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

Indicted Jackson prosecutor’s latest campaign finance report rife with errors

Published

8 hours ago

July 18, 2025

Staff Editor

mississippitoday.org – @ayewolfe – 2025-07-18 11:00:00

by Caleb Bedillion, The Marshall Project and Anna Wolfe, Mississippi Today
July 18, 2025

Tangled finances, thousands in personal loans and a political contribution from a supposed investor group made up of undercover FBI informants — this was all contained in a months-late campaign finance report from Hinds County District Attorney Jody Owens.

Owens, a second-term Democrat in Mississippi’s capital city region, is fighting federal bribery charges, to which he’s pleaded not guilty. At the same time, his recent campaign finance disclosure reflects a pair of transactions that correspond with key details in the government’s allegation that Owens took money from undercover informants to pay off a local official’s debt.

Regarding payments from Facility Solutions Team — the company name used in the FBI sting — to former Jackson City Councilwoman Angelique Lee, Owens allegedly stated the need to “clean it out,” according to the indictment, which was unsealed in November.

“[L]ike we always do, we’ll put it in a campaign account, or directly wire it,” he said, the indictment claims. “[T]hat’s the only way I want the paper trail to look.”

Agents recorded hundreds of hours of conversations with Owens and other officials, and after his arraignment last year, Owens responded to the charges, saying, “The cherry-picked statements of drunken locker room banter is not a crime.”

Throughout 2024, a non-election year during which federal authorities allege Owens funneled thousands of dollars in bribes to Jackson’s city officials, Owens loaned his campaign more than $20,000, according to his campaign committee’s finance report. He’d won reelection in late 2023.

Owens and his attorneys did not respond to questions about his campaign finance report.

Owens’ report, filed May 30 – months late and riddled with errors – is the latest example of how Mississippi politicians can ignore the state’s campaign finance transparency laws while avoiding meaningful consequences. It’s a lax legal environment that has led to late and illegible reports, untraceable out-of-state money that defied contribution limits, and, according to federal authorities, public corruption with campaign finance accounts serving as piggy banks.

Enforcement duties are divided among many government bodies, including the Mississippi Ethics Commission. The commission’s executive director, Tom Hood, has long complained that the state’s campaign finance laws are confusing and ineffective.

“It’s just a mess,” Hood said.

Owens filed the annual report months past the Jan. 31 deadline, after reporting from The Marshall Project – Jackson revealed he had failed to do so. He paid a $500 fine in April.

He was also late filing in previous years, paying fines in some years and failing to pay the penalties in other years, according to records provided by the Ethics Commission.

The report, which Owens signed, is full of omissions or miscalculations, with no way to tell which is which. The cover sheet of the report provides the total amount of itemized contributions and disbursements for the year — $44,000 in and $36,500 out. But the body of the report lists the line-by-line itemizations for each, and when the Marshall Project – Jackson and Mississippi Today summed the individual itemizations, the totals didn’t match those on the cover sheet.

Based on the itemized spending detailed in the body of the report, Owens’ campaign should have thousands more in cash on hand than reported. In the report’s cover sheet, Owens also reported that he received more in itemized contributions during the year than he received in total contributions, which would be impossible to do.

While the secretary of state receives and maintains campaign finance reports, it has no obligation to review the reports and no authority to investigate their accuracy. Under state law, willfully filing a false campaign finance report is a misdemeanor. Charges, however, are rare.

Owens is the only local official in the federal bribery probe — which is set to go to trial next summer — who remains in office. The government alleged that Owens accepted $125,000 to split between him and two associates in late 2023 from a group of men he believed were vying for a development project in downtown Jackson. Owens accepted several thousand dollars more to funnel to public officials for their support of the project, the indictment alleges. The use of campaign accounts was an important feature of the alleged scheme, according to the indictment.

Owens divvied up $50,000 from Facility Solutions Team, or FST, into checks from various individuals or companies — allegedly meant to conceal the bribe — to former Jackson Mayor Chokwe Lumumba’s reelection campaign, the indictment charged.

Lumumba accepted the checks during a sunset cruise on a yacht in South Florida, the indictment alleged. His campaign finance report, filed earlier this year, reflected five $10,000 contributions near the date of the trip, with no mention of FST.

Lumumba, who lost reelection in April, has pleaded not guilty.

While the indictment accused Owens of saying that public officials use campaign accounts to finance their personal lives, state law prohibits the use of political contributions for personal use.

The indictment alleges Owens accepted $60,000 — some for the purpose of funneling to local politicians — from the men representing themselves as FST in the backroom of Owens’ cigar bar on Feb. 13, 2024. On his campaign finance report, he listed a $12,500 campaign contribution from FST two days later, the same day the indictment alleges he paid off $10,000 of former Councilwoman Lee’s campaign debt. Lee pleaded guilty to charges related to the alleged bribery scheme in 2024.

