Mississippi Today
‘These people were never given the chance to catch up’: Inside the diabetes belt of rural Mississippi
Melvin Jones, a 64-year-old native of Cleveland, was in his 30s when he was diagnosed with diabetes. He knew he was at an increased risk because of his family history.
In 2013, at 54 years old, Jones had two toes on his right foot removed and would later lose the big toe on his left foot. He didn’t know it then, but he had peripheral artery disease, or PAD, a condition where plaque builds up in peripheral arteries – those that do not supply blood to the heart or brain – and restricts circulation. Without treatment, a patient will continue to need further amputations and will die young.
One doctor told Jones he would likely need to amputate his entire foot – but Jones, whose condition made him retire early from his job at Baxter Pharmaceuticals, was resolved not to let that happen.
“I thought ‘I don’t want that,’ and me and the doctor were through,” Jones said. “It would have changed my life. I already can’t drive my truck no more.”
But many diabetics in rural Mississippi don’t have access to the care Jones went on to receive to avoid further amputations. Diabetes and the cardiovascular problems it causes are often asymptomatic at first, or symptoms are obscure. A lack of specialists coupled with some of the lowest social determinants in the country leave regions like the Delta prone to late detection of diabetes and a high rate of amputations.
Now, Jones goes to cardiologist Dr. Foluso Fakorede’s Cleveland clinic, Cardiovascular Solutions of Central Mississippi, for regular wound care from a nurse practitioner who travels to the clinic every Thursday from Oxford.
His life is different now, but he’s thankful he can still move around and hasn’t had to undergo a major amputation, which, for legs, is characterized as any cut above the ankle joint.
Mississippi is the only state with every county represented in what is called the “diabetes belt” of the U.S., which spans an upward arc from the deep South to Appalachian states, according to the Centers for Disease Control and Prevention.
Fakorede said academic institutions should be investing in the region through medical research, but it’s not an attractive market.
“I’ll make the argument that it should be,” he said. “Because these people were never given the chance to catch up. And now we’ve left them to suffer in isolation and in pain.”
With 14.8% of its adults diagnosed with the disease, Mississippi is second only to West Virginia in prevalence.
Uncontrolled diabetes, which runs rampant in rural and underserved areas, can lead to blindness, kidney failure, high blood pressure, high cholesterol, heart attacks, strokes and gangrene.
Mississippi, one of 10 states that has not expanded Medicaid, is the fifth highest uninsured state. In Bolivar County and several other Delta counties, at least one in five residents have medical debt in collections.
About one in three diabetics over the age of 50 will develop PAD, which often goes undiagnosed and untreated in medical care deserts like the Delta.
When it is caught, doctors often have an “amputation-first” mentality, which results in the loss of limbs and early mortality – despite the fact that a procedure exists to clean out the arteries of a PAD patient and restore blood flow to extremities.
Within five years of an amputation, diabetics stand a good chance of being dead. Nationally, Black patients are four times more likely to suffer diabetes-related amputations than white patients.
“It’s a death sentence,” Fakorede said, “and it’s very often preventable.”
The procedure capable of decreasing a PAD patient’s odds of amputation by 90% is called an angiogram, an invasive diagnostic imaging test that detects arterial blockages. Revascularization is the therapeutic procedure that cleans out those arterial blockages.
Jones received five angiograms and revascularization procedures in both his legs over the course of the last two years.
The number of angiograms a diabetic patient with PAD will need depends on a number of risk factors such as age, race, hypertension, heart conditions and habits such as diet and tobacco use.
In the U.S., more than half of patients never receive an angiogram or revascularization procedure before a major amputation.
At his Delta clinic, Fakorede, the only cardiologist in Bolivar County, estimates that the number of amputees who never had an angiogram is close to 90%.
Fakorede, who was born in Nigeria and spent his teenage and young adult life in New Jersey, struggled to justify moving to Mississippi and opening his own clinic. He knew nothing about the place and had never operated his own business. But when he saw how great the need was in the Delta for a procedure he was skilled at, he knew his mind was made up.
“You walk through Walmart or Kroger here,” Fakorede said, “and I promise you you’ll see someone who has had a limb taken off or a dialysis catheter around their neck.”
In the end, Fakorede said the Delta proved to be far more similar to his hometown in Nigeria than he thought. They are regions that, for the majority of residents, reflect nothing of their country’s wealth – despite the rich resources they provide that contribute to that wealth.
“That is actually what made me stay – that similarity,” he said.
In the Delta, Fakorede explained, there are a number of socioeconomic factors that contribute to what he calls “the perfect storm” and leave people at a greater risk of chronic and life-threatening conditions.
