John W. Hatch, Professor in the School of Public Health, has led in the crusade to bring community based health care and education to African Americans, using the black church as a conduit. (Interviewed in September 1991 by Fay Mitchell)

I came from a health project in Mississippi. I had been there about five years and met various people from Chapel Hill and was powerfully impressed with the insight and understanding that they could bring to the kind of work that we were trying to do there. I was rather pleasantly surprised at a group of people who seemed to understand what it was we were about. I suppose those initial contacts with Chapel Hill people probably began around 1965 with consultation with Dr. Lucy Morgan, and then at a later point I met Guy Steuart, who was chairman of this department [Health Education], John Cassel, who was chairman of epidemiology, Don Madison, who's still here with administrative medicine and health services research. They more or less said Chapel Hill is the kind of place that we think could contribute to your career development and professional growth and so forth. That was attractive, and I suppose another very powerful factor was the fact that my parents had many years ago moved to North Carolina. My father was an AME Zion pastor, they tend to move around a lot. I guess it was about 1949 or 50 that my parents came here. So, coming to North Carolina in addition to the resources of this institution and what it might do, it was also an opportunity for my children to get to know their grandparents better and interact with their cousins who also live here.

I came here in 1970 as a research associate with the Health Services Research Center, with the notion that I would work part time and work toward a doctorate. I actually did both, but then within about a year and a half, switched over to full time toward doctoral studies. I didn't have firm plans beyond that point.

I suppose I should back up and say, prior to, I guess it was only a month before I was to leave Mississippi, my plans were to go on to Boston, but the opportunity to come here, in addition to family and the institution [won out]. It was also an opportunity to stay in the South, and that's something I wanted. [I've lived] in the South all over the place, in Kentucky, in Arkansas, in Mississippi. I also lived in Tennessee. I have always felt that the region has tremendous potential. But many people especially then, after completing school, unless you wanted to be a preacher or a teacher, the best shot was probably to go North or to go West. Because opportunities in this part of the country prior to the really mid '60s, early '70s were not great.

Mitchell: What has been your involvement with AHEC?

Hatch: AHEC contact has not been the strongest part of my participation here. They have facilitated some of the things that I have been interested in, I've also participated in a number of AHEC conferences. I've always welcomed these opportunities because it does provide contact with people who are on the front lines of practice, and I always feel that the exchange is a bit more than equal. I always learn more than I take. I think it's an excellent program here in North Carolina and I would like to see it continue for a very long time.

Mitchell: What is your specialty area?

Hatch: The area of health promotion in churches. Over the last twelve years I've been able to get about seven funded projects of various types, focused toward church networks. Most of these projects have been denomination focused, with the AME Zion Church, with the General Baptist State Convention, with the United Methodist Church in South Carolina and in both North and South Carolina work with networks of churches across denominations. The reason for this is that the church is the most important institution in the black community. It has a tradition of service, and it seemed to me that if you could influence those systems that are already focused and devoted to service, if you could influence them to do this in a more precise way, with perhaps more careful attention for the type of input that would have the greatest impact, that would be the way to go. After 12 years of fairly intensive involvement I'm still convinced that is the way to go.

Mitchell: [What projects or programs did you carry out?]

Hatch: The first phase programs were based on essentially increasing the level of technical awareness of certain high risk conditions of black people in North Carolina rural communities in particular were exposed to. These were hypertension, diabetes and problems in maternal and child health as sort of a core. What we attempted to do was raise the level of awareness of what ideally should happen, and to identify people in churches who could take on the role of health advocate and facilitator. Not only would they identify people who might find the information useful, but they would also establish contact with provider organizations, as well as identify things that could happen at the individual, family and community level to make it better for people who were suffering these disabilities. An example of this would be in black communities so much of the celebration of life is around food, and I guess I'm a prime example of the consequences of that. One of the criteria for evaluation is to be able to attend these wonderful celebrations of life and not violate the diet that a hypertensive should be on, or a diabetic, to have choices, and if you can get some of these folks in these churches who can cook food that you cannot resist - if we can get these people into an awareness of the kind of foods that are all right - I'm sure their gonna make it the very best in the world.

Mitchell: How has the University been of assistance to you in getting these programs carried out?

