Mississippi Today

‘These people were never given the chance to catch up’: Inside the diabetes belt of rural Mississippi

Published

2 years ago

December 20, 2023

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%.

Dr. Foluso Fakorede follows up with patient Joann Moore at Cardiovascular Solutions of Central Mississippi in Cleveland, Miss., Wednesday, Nov. 29, 2023. Credit: Eric J. Shelton/Mississippi Today

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.”

Dr. Foluso Fakorede takes a call from a professional in wound care while at Cardiovascular Solutions of Central Mississippi in Cleveland, Miss., Wednesday, Nov. 29, 2023. Credit: Eric J. Shelton/Mississippi Today

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.

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Mississippi Today

Jackson’s performing arts venue Thalia Mara Hall is now open

Published

11 hours ago

June 30, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-06-30 17:29:00

by Maya Miller, Mississippi Today
June 30, 2025

After more than 10 months closed due to mold, asbestos and issues with the air conditioning system, Thalia Mara Hall has officially reopened.

Outgoing Mayor Chokwe A. Lumumba announced the reopening of Thalia Mara Hall during his final press conference held Monday on the arts venue’s steps.

“Today marks what we view as a full circle moment, rejoicing in the iconic space where community has come together for decades in the city of Jackson,” Lumumba said. “Thalia Mara has always been more than a venue. It has been a gathering place for people in the city of Jackson. From its first class ballet performances to gospel concerts, Thalia Mara Hall has been the backdrop for our city’s rich cultural history.”

Thalia Mara Hall closed last August after mold was found in parts of the building. The issues compounded from there, with malfunctioning HVAC systems and asbestos remediation. On June 6, the Mississippi State Fire Marshal’s Office announced that Thalia Mara Hall had finally passed inspection.

“We’re not only excited to have overcome many of the challenges that led to it being shuttered for a period of time,” Lumumba said. “We are hopeful for the future of this auditorium, that it may be able to provide a more up-to-date experience for residents, inviting shows that people are able to see across the world, bringing them here to Jackson. So this is an investment in the future.”

In total, Emad Al-Turk, a city contracted engineer and owner of Al-Turk Planning, estimates that $5 million in city and state funds went into bringing Thalia Mara Hall up to code.

The venue still has work to be completed, including reinstalling the fire curtain. The beam in which the fire curtain will be anchored has asbestos in it, so it will have to be remediated. In addition, a second air-conditioning chiller needs to be installed to properly cool the building. Until it’s installed, which could take months, Thalia Mara Hall will be operating at a lower seating capacity of about 800.

“Primarily because of the heat,” Al-Turk said. “The air conditioning would not be sufficient to actually accommodate the 2,000 people at full capacity, but starting in the fall, that should not be a problem.”

Al-Turk said the calendar is open for the city to begin booking events, though none have been scheduled for July.

“We’re very proud,” he said. “This took a little bit longer than what we anticipated, but we had probably seven or eight different contractors we had to coordinate with and all of them did a superb job to get us where we are today.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Jackson’s performing arts venue Thalia Mara Hall is now open 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: Centrist

The article presents a straightforward report on the reopening of Thalia Mara Hall in Jackson, focusing on facts and statements from city officials without promoting any ideological viewpoint. The tone is neutral and positive, emphasizing the community and cultural significance of the venue while detailing the challenges overcome during renovations. The coverage centers on public investment and future prospects, without partisan framing or editorializing. While quotes from Mayor Lumumba and a city engineer highlight optimism and civic pride, the article maintains balanced, factual reporting rather than advancing a political agenda.

Mississippi Today

‘Hurdles waiting in the shadows’: Lumumba reflects on challenges and triumphs on final day as Jackson mayor

Published

15 hours ago

June 30, 2025

Staff Editor

mississippitoday.org – @ayewolfe – 2025-06-30 17:08:00

by Anna Wolfe and Molly Minta, Mississippi Today
June 30, 2025

On his last day as mayor of Jackson, Chokwe Antar Lumumba recounted accomplishments, praised his executive team and said he has no plans to seek office again.

He spoke during a press conference outside of the city’s Thalia Mara Hall, which was recently cleared for reopening after nearly a year of remediation. The briefing, meant to give media members a peek inside the downtown theater, marked one of Lumumba’s final forays as mayor.

Longtime state Sen. John Horhn — who defeated Lumumba in the Democratic primary runoff — will be inaugurated as mayor Tuesday, but Lumumba won’t be present. Not for any contentious reason, the 42-year-old mayor noted, but because he returns to his private law practice Tuesday.

“I’ve got to work now, y’all,” Lumumba said. “I’ve got a job.”

Thalia Mara Hall’s presumptive comeback was a fitting end for Lumumba, who pledged to make Jackson the most radical city in America but instead spent much of his eight years in office parrying one emergency after another. The auditorium was built in 1968 and closed nearly 11 months ago after workers found mold caused by a faulty HVAC system – on top of broken elevators, fire safety concerns and vandalism.

“This job is a fast-pitched sport,” Lumumba said. “There’s an abundance of challenges that have to be addressed, and it seems like the moment that you’ve gotten over one hurdle, there’s another one that is waiting in the shadows.”

Outside the theater Monday, Lumumba reflected on the high points of his leadership instead of the many crises — some seemingly self-inflicted — he faced as mayor.

He presided over the city during the coronavirus pandemic and the rise in crime it brought, but also the one-two punch of the 2021 and 2022 water crises, exacerbated by the city’s mismanagement of its water plants, and the 18-day pause in trash pickup spurred by Lumumba’s contentious negotiations with the city council in 2023.

