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Duke Health aims for statewide expansion

Growth collides with rising seas in Charleston, Why Dozens of Killings In Mississippi Prisons Go Unanswered, Feds Cancel Study on Health Impacts of Industrialized Hog Farms That Produce Biogas

Duke Health aims for statewide expansion
Photo by Ian Palmer / Unsplash

It's Friday, September 12, 2025 and in this morning's issue we're covering: Growth collides with rising seas in Charleston, Federal operation at Savannah-area Hyundai plant nets 475 detentions, Duke Health aims for statewide expansion, Why Dozens of Killings In Mississippi Prisons Go Unanswered, Federal government cancels study on health impacts of industrialized hog farms that produce biogas, Can Zohran Mamdani Really Freeze the Rent?

Media outlets and others featured: Floodlight, The Current, North Carolina Health News, Mississippi Today, Inside Climate News, The City.


This story is from Floodlight, a nonprofit newsroom that investigates the powerful interests stalling climate action. Sign up for Floodlight's newsletter here.

Building toward disaster: Growth collides with rising seas in Charleston

A billion-dollar seawall may shield the city’s wealthy core — but not the vulnerable communities beyond it. Who will be forced to move?

Ames Alexander/Floodlight

On a quiet street near the marsh in Charleston, South Carolina’s Rosemont neighborhood, Luvenia Brown watches the weather reports more than she used to. She’s lost lawn mowers, bikes and outdoor furniture to the rising waters that have repeatedly crept into her yard.

Brown’s home is elevated, so the water hasn’t reached the interior. Not yet. But she’s deeply worried about what the future will bring.

“If the water continues rising the way it is, I don’t want to be here,” said Brown, 58, who works as a medical driver. “... I love my area. But I think my life is more important.”

Just a half mile to the south, a massive new development — expected to bring stores, offices and 4,000 homes — is springing up. Brown fears that all the new concrete and pavement will only make flooding where she lives worse.

Charleston is one of the fastest-growing cities in the country — and one of the most flood-prone. As climate change prompts sea levels to rise and storms to grow more intense, this historic city has become a warning bell for what’s to come along America’s coasts: Some neighborhoods will retreat and others will be protected, and still others — often lower-income communities — may be left behind.

In Charleston, those futures are colliding. The city and the federal government are planning a $1.3 billion seawall to defend the iconic downtown peninsula with its regal, pre-Civil War mansions and majestic moss-covered live oak trees. 

But under the current plans, the wall would not extend to lower-income neighborhoods like Rosemont, a historically Black community bordered by a freeway and hemmed in by industrial sites. That could leave those families more exposed than ever.

“I’ve seen how all those floodwaters demolish people’s houses,” Brown said. “I don’t think I want to be part of that.”

What’s happening in Charleston is playing out in dozens of coastal cities from New York to California. Driven largely by sea level rise, flooding in the coastal United States is projected to occur 10 times more often over the next 25 years, according to a recent analysis by Climate Central, a nonprofit group of scientists and journalists who conduct research on the changing climate. An estimated 2.5 million Americans could be forced to relocate over the next 25 years, the group found.

Nationally, poor communities are disproportionately affected by hurricanes and flooding, research shows.

The increasing floods are prompting insurance companies to raise premiums and decline policy renewals. In fact, ZIP codes in coastal South Carolina are among those with the highest insurance nonrenewal rates, according to a Brookings Institution analysis. All of that is likely to push some residents to higher, or drier, ground.

To understand how Charleston reached this tipping point — and what makes it especially vulnerable — you have to start with its geography.

Rising water, growing crisis

Charleston has always lived with the water. 

Built along the confluence of three rivers and the Atlantic Ocean, the city was founded on marshland and mud flats. Flooding there was once far less frequent. 

But now, even an afternoon thunderstorm or an unusually high tide can overwhelm drainage systems and submerge streets.

On Aug. 11, a combination of heavy rains and high tide flooded large parts of the city, prompting some motorists to abandon flooded cars. Just 11 days later, another round of flash flooding left parts of Charleston knee-deep in water, forcing dozens of road closures and prompting the city to offer free parking in elevated garages. 

And during a recent visit to James Island, just south of the main Charleston peninsula, a Floodlight reporter and photographer observed cars splashing through 2 inches of standing water — the aftermath of a short storm. 