Also on Feb. 15, 2024, the campaign finance report Owens filed shows a $10,000 payment to 1Vision, a printing company that used to go by the name A2Z Printing, for the purpose of “debt retirement.” Lee had her city paycheck garnished starting in 2023 to pay off debts to A2Z Printing, according to media reports. No mention of Lee was made in the campaign finance report filed by Owens. The printing company did not respond to requests for comment.

Campaigns are allowed to contribute money to other campaigns or political action committees. If Owens’ committee used campaign funds to pay off debt owed by Lee’s campaign, the transaction should have been structured as a contribution to Lee’s campaign and reported as such by both campaigns, said Sam Begley, a Jackson-based attorney and election law expert who has advised candidates about their financial disclosures.

The alleged debt payoff on behalf of Lee is not the first time Owens has described transactions on his campaign finance filings in ways that may obscure how his campaign is spending money. Confusing or unclear descriptions of spending activity are common on campaign finance reports across the state.

Owens previously reported that in 2023, he paid $1,275 to a staff member in the district attorney’s office who also worked on his campaign. The payment was labeled a reimbursement, which Owens explained in a May email to The Marshall Project – Jackson was for expenditures this person made on behalf of the campaign, “such as meals for volunteers/workers, evening/weekend canvassers, and election day workers.”

State law requires campaigns to itemize all contributions and expenses over $200. Begley said he believes Owens’ committee should have itemized any payments over $200 made by anyone on behalf of the campaign.

Upfront payments, with the expectation of repayment by the campaign, might also be considered a loan, according to a spokesperson for the secretary of state. Campaigns are barred from spending money to repay undocumented loans.

The state Ethics Commission has addressed undocumented loan repayments in several opinions, outlining the required documentation to make repayments legal.

Since 2018, the Ethics Commission has had the power to issue advisory opinions upon request to help candidates and campaigns sort through laws that Hood, the commission’s executive director, said aren’t always clear.

The commission has issued just six opinions in seven years.

“I was surprised in the first few years that there weren’t more,” Hood said. “But now it seems to be clear that for whatever reason, most people don’t think they need advice.”

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

The post Indicted Jackson prosecutor's latest campaign finance report rife with errors 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 critically examines the conduct of Hinds County District Attorney Jody Owens, a Democrat, and highlights systemic weaknesses in Mississippi’s campaign finance laws. While the reporting is grounded in factual evidence, legal documents, and expert commentary, the tone leans toward exposing flaws in enforcement and transparency—issues typically emphasized by center-left or reform-oriented journalism. The article does not display partisan rhetoric or ideological framing beyond its focus on accountability and legal integrity. Its publication by Mississippi Today and The Marshall Project, both known for investigative work with slight progressive leanings, further supports a Center-Left classification.

Mississippi Today

Whooping cough cases increase in Mississippi

Published

23 hours ago

July 17, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-07-16 11:25:00

by Gwen Dilworth, Mississippi Today
July 16, 2025

The Mississippi State Department of Health issued an alert Wednesday that cases of pertussis, or whooping cough, are climbing in the state.

The year-to-date number of cases in Mississippi ballooned to 80 as of July 10. That compares to 49 cases in all of 2024.

No whooping cough deaths have been reported. Ten people have been hospitalized related to whooping cough, seven of whom were children under 2 years old.

Cases have largely been clustered in northeast Mississippi. The region accounts for 40% of cases statewide.

The nation has also seen rising rates of whooping cough, though cases have been climbing less steeply than in Mississippi. About 15,000 whooping cough cases have been reported nationwide this year, according to the Centers for Disease Control and Prevention.

The highly contagious respiratory illness is named for the “whooping” sound people make when gasping for air after a coughing fit. It may begin like a common cold but can last for weeks or months. Babies younger than 1 year are at greatest risk for getting whooping cough, and can have severe complications that often require hospitalization.

Whooping cough cases fell in Mississippi after the COVID-19 pandemic began, but have since rebounded. This is likely due to people now taking fewer mitigation measures, like masking and remote learning, State Epidemiologist Renia Dotson said at the state Board of Health meeting July 9.

The majority of cases – 76% – have occurred in children. Of the 73 cases reported in people who were old enough to be vaccinated, 28 were unvaccinated. Of those 28 people, 23 were children.

“Vaccines are the best defense against vaccine preventable diseases,” State Health Officer Dr. Dan Edney said after the State Board of Health meeting.

Mississippi has long had the highest child vaccination rates in the country. But the state’s kindergarten vaccination rates have dropped since a federal judge ruled in 2023 that parents can opt out of vaccinating their children for school on account of religious beliefs.

The pertussis vaccination is administered in a five-dose series for children under 7 and booster doses for older children and adults. The health department recommends that pregnant women, grandparents and family or friends that may come in close contact with an infant should get booster shots to ensure they do not pass the illness to children, particularly those too young to be vaccinated.

Immunity from pertussis vaccination wanes over time, and there is not a routine recommendation for boosters.