Studies have shown that the body’s inflammatory response to chronic stressors like poverty, food deserts and unemployment – all of which pervade the Delta – can accelerate diseases like PAD.
Fakorede believes that a large part of the problem is inadequate screening measures. The United States Preventive Services Taskforce, or USPSTF, is the governing body that doctors look to for recommendations on who to screen for which conditions.
The USPSTF has not endorsed a screening for PAD, despite the fact that the five-year mortality for undiagnosed or untreated PAD patients is higher than that of breast cancer and prostate cancer, and studies have shown minorities are disproportionately affected.
“That is atrocious,” Fakorede said. “These patients have existed for decades. We know that this disease is destroying them because it’s taking them out of the workforce. It’s taking them out of their homes. They’re ending up in caskets early on.”
Meanwhile, Ozempic shortages are sweeping the nation as doctors prescribe the FDA-approved, weekly Type 2 diabetes medication to patients without diabetes for weight loss.
In Mississippi, nurse practitioner KC Arnold, director of the Ocean Springs Diabetes Center, witnesses the shortage daily.
“Every single day I’m getting a call: ‘hey, my pharmacy can’t get this,’” Arnold said. “In all my years of helping people with diabetes, this has been the biggest challenge for me to help people get what they need.”
Arnold’s facility is nurse practitioner owned and run – a rarity in Mississippi, where restrictive and expensive collaboration agreements limit the freedom with which nurse practitioners can operate.
Ozempic has a weight-loss version called Wegovy, but it isn’t covered by Medicare, so doctors will sometimes prescribe Ozempic in its place. The Mississippi Board of Nursing has guidelines that prohibit nurse practitioners from prescribing the weight loss drugs off label. But that rule doesn’t apply to doctors.
Arnold says she supports insurance companies covering a drug that addresses obesity. But until that happens, doctors shouldn’t be prescribing Ozempic to patients for weight loss.
“I can’t get the medicine for my patients with Type 2 diabetes,” she said. “Insurance needs to change to help people with weight – I’m all for that – but right now my patients with diabetes need medicine they’re not getting.”
And the drug isn’t just prescribed to people with diagnosed obesity. Chelsea Handler, a comedian and host of the 2023 Critics Choice Awards, joked that “everyone’s on Ozempic” in Hollywood.
Many insurance companies don’t cover drugs prescribed off label, but those who can afford it are paying premiums out of pocket.
“You know who ain’t getting it?” Fakorede said. “We ain’t getting it here in the Delta. There are people who are not even diabetic who are getting it in the Upper East Side in New York. Socioeconomic status matters.”
Mississippi’s alarming rate of diabetes plays a significant role in another of the state’s abysmal health statistics: leading the country in infant and maternal mortality.
Pregnancy tends to highlight the socioeconomic disparities of diabetes since some women receive Medicaid coverage for the first time during pregnancy, according to maternal-fetal specialist Dr. Sarah Novotny.
“Often, pregnancy is the first time women have access to health care insurance,” Novotny, who serves as division director of maternal-fetal medicine at University of Mississippi Medical Center, said. “So, a lot of times patients are coming into pregnancy with very poorly controlled diabetes because they didn’t have access to pre-pregnancy care.”
In pregnancy, diabetes can be separated into two categories: women who already had diabetes, whether it be Type 1 or Type 2, and then became pregnant, versus those who developed gestational diabetes during pregnancy.
Women who have preexisting diabetes and become pregnant are at risk of developing vascular problems, high blood pressure, renal problems and retinopathy. Gestational diabetes doesn’t carry the same risks for the mother. Both conditions carry increased risks such as abnormal growth and birth defects for babies.
Women who develop gestational diabetes carry a 50% risk of developing Type 2 diabetes later in life.
Managing diabetes before conception would go a long way in mitigating the state’s maternal and fetal mortality and morbidity rates, according to Novotny. But at the very least, recognizing and diagnosing diabetes during pregnancy can serve as an opportunity for previously uninsured or underinsured women to improve their quality of life.
In the last three decades, despite all the technological and medical advancements that have been made, diabetics in minority populations have seen worse outcomes.
Turning those statistics around would mean prioritizing tackling inequities in health care and recognizing places like the Delta as meccas for research, according to Fakorede.
“We need to be collaborators,” he said. “We need to be hope dealers. We need to be disruptive in terms of using our positive thinking to address some of the systemic inequities that have plagued these people and this region for decades.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons license.