The problem isn’t just more rain — it’s higher water. The sea level around Charleston is rising faster than ever. It’s risen about 13 inches over the past century. But by 2050, scientists project it will rise an additional 1.2 feet; and by the end of the century, the water is expected to be about 4 feet higher than it is today.

The ground is sinking, too.

Charleston is one of the most rapidly subsiding cities in the United States, mainly because of groundwater pumping and the settling of natural sediments and filled marsh areas. That double threat — rising seas and sinking land — leaves the city increasingly exposed to flooding.

According to Climate Central’s Coastal Risk Finder, more than 8,000 people and 4,700 homes in Charleston County will be at risk of annual flooding by 2050, even under moderate climate action scenarios. By 2100, more than 60,000 people could be affected.

The Lowcountry, as this region is known, was always low. But now, it's getting lower, wetter and harder to protect.

Rapid development, meanwhile, is paving over forests and wetlands that once soaked up stormwater, which means water runs into residential areas more quickly during torrential rains. Every new subdivision and strip mall replaces absorbent ground with impervious surfaces — asphalt, rooftops, parking lots — that send rainwater rushing into neighborhoods like Rosemont.

The uneven fight against the sea

After Hurricane Matthew sent water surging over Charleston’s iconic Battery wall in 2016, city leaders searched for a new approach. Then-Mayor John Tecklenburg and other officials began consulting with Dutch flood experts, seeking to tap the know-how of a country renowned for its expertise in holding back the sea.

Those conversations helped lay the groundwork for a comprehensive city water plan, which focuses on protecting Charleston from flooding and rising seas while promoting smart, resilient growth. Building on that effort, federal officials introduced a bold proposal: an 8-mile-long seawall, designed by the U.S. Army Corps of Engineers, to shield the city’s historic peninsula from future storm surges and sea level rise.

The total cost of the seawall: $1.3 billion. The city’s share will likely be more than $450 million, and Tecklenburg said that won’t be an easy sell. But to the former mayor, the choice is clear. 

“You can't give up the peninsula,” he told Floodlight. “If you give up the peninsula, you might as well head for the hills.” 

But the seawall will protect only the downtown. Neighborhoods like Rosemont — just beyond the wall’s reach — will remain exposed. And some fear the wall could actually make flooding worse in unprotected areas.

Federal sea rise projection maps show that some streets in Rosemont, including Luvenia Brown’s, will likely be underwater by the end of the century. That doesn’t even account for the stronger, more frequent storms scientists say are on the way — the kind that could make flooding here even worse. 

Skip Mikell, a longtime community leader in Union Heights, a historically Black neighborhood just north of Rosemont, has become vocal about the threats that face low-lying communities across the area.

Mikell recently stood at the end of Peace Street in Rosemont, looking out over the neighboring marsh as he discussed what’s ahead: “In 70 years, where we’re standing, if nothing’s done, it’s going to be water.” 

In her home one block over, that brings little comfort to Brown. The Ashley River is about a quarter mile from her house, and when storms come, there’s nothing to keep the water away.

But housing prices in Charleston have climbed so high, she’s not sure where she’ll go once it’s time to move.

“The gentry of Charleston have connections, they have money, they have a voice,” Mikell said. “These communities are voiceless.”

The long road to retreat

About 12 miles northwest of downtown Charleston, a tranquil expanse of weeds, marsh grasses and black-eyed Susans stretches across what used to be a neighborhood. Bridge Pointe was once a compact community of 32 townhomes. 

Now it’s gone.

The site was returned to nature after the city and federal government bought out its flood-weary residents. But like many buyouts across the country, the process was slow, bureaucratic and agonizing for those caught in limbo.

John Knipper was one of them.

He moved to Charleston in early 2015, newly retired from an IT job in New York. Drawn by the milder winters and lower taxes, he bought a three-bedroom townhome in Bridge Pointe for $172,000. At the time, it seemed like a safe investment. It was a tidy, attractive community, with garages, wood-burning fireplaces — and no history of flooding, even during Hurricane Hugo in 1989, he said. His flood insurance premium was minimal.

But just six months after he moved in, an August thunderstorm turned a nearby creek into a river. Several inches of water crept into his living room. Then came October 2015. A stalled weather system dumped more than 15 inches of rain on the region. His first floor was submerged under 2 ½ feet of water.

