In the first year of the global pandemic, COVID deaths among Native Americans were significantly higher than any other ethnic or racial group in America due to exceedingly poor public health infrastructure. To combat the inequity, a group of public health workers in North Carolina led by Dr. David Tillman, supported by a grant from Interfaith America, worked to foster trusting relationships to tackle vaccine hesitancy and combat misinformation with the Coharie tribe in Sampson County. Producer Monique Parsons of Interfaith America reports this story from North Carolina.
Listen to the audio story on the “Interfaith Voices” podcast:
It’s been a busy few years for David Tillman. He’s a professor at Campbell University in tiny Buies Creek, North Carolina. He knows the place well.
David Tillman: I came to Campbell as an undergrad in ‘97. So I’ve been here a long time.
Campbell is a Baptist school with about 6,000 students …
Tillman: This is the academic circle … you can see the chapel ….
Tillman studied literature here. For a time he thought about becoming a pastor, like his dad. But he discovered a passion for public health, and he now leads Campbell’s public health program. It draws graduate students from far beyond North Carolina.
Tillman: … a bunch of students who were from California and the South Side of Chicago and places like that. They come to Buies Creek to study rural health, which is wild.
When the pandemic hit, he wanted to help. He teamed up with a colleague ..
Amy Hinkelman: I’m Dr. Amy Hinkelman, and my official title here at Campbell is associate professor of microbiology and immunology.
She also advises masters students studying biomedical science. In spring 2020, she had been wrapping up a study on vaccine hesitancy — and felt a bit helpless as she watched colleagues in medicine and nursing step up to serve on the front lines of COVID response.
Hinkelman: And then I’m like, ‘Girl, you’re an immunologist and an educator. You can use this to do something, you have a unique skill set, so let’s use it.’
Her research was on point. She contacted a professor at Wake Forest University, Ronny Bell, who suggested they look in their own backyard: specifically to North Carolina’s tribal communities. The state is home to eight state-recognized Native American tribes, and the Coharie tribe is centered in Sampson County, Campbell’s home base.
The need was dire: Studies showed that in the first year of the pandemic, COVID death rates among Native Americans were more than double that of whites and higher than other racial groups. Researchers point to many reasons: underlying health problems like obesity and diabetes, poverty, discrimination and a lack of quality health care in rural areas.
What happened next was an eye opening journey for Tillman and his students. It turns out that not only are many of their neighbors members of Indigenous tribes, but they also belong to small churches — small Southern Baptist Convention churches. Even though Tillman grew up Baptist himself, he didn’t know any of them.
Tillman: It was a cold call.
Turns out there’s a network of more than 70 Southern Baptist churches with indigenous roots, in North Carolina and beyond. With a grant from Interfaith America, which awarded Campbell “Faith in the Vaccine Ambassador” funding to do the work, Tillman, Hinkelman and their students set out to build bridges to some new territory. It was sometimes … uncomfortable.
The first time he met with a group of American Indian pastors …
Tillman: They were very kind. But the moderator said these words in introducing me, he said this is Dr. Tillman, he’s from Campbell University, he’s a public health professor, and Dr. Tillman — he looked over at me — he said, just so you know we have a hard time hearing folks like you sometimes because we still remember smallpox blankets. I get chills just thinking about it now because I’ve always since the beginning of our program 10 years ago talked about smallpox blankets as an example like you talk about the Tuskegee syphilis study as reasons that minority communities mistrust public health and government science.
And at one early meeting, he got some hard questions.
Tillman: I bet 40 minutes of that time was spent with me talking with them about whether or not the vaccine was the mark of the beast. That’s just not a conversation that a lot of folks in public health are ready to have or have any reference point for.
He knows that he can’t answer the question with science. Instead, he’s speaking to them as a neighbor and a fellow Christian. He makes it clear he’s not making money off the vaccines. And he tries to hear the concern about an impending apocalypse as rooted in real fear — fear of uncertainty and of being misled.
Tillman: A lot of times when there’s doom and gloom all around, it’s hard to know what to trust. And yet, the Christian faith is about in the midst of doom and gloom, finding hope. And hope in community. And it’s a community of folks who brought us the vaccine, and that’s the way that I try to reframe it.
Tillman spoke about the unique project with colleagues at a national public health meeting last summer.
Tillman: And I was sitting at a table with Berkeley and UCLA and Yale and Harvard, NYU …
When he mentioned Campbells’ work doing COVID outreach to rural neighbors who were Indigenous and Southern Baptist …
Tillman: You just saw their heads explode! They just had no reference point for this work … But one of the things that it reveals is both the challenge of COVID vaccine work in this particular instance but also the opportunity that an institution with faith history has in building bridges that are hard to build because what we have here is a racial minority group with this deep history of historical trauma that is also very politically and religiously conservative. It doesn’t really fit the boxes of the polarization that exists in our society.
Phillip Bell is a member of the Coharie tribe. He grew up in Sampson County. His dad was a sharecropper. Bell retired in 2012 after a 34-year career with the U.S. Department of Agriculture, and he met me at the Coharie tribal headquarters — in a building that once housed his high school — the first Indian school in the area and during Jim Crow days, it was the only high school open to Coharie teens.
Bell: Good morning!
Parsons: Good morning, thank you so much.
