Dr. John W. Hatch is a social worker, sociologist, and Professor Emeritus at the Department of Health Behavior in the Gillings School of Global Public Health at the University of North Carolina – Chapel Hill. He served as the primary community organizer for the community health center in Mound Bayou, the first community-based public health program that delivered health care to Black Americans in the South. His leadership has established the framework for community engagement that health centers use to this day. The Our Health Stories team interviewed Hatch on June 29, 2023, August 29, 2023, and November 2, 2023. This profile was co-authored by Hatch in collaboration with Our Health Stories.
“John Hatch, in my book, is the most brilliant community organizer in the country and certainly the most brilliant I have ever met or known or worked with.”
— Dr. Jack Geiger (interview 2013)
Early Life
Dr. John Wesley Hatch was born on November 27, 1928 in Louisville, Kentucky, and raised in Corydon, Kentucky. Jim Crow Laws enforced segregation in restaurants, schools, and neighborhoods. His parents’ generation were fearful of the future and the violence they would face as Black Americans. But Hatch’s grandmother, a woman who spent the first 13 years of her life enslaved, held a deep conviction that the United States would achieve racial equality, that there would be a Black president, and that Hatch would have all opportunities available to him. Hatch remembers wondering “How is she out dreaming my college-educated parents?”
Hatch learned a lot from his grandmother. When he was 8 years old, Hatch accompanied her on long walks to Sunday church. He listened to his grandmother tell stories of how slave auctions forcibly separated his grandfather from his siblings and mother, why unrelated families shared the same last name, and how slavery haunted the lives of freedmen. Though Hatch did not quite understand slavery, he felt the emotion during these Sunday sessions.
Churchgoers found respite in each other when they shared the pain and hurt they endured while enslaved. People gathered to hug and comfort each other. Together, churchgoers dreamed of “a better day, a better time, and a brighter light”. These were the childhood experiences that cultivated Hatch’s reverence for churches as an institution for community building and healing, and as landmarks central to his future work.
Hatch’s grandparents were inspired by Booker T. Washington and believed education was the key to upward mobility. His grandmother knew that Hatch would be somebody and supported his ambition to become a senator. Hatch attended the University of Kentucky Law School. He was the first and only Black student at the institution, but the educational experience was “untenable”. He was taught a separate curriculum, had a “special table” in the corner of the Law Library, and could not practice in groups with other students.
Hatch left law school and enlisted into the military. Still, segregation and discrimination were pervasive. Hatch was not invited to the military state dinner despite being the top scorer of the comprehensive exam. It was only after he served in Japan and Korea for three years that he was able to experience luxuries, like attending the opera, freely. During his tour, Hatch saw the consequences of the US’s nuclear attack on Hiroshima and Nagasaki. He was struck by humanity’s capacity for destruction. His overseas experience shaped his interest in the human condition and compelled him to fight for Black freedom at home. Hatch studied sociology at Knoxville College and received his master’s degree in social work from Atlanta University.
Becoming somebody
Hatch’s professors at Atlanta University recommended he work in Boston at United South End Settlement to fulfill his urban setting practicum, which was required by the Master of Social Work program. Because it gave Hatch the opportunity to work with the seminal authors of and lead figures from the books he studied, he moved to Boston to work with settlement housing as a community organizer in training. Working primarily with immigrants, Hatch was immersed in diversity: Cape Verdeans, Haitians, Cubans, Jamaicans, etc. His definition of who was Black expanded.
While he attended to the housing needs of immigrants, he could not ignore the obvious connection between health and housing conditions. He found himself providing immigrants with the elemental basis of human needs: safety, food, housing, employment, and opportunity. He fixed potholes in the street with cement he mixed and poured himself.
Hatch would visit people personally, attend church services, and show up to tenant meetings to connect people to health care and housing resources. In doing so, he learned that elderly immigrants were primarily concerned with passing away with dignity. Collaborating with churches to improve quality of life, Hatch “realized that… the most active places for social action really were the churches”. Faith and health were important to Hatch and served as an entry point to learn about community needs.
Later, Hatch became the Director of Community Health Services for the Boston Housing Authority (BHA). His hands-on and innovative approaches in community engagement earned recognition from Tufts University. He was invited to present his work with BHA at the same meetings Dr. Count Gibson, the Director of Community Health of Tufts, attended. Intending to build a community health center in the South, in addition to Dorchester, Gibson was looking for somebody who could speak the same language as Southern folk, and Hatch, a Black, native Southerner, could overcome the community’s “reluctance of receiving help from White people or people of certain authorities”. So, Hatch joined Drs. Gibson and Jack Geiger in the community health center movement as faculty of Tufts University.
