Routt County, Mississippi’s Holmes County offer lessons in health, obesity
August 4, 2013
Lexington, Miss. — Kennedy Powell is 49 years old, and he has never had a job.
He receives $610 every month in disability assistance from the U.S. government because of a spinal injury he sustained as an infant. In addition to the check, the injury gives him a severe limp, a hitch in his get-along that would draw stares from children in a shopping mall if Powell ever went to a shopping mall.
"I've heard so many different stories," he said slowly and with a laugh. "Even I don't know what actually happened."
He leaned against a rusty pickup, sweating under the shade of an awning at an abandoned filling station near Mileston, Miss., on a July afternoon. It wasn't as hot as it could have been, but it's Mississippi, and that means you could clear the humidity with windshield wipers.
Powell in many ways represents his corner of the world — Holmes County, Miss.
He's poor and on government assistance.
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He's black, the descendant of slaves.
He never finished high school and has no plans for long-term employment.
He's obese, not as overweight as he has been, but by the numbers, it's not debatable. He's 5 feet, 8 inches tall and 200 pounds. He needs to lose 40 pounds to not be considered overweight.
He's increasingly concerned about his health.
"It wasn't too important to me," he said, talking about diabetes, "but when people started losing limbs and passing away, that will get your attention."
Holmes County has one of the highest rates of obesity in Mississippi, which has the highest rate of obesity of any state. According to Behavioral Risk Factor Surveillance System survey results released by the Centers for Disease Control and Prevention, more than 40.7 percent of the county weighs in as obese. Routt County is the exact opposite, the fittest county in Colorado, which is the fittest state, with an obesity rate of 13.7 percent.
Despite a great deal of differences — including glaring divides in every socioeconomic sense — Powell and the others who bring each county to life make it evident there's more that connects Holmes and Routt counties than agrarian roots and a few statistical quirks.
Obesity is a problem that will define the next century for the country's health care system, and American citizens, from the country's fattest corner to its skinniest, are worried and trying to fight back.
Away down South
What might be America's most statistically depressing county doesn't look like as much, at least not from the highway, which is walled with immense trees and thick forest.
Holmes County's sorry stats — it's also the poorest county in the poorest state — aren't painted on the "Welcome" sign.
Durant, the county's largest city with a population of about 2,700, sits on Holmes' eastern edge, has a baseball diamond at its entrance and hosts youth football camps on summer evenings.
Lexington, the county seat, charms with its ornate courthouse that commands a historic town square.
More than 40 percent fall under the poverty line, but poverty and obesity aren't immediately obvious to the west, either, where forests give way to rich farm ground and well-irrigated crops growing in the rich Mississippi River Delta soil.
People aren't sitting in idling vehicles at fast food drive-thrus or waddling down broken sidewalks.
Holmes County isn't always what you'd expect, but in some ways, it is.
There's not a Natural Grocers there, and fresh, healthy food is hard to come by. Unemployment is, and has been, through the roof for decades, still lingering near 20 percent when it's not harvesting or planting season.
Diabetes affects 14 percent of the population, and there's a dedicated dialysis business with a packed parking lot and prime-time frontage on the road coming into Lexington.
Schools in the area deal with overcrowding on buses as two children now fill a seat meant for three.
County health care officials admit to being exhausted and overwhelmed in their work.
Many men, almost exclusively black, sit under the shady awning of abandoned businesses in the county's deserted small towns, watching traffic and life roll by. Men in Holmes County have one of the highest rates of hypertension in the nation. They also have among the lowest life expectancy in the nation. On average, they won't live to see their 68th birthdays.
In the land of cotton
Rich delta farmland provided the initial draw for settlers in Holmes County, and soon, large amounts of fruit, grain, vegetables and cotton were being shipped north through Durant on the Illinois Central Railroad.
A 1907 history of the state of Mississippi describes the county's early days of agriculture:
"It produces abundant crops of corn, cotton, oats, wheat, field peas, millet, sugar cane, sorghum and grasses and the Louisiana ribbon cane. Much attention is paid to the raising of fruits such as peaches, pears, early apples, figs, plums and strawberries, which do well and are shipped north in considerable quantities."
