All aspects of improved quality of life, including food systems and economic development, are connected to issues of health. Delta Directions has researched and developed reports on critical aspects of public health in the Delta and in Mississippi overall, including HIV/AIDS, infant mortality and perinatal care, public mental health services, and the benefits of breastfeeding. These reports and their accompanying efforts have led to tangible change, including the passage of laws, the development of a more youth-friendly court system, and more business and state support for breastfeeding. In addition, Delta Directions took the lead in producing a study on the financial challenges facing rural hospitals, a crucial healthy policy issue in Missisisppi, where 41 of its now 91 hospitals are in rural counties (three closed during and after the 2015 Delta Directions study).
Lead Testing and Drinking Water Quality:
Every spring, the Delta Fellow supervises a group of students from Harvard Law School that travels to the Mississippi Delta to participate in a weeklong “spring break pro bono project” funded by HLS’s Office of Clinical Programs. This year’s project contributed to an ongoing, interdisciplinary collaboration between the University of Mississippi’s Center for Population Studies, the University of Mississippi School of Pharmacy Division of Environmental Toxicology, and the Mississippi Law Research Institute/Sea Grant Legal Programs focused on improving water quality and reducing lead exposure through strategic community engagement, testing, and communication.
Students conducted research and interviews with key stakeholders to better understand the kinds of policies and practices that can help or hinder attempts to reduce exposure to lead in drinking water, and to identify systemic challenges that may serve as barriers to implementing effective policies. The Delta Fellow will continue to build off the students’ research and work with our partners at University of Mississippi to develop formal policy recommendations that can be used to inform future advocacy efforts around monitoring and reducing exposure to lead.
The public health benefits of breastfeeding are overwhelming. Among the many, breastfed babies are at a significantly lower risk for SIDS, certain infections, diabetes, and adult obesity. This is especially pertinent to Mississippi, a state with the highest obesity and infant mortality rates in the country. From 2014-2017, then Delta Fellow Desta Reff undertook a multitiered strategy to increase breastfeeding rates in Mississippi, including:
Drafting a resolution that outlined the benefits of breastfeeding, asked the state to acknowledge these benefits, re-commit to upholding existing breastfeeding laws, and called upon employers, hospitals, and the general citizenry to take affirmative steps to support breastfeeding mothers within the state. The resolution was passed by the State Senate in August 2014 was signed by the Lieutenant Governor.
Drafting a “Breastfeeding Bill,” which promoted more supportive and comprehensive policies for Mississippi mothers, and coordinating the efforts of the Mississippi Breastfeeding Coalition and the North Mississippi Breastfeeding Coalition in support of the bill. The bill eventually passed the legislature in 2016 as SB 2070.
Drafting a sample mayoral proclamation that called upon municipalities to recognize the benefits of breastfeeding outlined in the proclamation and establish August, which is national breastfeeding awareness month, as breastfeeding awareness month in their respective municipalities. The proclamation was circulated to the mayors of Northwest Mississippi and was passed by a handful of communities, including Clarksdale.
Partnering with the Tougaloo College Delta HealthPartners to establish and organize the annual “Big Latch Brunch”—a local celebration in Clarksdale to support breastfeeding.
Organizing a workshop for Mississippi employers on “Making Breastfeeding Your Business: Strategies to Support Breastfeeding Mothers in Your Workplace.”
Providing assistance and support to the Mississippi Department of Health as it worked to fulfill a grant from the CDC to implement the Baby Friendly Hospital Initiative, a WHO/UNICEF initiative that outlines 10 steps hospitals can take to become places of support for breastfeeding mothers, in Mississippi.
Becoming Baby-Friendly: Recommendations for Mississippi (Spring 2015)
The Business Case for Breastfeeding (Spring 2016)
Mississippi leads the nation in economically challenged hospitals, with a projected 49 percent of its rural hospitals at financial risk of shutting their doors. Delta Directions Public Health Fellow Dr. Maya McDoom-Echebiri undertook a study of the state’s 41 rural hospitals which identified 31 financially troubled hospitals and outlined potential remedies. Nine hospitals were identified as being at high risk of potential closure. The timeliness of the study was underscored by the shutdown of two Mississippi hospitals before the study’s completion and another small hospital’s closure soon after. Dr. McDoom-Echebiri is now at Johns Hopkins University, where her continued interest in Delta health demonstrates the capacity-building impact of the work that Delta Directions is spurring.
The Economic Impact of Potential Closures of Rural Hospitals in Mississippi (Aug. 2015)
Delta Directions has worked with policymakers and activists in Mississippi to reform mental health care in Mississippi by providing research reports on best practices and legislative recommendations. Past projects have included:
Assisting in the development of the first mental health court in Hinds County.
Making legislative recommendations to modernize the state’s mental health system by expanding access to community-based care
Making recommendations to improve mental health and substance abuse treatment in juvenile detention facilities.
Legislative Recommendations for Strengthening Community-Based Care of Mental Illness in Mississippi (Dec. 2012)
Mental Health Court Practices (Fall 2013)
Improving Mental Health and Substance Abuse Treatment in Juvenile Detention Facilities (Spring 2014)
Mental Health in Mississippi: Analysis and Recommendations (March 2014)
Joint Use Agreements to Provide Community Sports and Recreation Spaces
In 2012, Mississippi passed HB 540 which limits liability for schools that open their facilities to the community for sports and recreation through shared use agreements. Finding that few schools were taking advantage of this protection because of misconceptions about the law, the Fellow organized a Harvard Law School student spring break on this issue in 2014, supervising a team of students through meetings with school administrators, the creation of toolkit materials, and a community presentation. The Fellow expanded those materials into a Joint Use Toolkit and in August 2015, the Fellow produced and recorded this information in a training webinar.
Medicaid, CHIP, and Healthcare Access
The Delta Fellow has worked with the Mississippi Health Advocacy Program (MHAP) and the Health Law and Policy Clinic at Harvard Law School on two projects related to health access in Mississippi. In 2010, they created a manual about the laws governing Medicaid and S-CHIP for MHAP’s Health Help for Kids Initiative. In 2010, they worked to expand the Health Law and Policy Clinic’s national State Healthcare Access Research Project (SHARP) into Mississippi. SHARP is a national project, conducted in conjunction with in-state community partners, that examines states’ capacity to meet the healthcare needs of people living with HIV/AIDS.
Nursing Workforce Development
In 2009-2010, the Delta Fellow worked with Dreyfus Health Foundation and the Office of Nursing Workforce to assist in implementation of a grant to increase the nursing workforce in the Delta. The grant included three main components: (1) recruiting unemployed or underemployed individuals, particularly first time or young mothers, to get their Certified Nurses’ Aid (CNA) certification; (2) implementing “Project Talent,” a study to learn nursing students’ interest in where to locate their practice so that targeted recruitment can be conducted toward those students; and (3) training local nursing students to plan community interventions related to vulnerable children and families using the Dreyfus Health Foundation Problem Solving for Better Health (PSBH) methodology.
Worksite & Community Wellness
In 2009-2010, the Delta Fellow worked with the Area Health Education Center and Delta Citizens’ Alliance to encourage worksite wellness programs by organizing a Coahoma County Worksite Wellness Council. The Delta Fellow also prepared a wellness guide for Coahoma County, which includes healthy places to eat, gyms, parks, and sports lessons available in the county, and helped form a committee to replicate the county wellness guide for all Delta counties.