Hatch led the effort in finding where to establish the Southern site. During the 1960s, the South was fighting against any forms of integration. It was crucial that Hatch could find a location where Black and White professionals could work together with minimal resistance. He toured Alabama, Mississippi, South Carolina, and Arkansas. Ultimately, he was brought to Mound Bayou, Mississippi. In the heart of the Mississippi Delta, there was already an established hospital, Taborian Hospital. And decades before, from 1935-1942, Dr. Dorothy Ferebee, a trailblazer for public health, civil rights, and women’s rights, set a precedent by conducting public health work in Holmes and Bolivar County. Hatch was inspired by Ferebee’s ability to bring plantation people, White Southerners, and public health departments together under the shared mission of health promotion for Black sharecroppers and their families.
Understanding the danger presented to civil rights activists and clinicians providing medical care to Black Americans in the South, Hatch navigated honest and open dialogue with all, including those who opposed a health center in rural Southern Mississippi. He met with plantation owners. Never daring to go alone, he was always accompanied by the local preacher when he approached the gates and armed guards. One owner was so convinced with the mission, he gave 10,000 potato seeds and a seed-planting machine to Hatch. With genuine relationships, Hatch was able to earn support for the community health center in Mound Bayou.
Most importantly, he met with community members to listen and learn about concerns, needs, and available resources. Hatch was so dedicated to community outreach he went off the grid and into the fields picking cotton with sharecroppers. Telephone lines were inaccessible from the fields. Unbeknownst to Geiger and Gibson’s anxiety for Hatch’s safety, Hatch returned to Boston three weeks later, eager to share what he learned. Again, Hatch saw the social drivers of health, long before the term was coined.
The community health center was revolutionary not only for desegregating health care for the patient and physician, but also for directly addressing the social drivers of health. Hatch remarks on the remarkable work of Dr. Andrew “Andy” James, a Black environmental engineer and sanitarian, who facilitated the development of environmental health. Women were miscarrying after falling off stone and log “steps”, so community health center staff built proper stairs to houses. Children were dying from encephalitis, so they installed mosquito screens and nets. Water conditions tested poorly, so they dug new wells and built sanitary privies. James taught people, who were not literate, the procedures for testing water conditions. Hatch remembers how at least 40 people lined up to look at a drop of water under a microscope.
So, Hatch and members of the Delta Health Center created workforce development programs to accelerate staff training, quadrupling the number of licensed sanitarians in Mississippi and providing opportunities for community health workers and high school students to further their education and become a nurse’s aide, a social worker, a radiology technician, etc. Another achievement of Hatch was founding the North Bolivar County Farm Cooperative for the Delta Health Center. Residents were empowered to use their farming expertise to create sustainable food sources within the community.
It was important that community health centers were based on community participation and governance. Hatch connected with leaders in the community, preachers, school principals, grandmothers, and local government leaders. He organized the community members into 10 local health associations in Northern Bolivar County, modeled after the Black Baptist church, so that patients were represented on the health center’s board. Patient board members would shape the agenda to their needs. When Northern doctors were interested in addressing infant mortality, community members were more concerned with their elderly. The health associations ensured that the health center priorities aligned with the community and that underrepresented voices were heard.
In recognition of the success and achievements of community health centers, Delta Health Center board members were invited to Washington DC to share their story. The travel journey was a feat. For many, it was the first time they got on a plane, first time they left Mississippi, and first time they rode an elevator. In that unfamiliar DC conference room, they led the meeting with song and prayer. That allowed “the whole event to take place with some degree of grace and joy”. This moment reinforced the power of faith towards healing, community-building, and resilience for Hatch.
Centering community governance and participation, Hatch built the foundational model community health centers use for community outreach and engagement. Today, at least 51% of board members must be patients to qualify as a federally qualified health center.
Reflections
Mound Bayou had a personal impact on Hatch’s academic and professional career. Dr. John Cassel, the chairman of the Department of Epidemiology at University of North Carolina (UNC) School of Public Health who worked at the Pholela Community Health Center in South Africa in the 1940s, recruited Hatch to UNC. In 1970, Hatch enrolled as a doctoral student in Public Health at UNC Chapel Hill. Hatch joined the Department of Health Behavior as a Professor studying health promotion and disease prevention. Hatch retired in 1995 as a professor emeritus of health behavior at UNC Chapel Hill’s Gillings School of Global Public Health.
Hatch continues to leave a legacy for community-based public health programs. Hatch’s life and work inspired the Hatch-Barnhill Scholarship, which is awarded to a UNC Gillings student who exemplifies Hatch and Dr. Howard Barnhill’s commitment to community-based advocacy and public health programs for underserved communities in North Carolina. In honor of Hatch’s pioneering work in the areas of faith, health, and community organization, and his commitment to social justice, the FaithHealth Division of Atrium Health Wake Forest Baptist created the Annual John W. Hatch FaithHealth Lecture Series.