Over the next few years, the floods kept coming. The neighborhood sits in the Church Creek basin, a low-lying, heavily developed part of the West Ashley section of Charleston, west of the city’s main peninsula. 

About a year after the second flood, the city applied for a FEMA buyout to help Bridge Pointe’s residents relocate. But the application was rejected.

In 2016, Hurricane Matthew struck. The next year brought Tropical Storm Irma. Knipper and his neighbors waited uneasily for the next storm. He kept a stack of bricks by his front door to quickly elevate heavy furniture when the floodwaters came.

In 2017, FEMA authorized $10 million to buy out the Bridge Pointe homes and a handful of others nearby. By then, Bridge Pointe had flooded four times.

“Those homes were really unsellable,” Knipper recalled. “So then you finally find out that you’re going to get bought out — it’s like, hallelujah.” 

But then he and his neighbors had to wait some more. Appraisals. Negotiations. It wasn’t until mid-2019 — nearly four years after buyout discussions began — that the last residents received checks to relocate.

“It was a classic story of government red tape,” said former Mayor Tecklenburg. “... It was just too hard and too long.”

Such delays aren’t unique to Charleston. A review by the Natural Resources Defense Council found that the median time to complete a flood buyout nationwide is more than five years.

A 2020 report by the U.S. Government Accountability Office, meanwhile, found there's no national strategy or steady funding for relocating people from flood-prone areas.

Knipper eventually settled in Summerville, 15 miles inland. His new home is at the end of a cul-de-sac on slightly higher ground than most of his neighbors. It has stayed dry so far. But even there, nearby streets sometimes flood during heavy storms.

“There’s flooding risk everywhere,” he said.

Back at the Bridge Pointe site, nature has returned. A pond formed where buildings once stood. On a recent morning there, ducks glided across the surface while an egret perched on a stump.

Looking out over the pond during a recent visit to his old neighborhood, Knipper said: 

“I guess what it says to me is the land shouldn’t have been built on in the first place.”

As wetlands disappear, risks grow

Just a mile away, many more homes are on the way. 

Long Savannah is expected to bring up to 4,500 homes. It’s one of several massive projects rising across Charleston County.

Environmental groups note that Long Savannah will destroy wetlands, which work like nature’s sponges, soaking up rain and slowly releasing it to keep flooding in check. As more land is paved, rainwater that once filtered slowly into the ground now surges across hard surfaces, overwhelming storm drains and flooding streets and homes.

Initially, state environmental officials approved plans to fill 137 acres of wetlands and excavate 72 more. 

“This type of ‘fill and build’ activity is exactly what has led to repeated flooding in adjacent neighborhoods,” the South Carolina Environmental Law Project (SCELP) warned in a 2020 news release.

Following a legal challenge by SCELP, the Southern Environmental Law Center (SELC) and other groups, the developers agreed to reduce the wetlands impact — though roughly 160 acres are still expected to be destroyed. 

Other massive developments on the books include Magnolia Landing, the 4,000-home project underway near the Rosemont community, and Cainhoy, a 9,000-home development planned for a peninsula near Charleston.

Environmental groups sued to prevent Cainhoy’s developers from filling wetlands. 

But in 2022, a federal judge dismissed their flooding concerns, citing a U.S. Army Corps of Engineers report, which concluded Cainhoy has a “high percentage of wetlands and ... numerous direct outfalls to tidal waters that will minimize the potential for heavy rains to overwhelm its infrastructure.”

As a former county floodplain management coordinator, Anna Kimelblatt understands the risks of allowing mega developments in flood-prone areas.

“People will be inundated,” said Kimelblatt, who now works for the Coastal Conservation League, a nonprofit that works to protect the environment in South Carolina. "Their roads will be inundated, their yards will be inundated, their homes will be inundated. And it creates this vicious cycle here in Charleston, where we fill, we build, we flood, we buy out.”

That pattern, some warn, is unsustainable.

“Charleston has a history of building in repetitively flooded areas,” said Robby Maynor, a climate campaign associate with the SELC. “We absolutely must stop building in low-lying and flood-prone areas to avoid making an already difficult situation even worse.”