A 74-year-old Navy veteran who says she was assaulted by a retired Long Beach police officer was hospitalized for a couple of days after the alleged attack because of a serious head injury that resulted in brain bleed.
Vivian Ramsay suffered a subdural hematoma of the brain, or a type of brain bleed, caused by a head injury during the April 24 attack, her attorney David Baria said.
“When I was serving my country in the Navy, I never thought there would be a day that any American, especially a retired policeman, would purposely confront me for expressing my opinion in a silent and peaceful manner,” Ramsay said in an interview Monday.
On the afternoon of the April 24 assault, Ramsay had parked her van at U.S. 90 and Jeff Davis Avenue for a peaceful protest against actions by President Donald Trump since he began his second term in office. Her van had signs denouncing various acts during the Trump administration. “We should not have to protect democracy from the President,” read one sign. In another, Ramsay proclaimed, “Married women lose voting rights. SAVE Act is voter suppression.”
Ramsay said she was surprised by the assault suspect, since identified as retired Long Beach Officer Craig DeRouche, 64, who she says approached her and ripped a protest sign off her van.
“He attempted to further intimidate me by grabbing at me,” she said. “I defended myself until he struck me in the head so hard that I fell to the ground, and I think I lost consciousness. His actions were unprovoked and outrageous. I defended my country in the Navy, and I defended myself on April 24, and I intend to defend myself in court for any charge that I violated the law.”
DeRouche has been arrested on a misdemeanor charge of simple assault against Ramsay in the April 24 incident. He is charged with a second count of misdemeanor assault in the same incident for allegedly assaulting a man who saw the attack and stopped to help the veteran protester, Long Beach Police Chief Billy Seal said.
READ MORE: See the full Sun Herald article here.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Coast protester suffers brain bleed after alleged attack by retired policeman appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Left
The article reports on an alleged assault at a peaceful protest, involving a retired police officer and a Navy veteran, without presenting a clear ideological stance. The coverage focuses on the details of the incident, including the victim’s perspective and the charges against the assailant, Craig DeRouche. The tone of the reporting is factual, detailing the actions of both Ramsay and DeRouche, with an emphasis on the harm done to Ramsay and her perspective as a veteran. There is no overt ideological language or framing that strongly suggests bias, but the focus on the victim’s narrative and her outspoken political views may appeal more to a center-left audience that supports protest rights and is critical of actions associated with the Trump administration. The article avoids making a direct political argument but presents the event through a lens that might resonate with those who share Ramsay’s concerns about the political climate. The report is primarily descriptive, allowing readers to form their own conclusions based on the facts presented.
When the Rankin County Sheriff’s Department agreed to a $2.5 million settlement after “Goon Squad” officers tortured two Black men, the department’s attorney said he hoped it would provide closure for the victims.
But at a breakfast Saturday sponsored by the sheriff and his former father-in-law, Irl Dean Rhodes, county officials struck a much different tone.
Two days after the announcement of the settlement, Rankin County Supervisor Steve Gaines said the department’s attorney, Jason Dare, “beat the pants off of those guys — the dopers, the people that raped and doped your daughters. He beat their pants off.”
Gaines was referring to Eddie Parker and his friend, Michael Jenkins, who were beaten, tased and sexually assaulted by the deputies before they shot Jenkins in the mouth during a mock execution. The deputies tried to plant a BB gun and drugs on the men to cover up their crimes, but they were ultimately convicted and sent to federal prison for decades.
Parker has one felony conviction in Rankin County is for failing to “stop vehicle pursuant to officer’s signal,” according to court records. In Alabama, he had a 2019 conviction for drug possession with intent to distribute. Jenkins has no felony convictions listed in Rankin County. Neither has a conviction in neighboring Hinds County.
Gaines declined to comment about his remarks.
LISTEN: Two days after the $2.5 million “Goon Squad” settlement, Rankin County Supervisor Steve Gaines praised the sheriff’s department’s lawyer, Jason Dare, and talked about the two Black men whom deputies beat, tortured and sexually abused. Click the link to hear what he said at the Saturday breakfast hosted by Sheriff Bryan Bailey.
The two men’s lawyer, Trent Walker, said Gaines’ remark fits the racist trope of falsely accusing Black men of raping white men’s daughters.
That remark, Walker said, makes obvious “that attitudes like this permit rogue police to prevail and allow for the conditions in which officers have been able to carry out their unlawful agenda against other citizens of the state of Mississippi.”
An investigation by Mississippi Today and The New York Times exposed a decades-long reign of terror by 20 Rankin County deputies, several of whom routinely tortured suspected drug users to elicit information and confessions.