Hatch: Well, first the flexibility in what you do in the area of research demonstration projects to follow your own interests, I think that's really important, and then the ability to pull together, not only the ability to do that, but the willingness of my colleagues within this environment to bring technical assistance and support to these projects. So when there are issues related to maternal and child health, I'm very comfortable reaching out to people in that department for expertise that I would not have. The same thing around issues of nutrition, or matters related to social psychological stress. I've had excellent support from other faculty as well as students generally in the School of Public Health, the School of Medicine, and Nursing. They've all at various times participated in projects that I've been interested in.

Mitchell: [Have you encountered sufficient acceptance for your work?]

Hatch: I suppose one has to find one's way. There were those people who had interests that were similar to mine, or complementary. Of course, you usually gravitate to those people. There are others who still probably regard my strong interest in churches as kind of fringy to the whole process of what we're about, but that's all right, as long as they can't stop me from doing it. Overall I would say that's fair enough. I think many of the things they're doing are perhaps of marginal value too. That's a fair way to handle it I think.

Mitchell: [What has been your experience with students?]

Hatch: That's been one of the really rewarding aspects of being here. First, students keep you on your toes. Secondly, they're at a point in their [lives] where many of them are open to new ideas. They're willing to modify their thinking, and it's particularly rewarding when students call back, five, six years later to get a project together or something in which they feel I have expertise and they'll call and ask me to review a paper, a grant proposal or something like that. I really appreciate that. In thinking of some of the really great things that have happened, I remember getting an invitation from a white woman, who was a nurse, to visit her nursing program because she had made an effort to introduce greater sensitivity to minority health issues in her setting. She had taken a course with me on that subject maybe six or seven years earlier, and I did visit, and was absolutely excited at the very high quality of her instruction in the area. She was teaching essentially many of the concepts that she had with me at an earlier point in time. And I was just excited by the fact that her students who were black and white and Indian North Carolinians were so conversant with the literature, and had some good notions of how they would approach a multicultural situation.

Mitchell: [Can you tell me about your work with the World Council of Churches?]

Hatch: Until this past February I had been moderator of the Christian Medical Commission of the World Council of Churches in Geneva. This was a very, very rich opportunity for me to see health operations that are church-based around the world, and provided extensive opportunity to travel and interact with people who were doing grassroots health and development in many different nations. I feel too, that having had the opportunity to contribute to this process of developing awareness of the need to take a more ecological prospective to health, that certainly just the delivery of health services alone or just chasing symptoms, as I'm afraid we often do here in North Carolina, is inefficient. We want to do something about infant mortality, so we go for teen-aged pregnancy. It's quite appropriate, but I see that as a symptom of a malaise within this society, and until we come to grips with the fact that we need to be much much more comprehensive in our approach to problem solving, then I think we're going to be frustrated.

Mitchell: [What about community relations?]

Hatch: I think it needs to be addressed. I think for many of us it is a dilemma in that the criteria for evaluating performance [are] not always congruent with the needs of the community, and if a young professor should come here and become too involved in the community, or very involved, they may neglect the research and money generating activities that are [the] basis for reward. That means tenure and promotion. I would like to see greater use of university resources toward trying to solve some of the social problems within society, and clearly black people are now experiencing disproportionate burdens because of many, many upheavals that have occurred. For an example, the movement from rural living to urban living would be one example. Another one was the desegregation and all that means, and clearly I support it, it was long overdue, it never should have been. On the other hand, to assume that a transition of this magnitude could occur without some negative consequences is naive. I think we're still wrestling with how to survive in a desegregated society with an intact ego, with a good sense of personhood, and a sense of community. We're learning to do this.

Mitchell: [Can people do that here?]

Hatch: To a considerable degree I think we can. I suppose in many ways I see myself as an insider to black institutions and perhaps to some degree an outsider here. So, I guess sociologists might say that I'm a marginal person in that I have anchorage in both systems. But given my life experience, the fact that I grew up and lived in a rigidly segregated society, my grounding in terms of a sense of who I am, is still within a context of these black institutions. Now, I'm not sure what kind of life my children are going to live, but for me, my grounding is within the church, and within the fraternal orders that my parents and grandparents took me to.

Mitchell: [What about the problem of Black student drop-out?]

Hatch: First I think for many it's kind of an alien experience. Certainly comparing the support, the emotional social support the students get. When I went to college [Knoxville College in Tennessee], a small, black Presbyterian college, [there was a] tremendous amount of social support. It was a very comfortable place. There was no doubt at all that some of the faculty cared about us very much. Here at Chapel Hill you can just simply get lost. I think that is a part of it. I think there still are people in the environment, both students and faculty, who perhaps undervalue black students, and may unwittingly say things or do things that cause them to feel uncomfortable. I have three children and they've gone to both white institutions and black institutions. I think it's a mixed bag. The one son who went to North Carolina Central, he comes back, he goes to visit his major professor, when he makes major life decisions he communicates with him, and it's just a very fine relationship and I have no doubt that this professor had impact on his career choices.