Bell has devoted his retirement to a project clearing and protecting the Great Coharie River, a sacred waterway that runs through Sampson County. He’s helped clear more than 120 miles of river for kayaking and helped the tribe secure federal and state grants to clean debris after hurricanes passed through.
Bell: The river was one of the cornerstones of the community. One cornerstone was the school here. One was the river and the other was the churches.
For generations, the Coharie have gone to the river to fish, meditate — and hold baptisms. While outsiders might expect him to feel a divide between his Native American identity and his Christian, Southern Baptist faith — well, that’s not his experience.
Bell proudly shows off the pride of the Coharie center — an historic canoe found in a county river in 2019.
Bell: The canoe is over 650 years. It’s made out of pine. It’s 19 feet long and I think at the widest point it’s 26 or 27 inches wide.
Visitors sometimes cry when they see it, Bell said. He believes the Lord helped bring it here — and when some young Coharie men sang and beat drums on the water one day, he felt Jesus’ presence.
Bell: The longer they played the better it got, until it was just like revival. Their voices just blended in the water, and …I could feel the hair standing up on my neck.
Southern Baptists know a few things about rivers too. Bell belongs to New Bethel Baptist Church in Clinton …
And at the front of the sanctuary, on a wall overlooking the baptismal pool, there’s a painting of the Jordan River — the river where Jesus was baptized. The Great Coharie is a long way from the Jordan, but perhaps — Bell texted me later — the process of evaporation and rainfall, some of Jesus is present in the Great Coharie river too.
Since the pandemic began, about 1 in 223 people have died in Bell’s rural county, a higher death rate than North Carolina at large. And vaccination rates lag here too. Less than a third of Native Americans in the state are fully vaccinated, compared to 63% statewide, and even fewer have received the new bivalent booster recommended by the CDC — statewide, only about 1 in 5.
Tillman, Hinkelman and a group of graduate students from Campbell University are at Bell’s church one recent winter evening. They bring dinner, and prizes and activities for the kids — and information about what’s being called the “tripledemic” — the wintry surge of COVID, flu and RSV cases. Close to 100 people show up.
The Senior Pastor, Dr. Christopher Webb. He is a proud member of the Waccamaw Siouan Tribe of North Carolina. He says his community appreciates the chance to sit down with experts from Campbell to learn more. And Tillman’s students appreciate the chance to be there as well —
Lauren Burke: My name is Lauren Burke, I am a master of public health student, first year.
She’s from Asheville, North Carolina, and graduated last year from the University of North Carolina Chapel Hill. She’s also been accepted to Campbell’s physicians’ assistant program.
Lauren: A lot of what we’ve learned in class is cultural humility, which is really just embracing others’ differences and helping them formulate a treatment plan that aligns with their mental, physical and spiritual selves.
After Pastor Webb leads a prayer ….
Followed by dinner, the group gathers in the sanctuary for a question and answer session with Tillman and Hinkelman.
There are questions about booster shots, and masks.
Hinkelman: The N95 is still recommended at any level if you’re a vulnerable person, if you’re immunocompromised.
Church members asked questions about healthy eating. And made suggestions for the next time Campbell University comes to the church, for a spring health fair. Overall, tonight’s session has been a success.
But Tillman admits he hasn’t always gotten it right — like a session he organized at the Coharie Tribal Center in summer 2021.
Tillman: Probably the greatest failure of this initiative is that we rolled out one of these beautiful mobile units. In the face of the community telling us, you know, we’re just not convinced that’s safe, we’re not convinced that it’s effective. It’s not convenience that’s the problem. We don’t need it to be more accessible, we just don’t trust it. All right, we knew that and yet we rolled a mobile unit out because that’s what we do. We had a bunch of vaccines and we had a handful of people show up.
And it can be hard to measure success, he says. He doesn’t follow people home from the info sessions to see if anyone decided to get a booster shot.
Tillman: One of the things I really appreciated about how Interfaith America ran this project is that the funding mechanisms were not tied to the things that in public health we love, which are quantitative measures. And that meant a lot to us because it meant we can do the work that I just described to you that’s relational and do it authentically.
But there are signs the outreach and the education sessions are working. Sometimes he hears anecdotes about people getting vaccinated after one of his talks. And he knew he was making progress when he got a text last year from one of the tribal members, asking if he and his students could help the tribe harvest sorghum fields the next day.
Tillman: I just thought that that’s the kind of text you get from a close friend or family member: “I need a little help tomorrow.”
After Campbell University’s recent “ask the expert” session at New Bethel Baptist church — Tillman and Hinkelman’s graduate students lingered near the front fo the sanctuary. A small choir practiced a new praise song …
Several of the students said they planned to return to the area after graduation — to be pharmacists, emergency room assistants and public health advocates. For Tillman, those kinds of anecdotes are the greatest signs of success.
Tillman: We see the pandemic as a call to action. Because the pandemic revealed to us in ways we’ve seen it before — we saw it with AIDS, we saw it with crack — crises just reveal the problems that already existed, so when you look in communities like American Indians in our state and the disparate outcomes with COVID or the disparate uptake in vaccines, that is a story with a long history and therefore we cannot wait for a crisis to begin addressing those things. You can’t wait until the hurricane to repair the levies. You have to have already done that work if it’s going to help save communities.
For Interfaith America, I’m Monique Parsons.