Some residents share those objections. “The thing I don’t understand is, why don’t they put a moratorium on coastal building?” Knipper asked. “They know they’ve got a problem. They know it floods. They know it’s only getting worse. … Yet the building continues.”

Despite environmental concerns, new construction continues at a brisk pace — though it now comes with updated building requirements.

Charleston city officials say they now require flood protections — such as higher elevation standards and better stormwater systems — for new buildings in flood-prone areas. But scientists and residents question whether those measures are enough, or whether building in risky areas simply shifts the danger to others.

“A similar story is playing out in cities all across the United States,” reports NASA’s Earth Observatory, “but the Charleston area stands out in one critical way — much of the new development has happened on low-lying land that is especially vulnerable to sea level rise and flooding.”

‘Canary in a coal mine’

Ana Zimmerman calls her old street on James Island the “canary in a coal mine” — an indication of what will happen across the coastal United States where homes were built in flood-prone areas and at low elevations.

Zimmerman and her husband bought their modest, one-story house on Shoreham Road — a short, peaceful street lined with similar homes — in 2005. 

It was a close-knit neighborhood where neighbors looked after each other’s kids, and where the Zimmermans’ backyard — with its homemade playground and Fenway-green treehouse — became a favorite hangout for the children on the block.

The first sign of trouble came early one morning in October 2015. It was still dark when she awoke that day, and when she put her feet to the bedroom floor, water lapped at her ankles. A powerful storm had overwhelmed the street. Zimmerman rushed to save photo albums and the family cats, but the house suffered more than $80,000 in damages. 

With the insurance payout and their own labor, the Zimmermans repaired the home.

But when Tropical Storm Irma hit two years later, the damage was worse. So was the emotional toll. Zimmerman remembers hearing neighbors screaming as floodwaters poured into their homes.

Her house took on 7 inches of water — and this time an insurance adjuster declared the house a total loss.

She and her husband soon made a decision: They were not willing to go through it again.

FEMA offered $30,000 if they would demolish the house. But there was a catch. The bank that held the mortgage would not allow that unless the Zimmermans paid off the mortgage — something they couldn’t afford to do. 

The Zimmermans loved their neighbors. But they felt they’d been left with few options. Ultimately they abandoned the flood-damaged home and let it go into foreclosure, walking away from 12 years of equity.

“We didn't even get to choose how we were going to lose,” Zimmerman said.

The family moved to a nearby home on James Island and brought a neighbor to live with them — an 88-year-old man who had lived alone across the street. Their new house is built on an elevated foundation, not on a ground-level concrete slab like their old house. So far, there’s been no flooding.

Zimmerman, who calls herself an “unintentional flood activist,” has pressed public officials for stricter building rules and clearer flood-risk disclosures.

Most of Zimmerman’s former neighbors on Shoreham Road have left the neighborhood, she says. During a recent visit back to the street, Zimmerman pointed to house after house: “This house has flooded. That house has flooded … This house has massively flooded. …”

New residents have moved into the homes vacated by the Zimmermans and their former neighbors. And they, too, have experienced flooding on their street.

So what’s ahead for Charleston and other coastal cities as the rate of sea level rise accelerates?

“Entire streets will have to move,” said Zimmerman, a college biology professor. “Entire neighborhoods will have to move.”

Those who have the money and ability to move will be OK, she said.

“But the vulnerable among us, there will be no one there to help them, save them, and they will not be able to save themselves,” she said.

‘We can’t live with this’

Susan Lyons lives on Gadsden Street, just two blocks from the Ashley River. Since moving there in 2004, she’s seen more than a dozen serious floods. She’s repeatedly been forced to replace the ductwork under her 122-year-old home — repairs that have cost thousands.

But what weighs on her even more is the anxiety. When bad storms threaten, Lyons sometimes checks into a hotel to find safety and peace of mind.

“Whenever these storms or high tides come around, my blood pressure goes up and my knuckles get white,” the 82-year-old former newspaper reporter says. “It scares me.”

Over the past decade, Lyons has watched her neighborhood change. Neighbors pour money into elevating homes. About half of the houses on her block have changed hands — some more than once — as families overwhelmed by flood risks sell and leave. 

Just half a mile away, Roper St. Francis Hospital is preparing to relocate, a stark sign of how flooding is reshaping the city’s landscape.