Slave labor was as much the kindling for prosperity as was that dark soil, and the African-American population grew rapidly.
Even before Holmes County sent nearly 2,000 men off to enlist in the Confederate Army during the Civil War, the 11,975 slaves outnumbered whites in Holmes County nearly two to one.
Slaves turned into sharecroppers after the war as agriculture remained Holmes County's focal point.
"The wealth of the region is in its abundant crops," author Dunbar Rowland concluded in the 1907 history.
Vast stretches of green prove that Rowland's claim still is true in 2013, but grocery shelves littered with rotting vegetables and the county's expanding waistlines show something has changed.
A growing problem
Routt County has enjoyed a different existence, one initially just as entrenched in agriculture though devoid of slavery.
First settled by gold miners in the 1860s and 1870s, the county traded on its natural resources, then grew in population as ranchers set cattle to graze and farmers dug into the Yampa Valley.
Skiing was a favorite local pastime in harsh winter months well before Steamboat Ski Area was opened on the slopes of Mount Werner. Now, that destination resort and the hundreds of thousands of tourists it helps attract annually define the county economically as much as agriculture ever has.
While Holmes County watched unemployment hover near 20 percent for the first half of 2013, Steamboat Springs, Routt's county seat, debated how to invest the roughly $6 million expected to be raised in the next decade by a tax on hotel and condo stays.
Routt County has kept its fit figure thanks to a populace largely focused on eating healthy and recreating outdoors on the hundreds of miles of the area's ski, cycling and hiking trails.
Despite all the healthy eating opportunities available — there are two full-size grocery stores and numerous smaller health-minded markets in Steamboat Springs alone — obesity still is on the rise, and the trend worries local experts.
The numbers particularly are troubling for the area's children, who, according to a recent study, are growing obese by 1 percentage point per year.
Barb Parnell, with LiveWell Northwest Colorado, began measuring height and weight data at the county's schools in 2009. The first year, 16.4 percent weighed in as obese. The last year, 19.4 percent tipped the scales.
"That's 30 kids per year moving into that category in Routt County. That's a lot," she said.
Despite its sterling national numbers when it comes to adult obesity, Colorado is very middle of the pack in childhood obesity, dropping from third to 23rd nationally.
For the adults and children of Colorado, thin doesn't just happen, not even in Routt County.
Courtney Reid said she's been big all her life. Unable to find the time to exercise and eat healthy while working the four jobs it took to pay the bills, she gained 80 pounds when she moved to Steamboat two years ago.
"My food source was my job," said Reid, who was working at two gas stations and McDonald's while baby-sitting on the side.
"It was getting hard to do normal things like going up and down stairs or tying my shoes. I said, 'I have to stop this. This isn't me,'" she said. "I've never been small, but I've never been a couch potato, either."
In Dixie Land
Calvin Head has been a witness to the change Holmes County has endured.
He was born 50 years ago into a sharecropping culture, and he spent his childhood working with his family in the plantation cotton fields owned by wealthy, white farmers.
The sun often was excruciating, the work horrible, but people did manage to eat healthier.
"Every backyard had a patch of vegetables. Fruit trees were everywhere, and even in the wild sometimes we found blackberries and blueberries," he said. "The stuff I ate, young people like my son don't have access to it."
Head left Holmes County for a time during and after college but felt drawn home and eventually returned.
The county to which he came back never has seemed quite the same.
Advances in agriculture have changed life radically on Southern plantations. What once took scores, even hundreds, of workers eventually took dozens and now often can be done by a few farmers. Machinery grew larger and smarter, slashing the man-hours it took to till, plant and harvest a field.
Employment always has been seasonal in Holmes County with the jobless rate spiking in the middle of the winter and the summer, then swinging hard the other direction in the spring planting and fall harvesting seasons. Now, the variation no longer is nearly as pronounced with unemployment settling at high.
"Chemicals are doing all of the work," Head said. "People used to work six or seven months. Now, they work maybe two or three months, then they're out of work that whole rest of the year."
The wide variety of crops grown in the 19th century has given way to vast swaths of high-yield, high-return corn, cotton and soybeans, and the backyard vegetable patches and fruit trees have vanished, at times victims of big-farm chemicals deployed by crop dusters.
