By Dr. Meneka Johnson Nicholson, Ph.D.

Chief Operating Officer, Rural Health Medical Program, Inc.

Divided image - Left: dentists work on a patient; Right - a line of cars wait for drive up COVID-19 testing
Images from Rural Health Medical Program clinics

In the Black Belt of Alabama, you can easily find Southern charm wrapped up in historic heritage. However, if you look just a little closer you will find some of the not so beautiful parts, such as poverty, health disparities, food deserts, transportation barriers and a limited access to resources – just to name a few. Even in the midst of a global pandemic where deficiencies are further exposed, our people find ways in which we can take care of each other as true Southerners usually do. Knowing the beauty and as well as the beasts of the Black Belt, Rural Health Medical Program (RHMPI) has tried to serve as pillar within the community to meet the various needs of the people.

Established in 1977, the Rural Health Medical Program, Inc. is a Federally Qualified Health Center that provides primary and preventive healthcare services, which are both comprehensive and of high quality, to medically-underserved populations. In addition to primary healthcare, our patients have access to dental, vision, optometry, podiatry, mental and behavioral health, case management and social services. We have eight locations and one mobile outreach unit, serving the rural Alabama counties of Dallas, Marengo, Monroe, Perry and Wilcox. The demographics of our five counties, according to 2019 U.S. Census Bureau Data, consist mostly of African Americans (average 61%) and Whites (average 37%) with median household income levels ranging from $23,447 to $33,241 with many in our communities living at or below the poverty level. For comparison, the state and national median household income levels are $50,536 and $62,843, respectively. Our patient population is consistent with the community, and while we strive to offer services at affordable rates to meet the economic needs, we also aim to staff our locations to physically reflect the communities they serve. That representation matters because research has shown the importance of race on the impact of patient health outcomes, patient-provider trust and communication as well as overall quality of life.

Since the pandemic, and similar to most organizations, we have had to recalibrate our operations to include COVID-19 testing and education in addition to implementing new processes to maintain continuity of care. This allowed for us to explore new avenues to provide care for our patients, such as conducting drive thru COVID-19 testing and expanding telehealth services. RHMPI quickly began testing across all our counties, partnering with various community-based organizations, laboratories, universities, local governments and others. With the increase of demand of our services for community testing, we were able to deploy our mobile unit into the field. Originally designated for our mobile optometry services, the unit quickly became a community backdrop best known for its free COVID-19 testing. This allowed us to attract three times the number patients and partners we had previously.

RHMPI staff prepare to offer testing out in the community
RHMPI staff out in the community to offer testing

Although, COVID-19 testing outreach presented RHMPI with new avenues of partnerships and visibility within the communities, we did not want to lose sight of some of the communities’ greatest challenges: health disparities. While simultaneously addressing the concerns of COVID-19, we continued to look for ways to make our general services safer in order to protect our communities who have been disproportionately impacted by the ramifications of COVID. In areas where a lack of rural hospitals due to closures can mean a life-or-death situation, it is important to try to maintain a sense of continuity of care for our communities. The better they are prior to an illness, the better the outcome after. We resumed offering specialty services such dental and vision. Fortunately, partners such as the Delta Dental Community Care Foundation realized the importance of providing additional funding for the safe execution of reopening in-person visits. Financial support for the procurement of safe supplies for the staff was a major initiative, and dental staff greatly appreciated the having the ability to return to work safely.

As the country is underway in exploring a new normal, RHMPI is doing its part to be able to provide vaccines to our patients so that we all can get back to safely doing the things we enjoy with the people we love and care about. When that day comes and the pandemic ends, we will continue our mission to improve the lives our patients and the condition of our communities. We will help ensure that the beautiful Southern charm of our region shines brighter than the challenges it faces.