“The F word (flooding) is being replaced by the R word: retreat,” said Lyons, who helped form a group called Groundswell to push for stronger city action on flooding issues.

Ann Auburn and her husband once lived across the street from Lyons.

Drawn to the neighborhood’s historic charm and welcoming community, they bought their 120-year-old house in 1999 and split their time between Charleston and Connecticut. 

But with each flood came more worry. She recalls friends wading through 6 inches of water to visit, and the time and money spent to replace ruined ductwork. 

Then came Hurricane Irma in 2017. Auburn sat on the stairs as water crept under the front door and seeped up between the floorboards.

The following year, the forecast for Hurricane Florence forced the couple to postpone a long-planned vacation. 

“At that point, we said, ‘We can't live with this. It’s just not who we want to be,’ ” she said. “ … I did not want to live through hurricane seasons, year after year after year, worrying about the house.”

Auburn and her husband left Charleston, moving back to Connecticut full time. Later, they returned — not to their old neighborhood, but to rent a house on higher ground. 

Their lease ends this spring, and the future is uncertain. But one thing is clear: They won’t be buying another house in Charleston.

“I think the whole concept of climate migrants is real,” Auburn said. “And Charleston, as beautiful as it is, as lovely as it is, as many people want to come there, I would suggest you come now. Because I don’t know what it's going to be like in 20 years.”

Floodlight is a nonprofit newsroom that investigates the powers stalling climate action.

Building toward disaster: Growth collides with rising seas in Charleston
A billion-dollar seawall may shield the city’s wealthy core — but not the vulnerable communities beyond it. Who will be forced to move?

Federal operation at Savannah-area Hyundai plant nets 475 detentions

by Craig Nelson, The Current
September 5, 2025

Editor's Note: This story was updated to include information from the federal warrant executed during the Thursday operation and to include a statement from Hyundai Motor Group.

The raid on Hyundai's Savannah-area electric vehicle plant was part of a lengthy investigation into the unlawful hiring of illegal aliens at the industrial site that Georgia officials had promised would create thousands of jobs for locals, federal officials said Friday.

Operation Low Voltage resulted in more than 475 people detained — more than 300 of whom were Koreans — for alleged immigration violations, while federal agents executed a criminal search warrant to gather evidence at the battery plant jointly owned by Hyundai Motor Group and LG, two of South Korea’s largest companies.

According to the search warrant, federal agents were seeking evidence including employment records from the lithium battery factory that could reveal illegal immigration and hiring practices at the HL-GA Battery Company LLC and five other companies identified by federal officials as subcontractors. Federal officials had identified four people with Hispanic names as part of the basis for the warrant signed by a magistrate judge in the Southern District of Georgia.

Steven Schrank, the special agent in charge of Homeland Security Investigations for Georgia and Alabama, said the raid at the Hyundai Motor Group Metaplant America was the largest single site enforcement operation ever carried out by the Department of Homeland Security’s enforcement division

Schrank told reporters that while some of the detained workers illegally crossed the U.S. border, others had entered the country legally but had expired visas or had entered on a visa waiver that prohibited them from working at the $7.6 billion site where Hyundai Motor Group and an interconnected group of suppliers are building vehicles.

Hyundai broke ground at the site three years ago after Georgia promised billions of dollars in tax credits and tax abatements if the world’s largest carmaker met its goals of creating more than 8,000 jobs at an average salary of approximately $58,000. 

As of March, Hyundai Motor Group Metaplant America, the legal entity that operates the site, reported that it had 1,200 people currently employed, not counting Koreans, and was operating one shift at the plant. At that time, the battery facility was not operational and remains under construction. 

No criminal charges had been filed Friday. Federal officials said the majority of workers detained this week have been sent to Folkston, the Immigration and Customs Enforcement agency’s detention center in Charlton County.

Governor Bryan Kemp speaks at the grand opening of the Hyundai Metaplant in Bryan County on March 26, 2025.

The governor’s office responded to the raid by saying that state agencies remain committed to the rule of law. “All companies operating within the state must follow the laws of Georgia and our nation,” said spokesman Carter Chapman.

There was no immediate comment from Georgia Attorney General Chris Carr. 

The South Korean government expressed “concern and regret” over the operation.