It's all come down particularly hard on the black community, once a vast agrarian labor force but now largely out of work and located in the most rural parts of the county.
They are at the heart of the area's obesity and poverty problems.
They're also at the heart of the plan Head and other community leaders hope can turn it all around.
Head sees his home's salvation in becoming what it was. He wants to bring the vegetables back.
Looking for results
Obesity is a statewide epidemic in Mississippi, and even the state's top health official isn't afraid to celebrate the small things.
Holmes County may be ground zero for the problem, but its headquarters is the Mississippi State Department of Health in Jackson, the state's capital.
State Health Officer Dr. Mary Currier spoke in early July, waving a stack of papers in a third-floor conference room and pointing excitedly to the smallest blip of progress.
The evidence came in the form of an anonymous survey handed out to the state's children. It's an admittedly flawed study, inherently inaccurate because when asked to self-report weight, even children tend to fudge the numbers.
But if the same percentage fudged the numbers as they did on the past survey, Mississippi has good news.
The children of Mississippi reported lower numbers than they had on the previous survey, dropping adolescent obesity from 18.1 percent to 15.8 percent.
"That's not a statistically significant change," Currier said carefully. "But everyone else is still going up, so to have a leveling off, even a decrease, that's a wonderful thing for us."
Currier and her staff have launched initiatives, large and small, in their effort to make progress. On one end, they encouraged workers on their own campus to take the stairs rather than the elevator. On the other end, they've worked hard to educate the poor, rural populace about the dangers of obesity, trying to win over a culture that often sees a big baby as a healthy baby.
There's a problem at every turn from roads too narrow to support a walking group to stray dogs that keep some people indoors.
"Who would think of stray dogs as an issue?" Currier said. "But it is."
The staff at the Department of Health may be embarrassed by its numbers, but it's proud of its effort, and yet, there's a Wendy's directly across the street.
Holmes County doesn't have a Wendy's. It has four traditional fast-food joints: two Subways, a Sonic and a Church's Chicken. More unhealthy food flows from area filling stations than from any of those restaurants, however.
In Colorado, "gas station food" typically is reserved for a hunger emergency. It's something else entirely in Mississippi, where it means a smorgasbord of fried options that leave health officials frazzled. There's fried chicken, of course, and corn dogs, fried catfish, fried shrimp, fried okra and even potato-sized french fries called tater logs, all for about $3.50 per meal.
The dedication to the fight and the bewilderment at the problem are just as acute at the local level as they are in the Department of Health hallways.
Beverly Brown, the head nurse at the Holmes County Health Department, said the difficulties are constant. It's impossible to reach everyone, and some bristle when told their child is too large.
Many, however, listen, no matter how difficult the message is.
"People are trying to do better," Brown said quietly, stealing a few moments away from another busy day at the county's health department.
"They're really trying," she said. "Some you won't reach no matter what, but so many people are trying."
In the land of the skinny
Steamboat's Courtney Reid is trying.
She has seen both ends of the spectrum. She grew up on the Mississippi Gulf Coast in Biloxi, where, she said, "food is everything."
"We have family gatherings, and there's always a big dinner or lunch," she said. "With my grandma, it's whatever you can fry. Then you have rice or potatoes, and my family is Italian, so we have pasta and bread, too."
She's had an ever-evolving relationship with her weight.
She often would walk more than a mile to school in high school to keep it off, but she gained when she went to college, then more after college when she had a desk job.
A more active job in Florida helped her drop 100 pounds, but that weight loss evaporated when she moved to Steamboat Springs.
Her weight has left her feeling uncomfortable at times, like when she hasn't felt like tagging along with friends enjoying the outdoors. She's worried she might get left behind while hiking a trail or that it wouldn't be safe to ski at her weight.
Still, she has a bright personality, peering at the world through blue eyes and greeting challenges with giggles and an unfailing optimism.
When household chores left her out of breath, she decided something had to change.
Now, she takes strength from the support system she's found in her gym, and she heaped praise on her personal trainer, Brady Worster, who had to wage her own battle to get fit in Steamboat Springs.