Then in 2024, Lumumba was indicted alongside other city and county officials in a sweeping federal corruption probe targeting the proposed development of a hotel across from the city’s convention center, a project that has remained stalled in a 20-year saga of failed bids and political consternation.

Slated for trial next year, Lumumba has repeatedly maintained his innocence.

The city’s youngest mayor also brought some victories to Jackson, particularly in his first year in office. In 2017, he ended a furlough of city employees and worked with then-Gov. Phil Bryant to avoid a state takeover of Jackson Public Schools. In 2019, the city successfully sued German engineering firm Siemens and its local contractors for $89 million over botched work installing the city’s water-sewer billing infrastructure.

“I think that that was a pivotal moment to say that this city is going to hold people responsible for the work that they do,” Lumumba said.

Lumumba had more time than any other mayor to usher in the 1% sales tax, which residents approved in 2014 to fund infrastructure improvements.

“We paved 144 streets,” he said. “There are residents that still are waiting on their roads to be repaved. And you don’t really feel it until it’s your street that gets repaved, but that is a significant undertaking.”

And under his administration, crime has fallen dramatically recently, with homicides cut by a third and shootings cut in half in the last year.

Lumumba was first elected in 2017 after defeating Tony Yarber, a business-friendly mayor who faced his own scandals as mayor. A criminal justice attorney, Lumumba said he never planned to seek office until the stunning death of his father, Chokwe Lumumba Sr., eight months into his first term as mayor in 2014.

“I can say without reservation, and unequivocally, we remember where we started. We are in a much better position than we started,” Lumumba said.

Lumumba said he has sat down with Horhn in recent months, answered questions “as extensively as I could,” and promised to remain reachable to the new mayor.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post 'Hurdles waiting in the shadows': Lumumba reflects on challenges and triumphs on final day as Jackson mayor appeared first on mississippitoday.org

Political Bias Rating: Center-Left

The article reports on outgoing Jackson Mayor Chokwe Antar Lumumba’s reflections without overt editorializing but subtly frames his tenure within progressive contexts, emphasizing his self-described goal to make Jackson “the most radical city in America.” The piece highlights his accomplishments alongside challenges, including public crises and a federal indictment, maintaining a factual tone yet noting contentious moments like labor disputes and governance issues. While it avoids partisan rhetoric, the focus on social justice efforts, infrastructure investment, and crime reduction, as well as positive framing of Lumumba’s achievements, aligns with a center-left perspective that values progressive governance and accountability.

Mississippi Today

Feds unfreeze $137 million in Mississippi education money

Published

17 hours ago

June 30, 2025

Staff Editor

mississippitoday.org – @devnabose – 2025-06-30 15:37:00

by Devna Bose, Mississippi Today
June 30, 2025

The federal government is restoring $137 million in education funds to Mississippi schools.

The U.S. Department of Education notified states last week that it would reinstate pandemic relief funds. The decision comes less than three months after the federal government revoked billions nationwide as part of Trump administration efforts to cut government spending.

State education agencies and school districts originally had until March 2026 to spend the money, but the federal government claimed that because the pandemic was over, they had no use for the money.

That March 2026 deadline has been reinstated following a series of injunctive orders.

A coalition of Democratic-led states sued the federal government in April over the decision to withhold the money. Then, a federal judge granted plaintiff states injunctive orders in the case, which meant those states could continue spending their COVID-relief dollars while other states remained restricted.

But the education department decided that wasn’t fair, wrote Secretary Linda McMahon in a letter dated June 26, so the agency was restoring the money to all states, not just the ones involved in the lawsuit.

“The original intent of the policy announced on March 28 was to treat all states consistently with regards to safeguarding and refocusing their remaining COVID-era grant funding on students,” she wrote. “The ongoing litigation has created basic fairness and uniformity problems.”

The Mississippi Department of Education notified school districts about the decision on Friday.

In the meantime, schools and states have been requesting exemptions for individual projects, though many from across the country have been denied.

Eleven Mississippi school districts had submitted requests to use the money to fund services such as tutoring and counseling, according to records requested by Mississippi Today, though those are now void because of the federal government’s decision.

Starting immediately, school districts can submit new requests to the state education department to draw down their federal allocation.

Mississippi Today previously reported that about 70 school districts were relying on the federal funds to pay for a range of initiatives, including construction projects, mental health services and literacy programs.

In 2023, almost half of Elementary and Secondary School Emergency Relief funds, pandemic relief money allocated to schools across the country, went to students’ academic, social, and emotional needs. A third went to operational and staff costs, according to a report from the U.S. Department of Education.

Though Lt. Gov. Delbert Hosemann previously said that legislative leaders might consider helping agencies that were impacted by federal funding cuts, House Speaker Jason White said Monday that he did not have an appetite for directing state funds to pandemic-era programs.

Small school districts were already feeling the impact of the federal government’s decision to rescind the money. In May, Greenwood Leflore Consolidated School Board voted to terminate a contract on a school construction project funded with federal dollars.

The litigation is ongoing, so the funding could again be rescinded.

Clarification: A previous version of this article misstated the status of school districts’ pandemic relief money.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

The post Feds unfreeze $137 million in Mississippi education money appeared first on mississippitoday.org

Political Bias Rating: Centrist

This article primarily reports on the federal government’s decision to restore $137 million in education funds to Mississippi schools after a temporary freeze. It presents factual information about the timeline, legal actions, and responses from various state officials without adopting a partisan tone. The piece mentions the involvement of Democratic-led states suing the federal government and notes Republican-aligned efforts to cut spending, but does so in a balanced way focused on reporting events and statements rather than promoting a political viewpoint. The language remains neutral and factual, avoiding loaded or biased framing, making it a straightforward news report with centrist bias.