Many people have filed lawsuits alleging abuses by deputies, or say they filed complaints with the department or reported these incidents directly to Bailey, but the sheriff has denied any knowledge of these alleged abuses.
Gaines, who worked for three decades as an agent with the Office of Inspector General, praised Bailey for enduring the scandals that have wracked his department and prompted investigations by the Justice Department and the state auditor’s office regarding Bailey’s alleged misuse of taxpayer money equipment and supplies used at his mother’s commercial chicken farm.
“It made me cry at night that Sheriff Bailey, my friend, was absorbing this,” he said. “I’m gonna tell you, he has weathered the storm, and we are back.”
Bailey thanked the county’s leaders for their support. “For the past 28 months through all of this,” he said, “my board of supervisors have stood behind me 110%.”
The sheriff said he was ready to quit several times, but Rhodes urged him to stay and run again for sheriff. “He kept pushing me,” Bailey said. “He’s still pushing me.”
Rhodes has long been regarded as “kingmaker” in Mississippi politics with many seeking his support in their campaigns. In the early 1980s, he was convicted and fined on multiple counts of felony tax evasion.
Gaines praised other Rankin County officials, citing the county’s smooth roads and relatively low crime rates, and expressed concern about the county’s growing pains, such as students from other counties attending Rankin schools.
“ How do you feel about paying the taxes that you pay and people from across the river coming over here and putting their kids in your school?” he told the nearly all-white crowd, referring to the Pearl River that separates Hinds and Rankin counties. “They’re gonna pay taxes maybe one year or maybe not at all.”
Rankin County is 72% white, while Hinds County is 72% Black.
Angela English, president of the Rankin County branch of the NAACP, said there is no mistaking Gaines’ words as a racial reference. “That’s the kind of toxic environment that we have in Rankin County,” she said.
A lifelong resident of Rankin County, English helped integrate Florence schools with her sisters. “It’s always good to know where he [Gaines] stands, whether you agree with him or not,” she said. “I’d rather know who I’m dealing with than to be caught by surprise.”
His remark, she said, “alludes to the kind of people who are upholding Bryan Bailey.”
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Rankin supervisor calls torture victims 'dopers' and rapists appeared first on mississippitoday.org
Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.
Political Bias Rating: Center-Right
The article reports on Rankin County Supervisor Steve Gaines’ comments regarding the victims of police abuse and the ongoing controversy surrounding the actions of the local sheriff’s department. While the article highlights Gaines’ remarks, which are racially charged and supportive of the sheriff, it primarily focuses on the factual reporting of the situation without overt ideological positioning. The article includes quotes from key figures such as Gaines and civil rights activists, and its tone remains neutral, reporting the conflict without endorsing a specific viewpoint. However, Gaines’ controversial language reflects a clear right-leaning stance in terms of support for local law enforcement, framing the victims negatively, which may influence public opinion in a direction that aligns with conservative political perspectives. The reporting itself maintains a factual narrative and refrains from pushing a partisan agenda, but the events described suggest a broader ideological divide in how law enforcement issues are viewed.
Mississippi Today
Pearl River Glass Studio’s stained glass windows for historic Memphis church destroyed in fire
For the Pearl River Glass Studio, located in the Midtown neighborhood of Jackson, it started as an honor and labor of love, with Memphis-based artist Lonnie Robinson, who out of hundreds of artistic contestants, won the privilege to create the stained glass windows along with artist Sharday Michelle, for the historic Clayborn Temple, located in Memphis, Tennessee, as part of a massive renovation project.
This team of artisans restored three enormous stained glass windows, panel by panel, for the historic church that was a bastion for the Civil Rights movement in Memphis, Tennessee, in the 1960s. The stained glass windows depicted Civil Rights icons and paid homage to the 1968 Memphis Sanitation Strike, which lasted 64 days from Feb. 12 to April 16, 1968. It is the site where sanitation workers agreed to end the strike when city officials recognized their union and their raised wages.
Over time, the church fell into disrepair and closed in 1999.
In 2018, it was officially named a national treasure by the National Trust for Historic Preservation.
The $14 million restoration of Clayborn Temple was a collaborative effort by non-profits, movers and shakers on the national scene, community leaders and donations.
The hard work, the labors of love, the beautiful stained glass arch windows and other restorative work at the historic church all came to an end due to a fire in the wee hours of Monday morning on April 28 of this year.
The cause of the fire is currently under investigation.
This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.
The post Pearl River Glass Studio's stained glass windows for historic Memphis church destroyed in fire appeared first on mississippitoday.org
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