The Beaufort-Jasper-Hampton Comprehensive Health Services in South Carolina is more than just a medical center — it’s an institution woven throughout the social fabric of the people it serves, connecting lives across racial, ethnic, socioeconomic, and generational lines. 

That’s due in large part to the vision of Dr. M. LaFrance Ferguson, the former Chief Medical Officer for BJH, who currently leads the hospital’s National Hypertension Control Initiative. Fifty years ago, she saw the opportunity to build something so much bigger than a medical center: a scalable blueprint for closing outcome gaps in health longevity and centering health equity. At the core of her approach to building equitable health longevity is a community-centered model that provides comprehensive, quality, and accessible health care for everyone — regardless of their ability to pay. 

Dr. Ferguson’s legacy isn’t just theoretical — it’s clear and measurable. Fifty years ago, when the center was built, Beaufort County had key health outcomes that were on par with some of the worst in the world. But ten years ago, Beaufort became the healthiest county in South Carolina — and has enjoyed that status for the last decade.

In partnership with AARP, NationSwell interviewed Dr. Ferguson about her work, her legacy, and what others who hope to advance health equity can learn from her. Here is what she had to say.

NationSwell: When did you know that you wanted to focus your life’s work on community health? Was there a moment in your childhood, professional journey, or any time at all?

I recall sitting in a room at our home, when I was eight years old, and having a conversation, but there was nobody else there. I said to myself, “What do you want to be when you grow up?” At first, I thought, “I want to be a nurse.” Then I said, “no, I want to be a doctor and I want to be in charge.” Then I wanted to have the best place in the city, the state — and then I said, no, the United States, then I said, no — in the world, and I wanted to work with the underserved. 

I just came to that realization, in the past couple of years because our new COO had us explain to the new hires why we do what we do. I remembered that conversation I had with myself. “What eight year old knows about the underserved?” she asked me. I thought about that myself.

I also wanted to come back home. I wanted to work with the underserved, and the National Health Service Corps was giving scholarships for underserved areas. I thought, “This is exactly what I want to do; my area is underserved.” So I got my education paid for, and that was that.

What makes Beaufort-Jasper-Hampton Comprehensive Health Services different from the average hospital?

The word comprehensive is key. They say it’s hard to be all things to all people, but when you serve a group of people and you know what they need, and you can make things accessible to them, you can do it. We’ve got a variety of services: family practice, adult care, pediatrics, OB, WIC services, and we have a pharmacy. We even have migrant care. We make it a one-stop shop for people. We provide patients with everything they could possibly need, making health care easier for them to access. That’s what makes a difference: being comprehensive.

We also have behavioral health services. Sometimes people in the community just need someone to talk to, or to air out their issues. Sometimes people may have behavioral changes, and these health services can make a difference, in young people’s lives and older people, especially for older people, who may be experiencing loneliness, or may not have anybody to talk to, when they experience losses. It’s important to have someone to help them, as well as social services. Many people don’t know how to navigate the healthcare system, so having someone to help them do it can make all the difference.

We even have school-based health because many children can’t get to the doctor after school. Parents leave home early and get back home late,so children can’t get seen for simple things. Since we’re at the school, we can see them. They don’t have to lose chair time. We provide dental services, nutrition, counseling — it’s a comprehensive thing.

We offer nutritional services because nutrition is a major part of keeping people healthy. We help people understand that what you eat and how much you eat, affects your overall health. Giving patients a breakdown of foods that are good for their health and substitutions for foods they enjoy that are not so good for their health, makes healthy eating more convenient and accessible.

What are the health needs of the communities you serve? How does it help to meet those needs, and bring the community together?

At the inception of the organization, we had two big problems: One was the infant mortality rate. We had an infant mortality rate on par with third world countries – over 20%. We’ve brought this percentage down to the single digits by making two major changes: 1) providing prenatal care and the same high quality of healthcare to all pregnant patients, regardless of whether they were insured or not, 2) offering nutritional counseling to address the large number of parasitic infections found in children. 

The health status in Beaufort county was very poor. It takes 40 years to change a generation. We’ve been here 50 years, and in the past 10 years, this county has been the healthiest county in South Carolina. We’ve made Beaufort the healthiest county in South Carolina by providing quality healthcare to those who are uninsured.

How does your work with BJHCHS support aging patients and their health needs?

In one of our centers, we’ve created a senior center which provides one of the most needed things for the elder community: a place where they can meet and socialize with other seniors.  It is connected to our St. Helena site, and the seniors there have access to our pharmacy, educational materials, and seminars providing much needed health education — and pre-COVID, we even provided some trips for them. They’re also provided transportation to the center since many no longer can drive themselves. They truly look forward to the gatherings — and as an added bonus, if they have a medical issue, the clinic is right next door.

What are one to three things that other leaders looking to advance health equity learn from BJHCHS, and your legacy as a whole?

To be a community health center, you have to really be engaged with the community. The community is made up of all people – you need to be able to reach the lowest person and raise them up. That’s my thing: translating the services we provide, so everyone can understand what’s available to them. The most effective tool has been the community health worker because they speak to the patient in a way that the patient understands. They also find out the little things that make it hard for patients to comply. We thought patients were non-compliant, but there are things we can do to help them to navigate the healthcare system and be successful with the treatments we prescribe. 

We found out our numbers went up quickly when the community health workers were involved. For me, the key to a good community health worker is their personality. They must have a desire to help, be accommodating enough to connect the dots for patients, and contain a certain level of compassion. As long as they possess these traits, we can train them in the medical terminology, then they can translate to the patient. 

Due to money, the community health workers were lost for some time. We got a grant to bring them back and it was like going back to the future — being able to make sure people don’t get left behind, just because they don’t fully understand the health system or their treatment. You can’t stop doing it once they get to a certain point because there’s always going to be someone who needs to be shepherded along. You don’t get to the point where you don’t have to do that anymore. You’re still going to have to do it because we will always have the poor we have among us, and we should always be willing to help them along.

That’s community health: it’s not somebody who went to medical school, not a nursing aid, but it’s somebody from the community that is willing to help, and we train them in some of the things medically to help the patient reach the goals that we set for them in the practice.

Affordability is another thing that makes us successful. If  you can’t afford care, how are you going to get it? Healthcare needs to be made affordable because some people have to buy groceries first, pay the light bill next, and then healthcare is further down the line.

NationSwell: As a lifelong health care professional, what has been your guiding philosophy, your principles, or your core values that you center in the work?

I want to make sure people know I care. No matter what you’re doing or who you’re helping, they will respond better and they’ll be more  willing to do what you ask them to do if they know you care. Sometimes they can’t do what you want them to do because they can’t afford it or they just don’t understand. Making sure that people know that you care for them — that is my guiding force and I try to treat everyone the same regardless of their ability to pay for it. That was another good thing about community health centers that drew me to it: they treat anybody regardless of their ability to pay.