“The business activities of our investors and the rights of our nationals must not be unjustly infringed in the process of U.S. law enforcement,” South Korean Foreign Ministry spokesperson Lee Jaewoong said in a televised statement from Seoul.

Asked about the raid on Friday, Trump said that the people arrested were immigrants who entered the country illegally. “We had as I understand it a lot of illegal aliens,” he said. “Some not the best of people. But we had a lot of illegal aliens working there.”

South Korean officials told The Wall Street Journal that many of the Koreans detained worked for LG Energy were at the metaplant on a business trip and had visas that allowed them to train employees in Georgia.

In addition to Koreans, foreign nationals from Guatemala, Colombia, Chile, Venezuela and Mexico had been detained, according to Migrant Equity Southeast, a Coastal Georgia migrant workers' organization.

Thursday’s operation was more complex than other ICE enforcement actions that have occurred since President Donald Trump took office earlier this year.

The raid involved 10 federal agencies, including the Federal Bureau of Investigation and the Internal Revenue Service’s criminal investigation unit, according to Margaret Heap, the U.S. Attorney for the Southern District of Georgia. 

“This was not a immigration operation where agents went into the premises, rounded up folks, and put them on buses,” Schrank said. “This has been a multi-month criminal investigation where we have developed evidence and conducted interviews, gathered documents and presented that evidence to the court in order to obtain a judicial search warrant.”

The Current has previously reported on a pattern of workplace deaths and injuries affecting both American and foreign workers at the metaplant, including the death of a Korean technical worker in March, as well as a pattern by key Hyundai suppliers of not reporting those incidents to the federal agency responsible for workplace safety.

HMGMA, the legal entity that negotiated nearly $2 billion in state tax abatements and credits with Georgia, has previously said that it was not responsible for the actions of its supplier companies on the site.

In response to the ongoing federal investigation, Hyundai Motor Group said Friday that its North America Chief Manufacturing Officer Chris Susock would assume governance of the entire EV site in Bryan County. "We will conduct an investigation to ensure all suppliers and their subcontractors comply with all laws and regulations," the company said in a statement.

"We are reviewing our processes to ensure that all parties working on our projects maintain the same high standards of legal compliance that we demand of ourselves. This includes thorough vetting of employment practices by contractors and subcontractors," the statement said.

This article first appeared on The Current and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Federal operation at Savannah-area Hyundai plant nets 475 detentions - The Current
Over 475 people were detained in a raid on the Hyundai electric vehicle plant in Georgia, part of a lengthy investigation into the unlawful hiring of illegal aliens at the site.

Duke Health sets its sights on statewide expansion

by Michelle Crouch and Charlotte Ledger, North Carolina Health News
September 8, 2025

By Michelle Crouch

Co-published with The Charlotte Ledger

For years, Charlotte’s health care market has been dominated by two names: Atrium Health and Novant Health. Between them, the two hospital systems hold a near lock on the region’s hospitals, a growing share of its doctors and much of its specialty care.

Now a third player is muscling into the market.

In April, Duke Health paid $284 million to acquire Lake Norman Regional in Mooresville, rebranding it as Duke Health Lake Norman. It’s the first Duke-branded hospital outside the Triangle.

Around the same time, Duke announced a partnership with Novant to open joint campuses across North Carolina.

Although details about the partnership are tightly guarded, Novant indicated at a recent regulatory hearing that the partnership would bring more of Duke’s specialty expertise, such as advanced cancer care and gastrointestinal surgery, directly into the Charlotte market.

“This is a big deal,” said Bryan Blitstein, a Huntersville surgeon in private practice who is joining the Lake Norman hospital as a surgeon. “For my entire career, Charlotte has been teal (Atrium) versus purple (Novant). Duke coming in disrupts that and creates a third option. Healthy competition is good for everybody.”

For now, Atrium and Novant control nearly all hospital care in the Charlotte region. Atrium commands about half of the market, while Novant holds roughly 35 percent, according to national financial ratings agencies

Duke’s moves won’t transform Charlotte’s health care landscape overnight. But the presence of a third provider could ultimately bring more choice and competition to the area’s health care market and provide an alternative for the many patients who choose to drive to the Triangle for care, industry observers said.

“This is good news for Charlotte and for North Carolina,” said Barak Richman, a health policy expert and George Washington University law professor who formerly taught at Duke. “It brings competition to a market dominated by Atrium, which is healthy for patients. For people in Charlotte, it might even lower some prices.”

