In Charlotte, a reporter traces health disparities back to the city’s long history of racism

It’s one thing to report about disparities in health outcomes.

It’s another to hear DonnaMarie Woodson’s story.

Woodson, a two-time cancer survivor, was the subject of an article I wrote on the real-world implications of health insurance access in Charlotte’s Black community as part of my “Womb to Tomb” series for the 2020 National Fellowship. Her very personal retelling of losing coverage when her husband was outsourced from his corporate job in Minnesota, signing up for Obamacare in Charlotte and then detection and treatment of her cancer as a result hit home. Not just with readers, but for me as a journalist.

That’s powerful stuff.

I’ve read countless articles and reports about disparities between Black Americans and the nation as a whole, but I wanted to explore how that gulf plays out in Charlotte, a city flush with growing wealth and a history of inequality that has left its poorest citizens marginalized. Woodson isn’t poor, but because of her financial situation, she and her husband were on the margins when they moved to Charlotte in 2008. In 2015, when doctors discovered cancer in her colon, it was only because she had federally subsidized health insurance. A few months later, an unrelated cancer was found in her breast. 

Without insurance, Woodson insists, she’d be dead.

Her story resonated with readers. Many were struck by Woodson’s willingness to share her story, which in many instances in the African American community, doesn’t come easily. It’s taboo to talk about a subject as terrifying as cancer within families, much less strangers. I lucked out: Woodson read the initial article in my series and was eager to open up about her personal ordeal because in her opinion, it conveys the power of health insurance access and advocacy.

Society doesn’t always live up to its stated goal of equality, even in what is considered a fairly moderate city like Charlotte. Its history of Jim Crow rules from housing to redlining Black communities still lingers in the 21st century, although most of its residents — who’ve moved here from somewhere else and are too young to have lived through it — have no idea.

These elements, I thought, would be more than adequate to build a foundation for the series.

To understand the connection between Jim Crow and health disparities, I sought out historian Tom Hanchett, an eminent expert of Charlotte and the South who skillfully linked the past to the present. He shared that Charlotte was a progressive city by southern standards in the late 19th century before a series of decisions by city leaders led to segregation of neighborhoods by race, stripping Black property owners of generational wealth that led to wider economic disparities throughout the 20th century. Without that economic underpinning, African Americans were forced to exist in a separate and unequal society that includes greater stress to their physical and monetary health.

What really struck me was that racial inequality is still fully present more than a century later. Black neighborhoods like Charlotte’s Brooklyn community were wiped out by construction of highways and extension of the Uptown business district, along with gentrification. Low-income African American neighborhoods were established next to heavy industry that took advantage of workers reduced to taking the most menial and dangerous jobs. In addition, those workers lived next to environmental hazards belching from those industries’ smokestacks as well as highways choked by increasing traffic congestion. The result is predictable: Generations of traumatized, sick, working-class Black people without the economic means to move to a better neighborhood, pursue education opportunities or access health care.

But the story doesn’t have to end there. One thing the reporting revealed is there is a passionate group of advocates pushing for change at the grassroots level. One of those advocates, state Rep. Carla Cunningham, is a nurse by training and profession. She’s worked in the North Carolina General Assembly to introduce legislation that would widen Medicaid eligibility as well as programs that would improve health outcomes for low-income residents. The hurdles are high in North Carolina, one of 12 states yet to expand Medicaid coverage under the Affordable Care Act. But Cunningham has managed to build some bipartisan bridges. 

No two projects or stories are alike, but there are always ingredients for success. Here’s what I suggest:

• Do your research prior to outlining your story. It’s one thing to roll out a grant-winning idea, but quite another to pull it off. Although I had an issue to focus on, it took some digging around to build out the infrastructure — sources, data and the like. In my project, there was a lot to consider. The workshops sparked ideas on where to look and who to talk to for details.

• Be liberal with outreach. You may know who to interview and what you’ll focus on but connecting with people outside of familiar channels can deliver the extra punch of pathos, personality or data. Whether it’s social media, telephone calls or random conversations, a call to participate can yield surprising results. That’s how DonnaMarie Woodson and I connected, and it’s a very good thing.

• Be curious. Is there an angle that can take your reporting to the next level? In my project, historian Tom Hanchett tied economics to environmental racism — something that has a direct impact on health outcomes. I hadn’t given that aspect enough consideration, but Mecklenburg County Health Director Gibbie Harris and Dr. Jerome Williams, senior vice president for consumer engagement at Novant Health, backed up Hanchett’s assertion. It added another layer that made for a fuller story.