out.”

      In addition to promoting health literacy, Mitcham also advocates for the state to expand Medicaid and Medicare. And she is hopeful that more rural healthcare systems will follow SMRHI’s efforts to eliminate financial barriers.

      “In addition to ensuring physical access, we find it necessary that patients can financially access healthcare,” Mitcham said. “SEMRHI sees every patient regardless of their ability to pay. For those who may need financial help we have many options to help! We offer a sliding scale payment option where patients pay a flat fee for their visits. This fee ranges from $50-$100. For some patients, $100 is still too much money. So, we allow patients to set up payment agreements. This is an interest free option where patients tell us how much they can reasonably pay per week/month towards their bill. There is no minimum payment for this agreement. Even if a patient can only pay $1 per week, we are happy to help.”

Disabled confront barriers finding help
in Mississippi's healthcare system

USM Broadcast Boot Camp team: Sandy Evans, Jaydon Koss, Keira French. Story coach: Garret Grove.
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The social worker at MMRC wanted to be really good, but she was so understaffed and

overworked by everyone that was there. And it was basically like, here are some pamphlets,

and here's some videos. But it was very brushed off, so my experiences from Vanderbilt just in Tennessee and MIssissippi were very different.

Dr. Wilbur Martin, WUSM FM general manager

   Mississippi citizens experience difficulties in the health care system due to ethnic and racial

backgrounds, gender, income, and social status.

      Wilbur Martin said he saw an inconsistency between the Mississippi health care

system and that in other states. Martin went through a traumatic accident that left him in a medically induced coma at Vanderbilt Hospital in Tennessee.

      He suffered from a brain injury that left him unable to recover by himself. Martin was then transferred to Mississippi Methodist Rehab Center, not long after he woke up from his coma where he saw a change in his treatment.

    “The social worker at MMRC wanted to be really good, but she was so understaffed and overworked by everyone that was there. And it was basically like, here are some pamphlets, and here's some videos. But it was very brushed off, so my experiences from Vanderbilt just in Tennessee and Mississippi were very different,” said Martin, adviser at the University of Southern Mississippi's radio station, WUSM.

    Mississippi is not blind to the disadvantages in their health care system. These issues are a

result of the state's social determinants of health. According to the Mississippi State Department

of Health, “Social determinants of health are conditions that include where people live, work, grew up, where they were born, and their age. They are created by the distribution of money, power, and resources at global, national, and local levels.”

    These components affect how easy or difficult it is for citizens to obtain effective health care.

Additionally, ethnic heritage and gender is another factor that contributes to the decline in

Mississippi’s health care. 

     Michelle McLease,  program coordinator for the sociology  notes, “If you look at gender, we know that women compared to men are

often not listened to as much. So when they go to the health care provider, it's often downgraded. And then we know, people of color, or non whites pains are also often overlooked. There's a lack of trust, and that trust is warranted because historically folks have been experimented on or been ignored.”

     Lastly, citizen geological location, and salary can cause a strain in acquiring affordable and

successful treatment.

      “The main issue in Mississippi is their lack of funding and a concentration of folks who lack resources. About 12% of the state's population is uninsured, so what is going to happen when they get sick. You also have folks that have lower means or income from a minority or underrepresented population that do not have a lot of providers or doctors,” McLease said.

 

State working to address health disparities, regional administrator says

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"Everybody should be taken care of no matter what racial makeup they are."
Dr. Christy Barnett,  southern regional state health director

    Mississippi residents face rising numbers of sexually-transmitted diseases, obesity, tuberculosis and other chronic illnesses and many lack adequate support and resources to treat them.

    Some of these factors include social economic standing, race and geological location. Across the board, Mississippi is often ranked the lowest in the nation in quality health. Dr. Christy Barnett, regional health officer for the southern region for the Mississippi Department of Health, said the state is working to bridge these disparities.

     "Everybody should be taken care of no matter what racial makeup they are,” Barnett said.

     Not only should patients have care available, but they need education on proper healthcare management, Barnett said. The state put in a place community health workers that help assist primary care physicians in assessing patients and determining the disparities that each patients face.

     “The staff in the clinic is limited to what they can do, but the community health workers can follow those things up whether it is internet access, job issues, getting insurance coverage,” Barnett said.

     Having extra hands in the field helps determine the different issues patients face. This helps patients become informed and know what they have and what is available to them.

      A major health disparity that Barnett has seen in the communities is how people view their healthcare. They believe that they only need to see a doctor when they feel sick. For many chronic diseases, catching the disease before a person starts to show signs of it can create a better prognosis. If a patient comes in on a regular basis, it can not only help them get healthy, but also keep them healthy. In order to do this, patients must come in to be regularly checked, not just when they are feeling ill.

    Another example put in place by the state are the clinics that offer contraceptives to patients to prevent sexually-transmitted diseases and unwanted pregnancies. Hospitals alike are offering condoms and birth control to people to prevent these diseases and pregnancies. 

    

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Expert: Education can predict health outcomes

USM Broadcast Boot Camp Team: Vanessa Turner, Aundriya Neely, and Mckenzie Walker. Story coach: Dalton Stanford.
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Dr. Vickie Reed, associate director of health programs at USM

  How has your education level affected your health? Many Mississippians who don’t have a high school diploma or higher education have more health problems.
     Statistics show that Mississippians are more likely to have diabetes, high blood pressure, and
obesity than those in the rest of the country. This statistic is advanced even further when considering the prevalence of these diseases in varying education levels.
     As shown in the Mississippi State Department of Health's Annual Mississippi Health Disparities and Inequalities Report, individuals without a high school education show a notably higher prevalence of diabetes (18.6%) compared to college graduates (9.2%).

     Generally, as educational attainment rises, diabetes rampancy decreases. In Mississippi, poor health outcomes are largely attributed to social determinants including education status. Data from the U.S Census Bureau identified that less than one fourth (21.3%) of all Mississippians aged twenty-five and older have a bachelor’s degree or higher. Individuals lacking a highschool diploma and earning less than $15,000 annually experience particularly unfavorable health consequences.
      Based on if you have a high school diploma or further degree, it may be hard to pay for
healthcare. Without healthcare you are prone to health issues. Education level also contributes to
what type of job you have, which can also determine the amount of coverage you have through
your workplace.
     Dr. Vickie Reed, associate director for health programs at the University of Southern Mississippi, said education, and financial status often go hand in hand. Those with less education tend to make less money and tend to have jobs that do not offer healthcare.
     The medical community is learning to join in the fight to understand the root causes of healthcare
disparities. Whether that be education, social economic status, or how much money you make. 
      It’s important to start teaching about good eating habits, exercise, and overall physical health at
an early age. Being taught about health in K-12 school and in college could drastically improve
what our state knows about their health. In these situations kids may take the information they
learn home and also teach their family about good health. This could really produce some
incremental changes.

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