Editor's Note: The Daily Tar Heel traveled to North Carolina's five poorest counties to gauge the University's mission to provide service to the state.
TABOR CITY - Beyond the Bell Tower lies a North Carolina that is completely alien to the world of elite education - a state where rural communities struggle against entrenched poverty, and poor farmers fight to save a dying way of life.
The hardscrabble life in Columbus County, the fifth-poorest county in the state, wears down residents - and economic deprivation often manifests itself in deadly disease.
"Eastern North Carolina, along this area, is considered the stroke belt of the nation," said Deborah Albritton, director of Columbus County Healthy Carolinians.
The health service area that encompasses Columbus, Bladen, Robeson and Scotland counties also faces daunting levels of cardiovascular disease, she said.
"We are the worst in the nation with heart disease and stroke rate."
Many residents simply aren't aware of basic healthy practices such as how to store fresh produce, she added. "A lot of time it's not that it costs more, it's just getting the information out."
She said student interns are a great help in distributing information across Columbus County, the state's third-largest county in terms of geographic area.
The county's health department has worked with several UNC-system schools, including UNC-Chapel Hill.
Students from the nursing and pharmacy programs at UNC-CH regularly complete clinical hours in Columbus, said Kim Smith, the county's health director.
The University's professional schools are a valuable resource for all county health directors, she said. "We feel free to call the School of Government and the School of Public Health to ask questions and get information."
UNC-CH organized a stroke registry that concluded last year, Albritton said, adding that the project fit in with the county's attempts to think more globally about its health issues.
"We can get more bang for the buck by pooling our resources together."
The heavy cost of health care
Kipling Godwin, chairman of the Columbus County Board of Commissioners, said the state's poorest counties are affected disproportionately by North Carolina's requirement that counties pay 15 percent of Medicaid costs.
"Those are also the counties that are least able to pay the Medicaid expenditures because they just don't have the revenue to support that."
Almost a third of the county's residents are eligible for Medicaid, and the county spends about a third of its property tax revenue, its main source of income, to fund the program.
"We fund law enforcement and education at the minimum level because that's all of the funding we have available," Godwin said.
Columbus' growing pains
Columbus County remains primarily a rural, agricultural area.
"Tobacco's still strong in Columbus County," Godwin said.
The county benefitted greatly from the tobacco quota buyout of 2004, which enabled many farmers to increase their output.
But he said the buyout is only a short-term fix - one that will last 10 years at the most. In the meantime the county is exploring alternate crops. "We're trying to help the farmers diversify."
The county also is developing agro-tourism and heritage tourism to capitalize on the aspects of its rural history that are unfamiliar to the state's urban residents.
Such local projects could benefit from an entrepreneurial initiative the University is developing.
Michael Smith, UNC-CH vice chancellor for engagement, said he is working to help city and county officials find local economic assets.
Smith said he would sit down with the Golden LEAF Foundation early next year to seek $10 million in funding for the project.
"If these communities appear to have a strong economic future, then the young people who may think about leaving will think about staying."
Although the area's population has grown slowly in the past decade, rapid growth from nearby Wilmington, Fayetteville and Myrtle Beach is starting to spill over into the county.
"The development, we believe, is coming," Godwin said.
As land prices increase in coastal areas, residential developers are looking to build in Columbus, and citizens are moving inland to take advantage of cheaper housing costs, said Jim Hinkle, interim director of the Columbus County Economic Development Commission.
"They want to be in the area, near the beaches and near the coast, but they can't afford half-million-dollar homes."
As the Port of Wilmington continues to expand, the eastern section of the county will become a hot spot for warehousing and distribution centers, Hinkle said.
"I think the prospects are much better for the future of Columbus County than what's it's been."
Godwin said the county also will gain 500 to 600 state jobs from the construction of a new state prison in Tabor City. "That's going to be a nice economic driver for our area."
Overcoming a violent past
The quality of life has changed drastically in areas of Columbus County because of Horace Carter.
When Carter came to Tabor City in the 1940s to start a weekly paper, the town was commonly referred to as Razor City, a not-so-subtle nod to its notoriously violent reputation.
Several years after he began publishing, Carter stood on a dark street corner and watched a parade of cars pass by, the lead car displaying a lighted cross on its hood.
The next week he wrote the first of nearly 80 editorials opposing the Ku Klux Klan. His editorial campaign earned him numerous death threats. "To this day I say it would have made a fine story if they had shot me - but they didn't."
Daily newspapers gradually joined his cause, generating enough heat that FBI officials were sent to investigate. A total of 254 indictments and 62 convictions ensued.
In 1953, Carter was awarded the Pulitzer Prize for Public Service, making the Tabor City Tribune the first weekly paper to win the prestigious award.
His family company, the Atlantic Corporation, has used its profits to donate a building to Tabor City; the site will become the new headquarters for city hall and the local police department early next year.
Carter said his greatest achievement is helping Tabor City escape its infamous reputation. "We're not Razor City anymore."
A celebration of agriculture
Hard-working Tabor City residents came together last weekend to celebrate the efforts of local farmers and gather free food.
In less than 40 minutes, 9,000 pounds of free sweet potatoes disappeared.
The sweet potatoes, mostly donated by local farmers, were the centerpiece of the annual N.C. Yam Festival.
"They tell me these people won't get no potatoes unless they get them here," said Paul Hathaway, owner of Carolina Packing House Supplies and organizer of the sweet-potato giveaway, now in its 21st year.
The Yam Festival is one of four major commodity festivals held in Columbus County. The Strawberry Festival, held in Chadbourn, is the oldest such festival in the state, dating back more than 70 years.
Such spirited celebrations can't mask the fact that agriculture is a hard way to earn a living.
But Tabor City Town Manager Al Leonard, who strolled around the festival in overalls, walkie-talkie in hand, said Columbus County has been an ideal place to raise his two girls, despite the challenges of rural life.
"Just raising them in a small-town atmosphere was really important to me and my wife."
Contact the State & National Editor at stntdesk@unc.edu.