Dealing with weight in Mississippi versus dealing with it in Routt County is different, Reid explained. Clothes that fit are easier to find in Mississippi, but people can be more judgmental. She shops online in Routt County but said people tend to look right past her weight.
She wants to know what she's missing out on — the hiking, the skiing, the jogging. She's already dropped 25 pounds and hopes to get down to 140, which would require losing about another 150 pounds.
"I've never been that low," she said, the giggle gone from her voice. "I want to know what it's like."
Routt County cares about its fitness, and so does Holmes County.
Ella Miller sees divine reasons to stay fit and thin.
She runs the Southern Barrel Restaurant just a block off the town square in Lexington, but she doesn't run it like she used to.
Walk in, and a customer is greeted by a few of the traditional trappings of a modern restaurant. There's one long, dark room with several long tables, and at the end, Ella, waiting with a wide smile behind a warming cart with the day's offering.
"What'll you have?"
You won't have fried chicken. Lard, a common ingredient in much Southern cooking, isn't there, and neither are any of the other high-fat foods she cooked a decade ago.
Now, there's baked chicken covered in herbs and other options, still delicious but made with health in mind.
"Some people still come in here looking for that, and I say, 'There ain't no greasy spoon in here,'" she said. "The Bible says, as you come into knowledge, you're supposed to do better, so I came into knowledge, and I'm doing better."
It's a message that resonates across the county.
One man ran 3 miles on a hot Mississippi afternoon just to get to a shady jogging trail.
Beverly Brown helps community leaders put on workshops to educate residents about their blood pressure and the dangers of obesity.
Kennedy Powell, the disabled man sweating under the gas station awning, dropped 60 pounds on his doctor's advice after he saw loved ones tangle with diabetes.
"I thought he wanted me to starve," Powell said, chuckling again.
But he's fallen off the weight-loss wagon and been pushed back into obesity, and it scares him.
Following the light
Holmes County has a proud history of innovation and advocation.
Durant was home to the first boys corn club, an agriculture organization that eventually grew into 4-H.
During the Civil Rights era, it was home to many of the Freedom Riders and was among the first battlegrounds as African-Americans fought to register to vote in the early 1960s.
Today, the county is filled with the children and grandchildren of those men and women and even a few of the Civil Rights pioneers themselves.
"We have learned to be resilient," said Calvin Head, who was drawn back to his birthplace. "I am proud to call Holmes County home."
Head sees a future for his county in its history as a vegetable and fruit cornucopia that both fed local residents and stocked regional grocery shelves.
He's assembled a co-op to help facilitate his dreams. It has signed on farmers with enough land — procured through government programs meant to help sharecroppers purchase the land they worked for decades — to begin the process.
"We're trying to set in motion this idea about growing and selling vegetables," Head said. "There's a huge demand for local grown produce and a lot of money to be made from doing it."
They have a farmers market near the town of Mileston and also take their crops to other markets in the area.
It has not been easy.
The operation was slowed this summer when the walk-in cooler being used to store produce was vandalized, the copper ripped from it to be sold. Head sees vast opportunity, though.
A vegetable-processing plant was planned for the county, and although that project hit roadblocks of its own, it could be part of an answer if it ever comes into being.
It would offer jobs to locals who have been out of work. It would help return the county to a day when fresh food was found in nearby fields, offering rural families healthy eating options near their homes. It even would keep money in Holmes County if the area grocery stores bought from the local processing plant instead of trucking in produce from far away.
"If we can get a few wrinkles ironed out, it will be a huge opportunity for the entire county," Head said. "It could be hope for the people here, the people like Kennedy Powell and some of the others who have given up on finding work."
Whether or not the county's problems can begin to be solved with such a plan remains to be seen, but as surely as the nation will be more obese in coming years, those in the areas most affected by the crises will try to fight back.
They'll try no matter how much is stacked against them.
"We don't just sit around and say, 'Oh, poor me,'" Head said, speaking with passion. "People here just need opportunities to better themselves. There is a light at the end of the tunnel."
To reach Joel Reichenberger, call 970-871-4253 or email jreichenberger@SteamboatToday.com