Then another son who attended this institution [UNC at Chapel Hill], realizing that these are different people with different personalities and all of that, but the son who attended this institution never developed those kind of ties with his professor nor had a strong identity to any one of them. I think the likelihood of establishing a positive affirming relationship is probably less in an institution first of this size, and one who's traditions are white.

Mitchell: [Is it correct that the Black community is suspicious of UNC?]

Hatch: I think it's right, in the sense that that's indeed the way most black people look at this institution. And I should add that when I first came here they looked at black people in this institution with a fairly high degree of caution. You know, what are you doing out there in the master's house and can we really trust you. I think the only way, not the only way, but certainly one of the ways to overcome this is to make the resources of the institution much more pertinent to the kinds of interests in improvement and development that now exist in the black community. There's been a lot of research there, but most of it has been in the interest of the researcher, or the institution, and not necessarily congruent with the community's perception of the greatest need. And there are great problems out there. Community leaders recognize this. But I haven't really had the kind of experiences with many researchers that would cause them to see this as a place that truly can help them to solve these problems, and I think it can be that kind of institution, and I think that those relationships are possible. Looking at the record, it has unfortunately been overwhelmingly white educators, sociologists and psychologists and education specialists who sort of defined who black people are in the literature, and much of this literature is negative. If my impression of who black people are rested on the literature about black people that I've read, then I'm not sure whether I would want to be very close to those folks because so much of that literature has a focus so strongly on the negative aspects of the community. You sort of find what you look for. If you look for weakness you will find that, conversely, if you look for strengths I think you'd find an abundance of those as well.

Mitchell: What are the advantages to UNC?

Hatch: I'd say, first, perspective. We know some things that white folks don't know because we've had the black experience in America. How I say much of what I say has been in fact focused or shaped by the experience of being a black man. In North Carolina right now, black people do carry a disproportionate burden of health problems for an example. We have been less successful academically, etc. This is not only harmful to black people, it's also harmful to whites. Because we're all Americans, we're all North Carolinians, and whatever we can do to help people of this state be more productive, then we should do it. It seems to be that the degree to which I can help those people who are not black to function more effectively in providing services to black communities and working cooperatively, with black organizations and institutions, that's a tremendous benefit.

Mitchell: How about attracting students?

Hatch: I think getting more out who have had positive experiences would be one way to do that, because as you point out, many students have come here, and the results have not been good, I think for a lot of reasons. I think I would hope the University could move toward a more comfortable posture in providing support to black students. There are always these criticisms of "Aren't you doing too much for these people, coddling them," and so forth. Well, you know, clearly, I don't think that is the case, and until enrollment comes closer to the actual percentage of blacks in the state's population, there will continue to be these concerns and you'll continue to see this as the white institution.

Mitchell: Do you feel good about your time here?

Hatch: Oh, yeah, very much so. Prior to coming here I was at Tufts University. That had been a positive experience. It was in Massachusetts. But I think the opportunities for community development in Massachusetts are somewhat less than they are here in North Carolina. I think here in the South black communities have tremendous strengths. First, many have been stable for a long time. People have developed institutions and linkages that are very, very supportive environments for raising children. Not saying that the North is a bad place at all, but the presence of extended family networks [and] the great importance of the church here, all point to sort of a social environment that I think it's potential has not been recognized by many people. I know communities that if you go into they don't look very impressive or imposing, many modest houses, some substandard. The quality of relationships are often high, just very high. You see situations where kids are being affirmed, where they're being nurtured, and we don't know nearly enough about that. I would like to see young black scholars devote more time and attention to these positive resources that are out there. Learn how to link these with technology and educational opportunities that would help black communities toward being more viable economically and politically.

I think that just to put things in perspective, and as I get older, now I've been here 21 years, that's really not a long time. That's a generation. I don't know what the next generation will be, nobody does, but I would hope that in another 20 years we're much further along, and in order to be further along, I think we have to set up goals and objectives, and I would hope that there would be monitoring along the way. 'Cause if we allow things to drift, I don't think they're ever going to get better by themselves.

[Edits by Vic Schoenbach, 11/19/2007 and 4/26,28/2008]

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4/28/2008 by Vic