State health officials also encourage vaccination against other childhood illnesses, like measles. While Mississippi has not reported any measles cases, Texas has had recent outbreaks.

The Mississippi Health Department offers vaccinations to children and uninsured adults at county health departments.

Correction 7/16/25: This story has been updated to reflect that the age of the seven hospitalized children is under 2 years old.

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

The post Whooping cough cases increase in Mississippi appeared first on mississippitoday.org

Political Bias Rating: Centrist

This article presents a straightforward, fact-based account of rising whooping cough cases in Mississippi without ideological framing. It cites official sources such as the Mississippi State Department of Health and the Centers for Disease Control and Prevention, offering context, statistics, and public health recommendations. While it mentions a 2023 federal court ruling that allowed religious exemptions to vaccinations—a potentially contentious topic—it does so factually without editorializing or assigning blame. The overall tone remains neutral and informative, aligning with public health reporting rather than political advocacy.

Mississippi Today

Driver’s license office moves to downtown Jackson

Published

1 day ago

July 17, 2025

Staff Editor

mississippitoday.org – @MSTODAYnews – 2025-07-17 12:31:00

by Simeon Gates, Mississippi Today
July 17, 2025

The driver’s license office in Jackson has moved downtown as the Mississippi Department of Public Safety prepares to shift its headquarters from the capital city to suburban Rankin County.

The department last month announced it was closing the license office that had operated for decades next to its headquarters just off Interstate 55 at Woodrow Wilson Avenue, near the VA Medical Center.

The new office is at 430 State St., near Jackson’s main post office and a few blocks from the Capitol.

A logo marks the main entry of a driver’s license office in downtown Jackson, Miss., on Tuesday, July 8, 2025.

“This location provides easier access for those who live and work in the area and ensures we can continue offering vital driver services in a more convenient and accessible space within the city of Jackson,” said Bailey Martin, spokesperson for the Department of Public Safety.

Mississippi has 35 driver’s licenses offices. The new Jackson office is in a former car dealership – an all-white building with floor-to-ceiling windows that fill the space with sunlight. On Wednesday, customers sat on black benches, chatting or scrolling on their phones while waiting to be called up to get or renew a license.

Carlos Lakes of Yazoo City speaks after renewing a driver’s license in Jackson, Miss., on Wednesday, July 16, 2025.

Carlos Lakes, 34, from Yazoo City, said he first went to the Richland office that issues commercial driver’s licenses but couldn’t get what he needed there. He said he then went to the old office on Woodrow Wilson and saw a note on the door showing the office had moved.

“So, it’s been about two hours of running around,” said Lakes, a truck driver.

He said the customer service at the new office was good, aside from the long wait time.

Medical student Seth Holton, 22, had a similar experience. He drove in from Flora, in Madison County, and went to the Woodrow Wilson location before finding the new office. He said it was his first time getting his license renewed.

Seth Holton of Flora waits to renew his driver’s license in Jackson, Miss., on Wednesday, July 16, 2025.

“I think it looks nice,” Holton said of the new location. “I think it’s organized. There’s good seating. It’s pretty quick, for the most part.”

Student Marquerion Brown, 19, posed for photos with a large cardboard frame of a driver’s license in the corner of the new office. He’d just passed his driver’s test for the first time.

“I’m just lucky and thankful to get this one this time,” Brown said. He hadn’t decided where he wanted to drive first. “I got a lot of places in mind.”

Marquerion Brown speaks after receiving his driver’s license in Jackson, Miss., on Wednesday, July 17, 2025.

The Department of Public Safety headquarters will open in Pearl within the next year, near the state’s crime lab, fire academy and emergency management agency.

Martin said the new headquarters will allow the department to have its divisions in one place – the highway patrol, bureau of investigation, bureau of narcotics, homeland security office and commercial transportation enforcement.

“As such, this move will enhance operational efficiency with other public safety partners, improve interagency collaboration, and position the department for future growth,” Martin said.

The headquarters move has been in the making for over five years. Public safety officials said the old building on Woodrow Wilson fell into disrepair after years of neglect.

Sen. David Blount asks questions during a TANF hearing at the State Capitol in Jackson, Miss., Thursday, December 15, 2022.

Sen. David Blount, D-Jackson, was part of a group of lawmakers who proposed moving the headquarters to a different location inside Jackson.

“I personally think that the state government should be based in the state capital,” he said.

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

The post Driver's license office moves to downtown Jackson appeared first on mississippitoday.org

Political Bias Rating: Centrist

This article from *Mississippi Today* offers a factual and neutral report on the relocation of the Jackson driver’s license office and the broader headquarters move by the Mississippi Department of Public Safety. It includes quotes from officials and everyday citizens without editorializing or promoting a specific viewpoint. The inclusion of Sen. David Blount’s comment presents a mild political contrast, but it is balanced and not framed in a confrontational or ideological way. The tone remains focused on public service logistics and community impact rather than political narrative.