Duke pivots to expansion

Across North Carolina, hospital systems including Atrium, UNC Health and Novant have been aggressively growing — buying up smaller hospitals and merging — to attract more patients, achieve economies of scale and boost their negotiating power with insurers. While the hospitals promise efficiencies and better care, critics point to research that shows consolidation typically eliminates competition and drives up prices without improving quality. 

Until now, Duke had largely resisted following its rivals in pursuing geographic expansion, Richman said, preferring to build its reputation as a national destination for complex care.

But that strategy is shifting. In a June 2025 bond prospectus, Duke said it was transitioning “to a regional health system.”

In the financial document, Duke leadership also set an ambitious expansion goal: to “touch 25% of the lives in North Carolina,” while nearly tripling revenue to more than $20 billion, up from  $6.8 billion in fiscal 2024.

Duke Health declined to answer questions about its plans, saying in an email: “We don’t have updates to share beyond our Lake Norman announcement in April and Novant partnership announcement in March. We will include you on any related announcements moving forward.”

“Duke-itizing” a hospital

Duke’s purchase of the 123-bed Lake Norman hospital included nearby medical office buildings and physician offices, including nine primary care and seven specialty practices. It plans to add an imaging facility and more office space, according to its filing.

Blitstein, who will start his job at Duke Lake Norman Hospital in October, said Duke has already poured millions into the facility to upgrade its technology and infrastructure to Duke standards.

“They call it ‘Duke-itizing’ the hospital,” he said. “They like that word.”

Many Charlotte-area patients already drive to Durham to see Duke specialists, especially for cancer care, cardiology and complex surgeries, Blitstein said.

The idea now is to bring that care closer to home, he said, with the Mooresville hospital serving as “a point of access” where all Charlotte-area patients — not just those in Iredell County — can begin treatment, participate in clinical trials or get follow-up care if they are already being treated at Duke.

Duke is frequently ranked as the top hospital in North Carolina and one of the best in the country.

“The hope is to bring that level of excellence from Durham to the Charlotte market,” Blitstein said. “Patients shouldn’t have to drive two hours for follow-ups or routine imaging. Those can be done here, with results sent seamlessly back to their doctors in Durham.”

Still, not everyone is convinced the pivot is a good one for Duke. By chasing market share, Richman said, Duke risks diluting its academic mission.

“It’s not surprising that they’re finally starting to do what everybody else is doing,” he said. “But this country already has way too much hospital expansion. … If I had my druthers, Duke would not be competing with Atrium for knee replacements. They would be competing with Mayo Clinic for the most complicated brain surgeries.”  

Proposed Duke-Novant centers along I-77 corridor

Duke’s partnership with Novant adds another layer to Duke’s entrance into the Charlotte market.

In a March news release, the two hospitals said they planned to “jointly develop new campuses across North Carolina that will expand access to affordable, high-quality care,” but they provided few details.

Novant and Duke declined to answer questions about the partnership, including what types of facilities they’ll open or where they will be located.

However, the two hospital systems have already requested state approval to build a jointly operated hospital in Mebane, a fast-growing city about halfway between Durham and Greensboro.

Duke’s financial filing also outlines plans for the hospitals to jointly develop a network of outpatient centers across the state, including along Charlotte’s I-77 corridor. The sites would offer primary care and such specialty services as cardiology, neurosciences and cancer, along with laboratory and imaging services — and potentially surgery, infusion and urgent care services, according to the filing.

The move comes as the North Carolina legislature has moved to loosen the state’s certificate of need regulations for ambulatory surgical centers beginning this November, which would make it easier for hospitals to open them in urban areas.

At an August hearing where it requested state approval for more operating rooms, Novant also hinted that Duke specialists may perform surgeries and do other work in Novant hospitals.

Matthew Hanis, a Charlotte-based consultant and expert in the business of health care, said the partnership gives Novant a credibility boost by tying it to Duke’s research and academic reputation. That could help Novant compete with Atrium, which partnered with the Wake Forest University School of Medicine to recently open Charlotte’s first medical school, Hanis said.

Steve Lawler, a former CEO of the North Carolina Health Care Association and now a health care consultant, said the deal should also make it easier for Novant to participate in advanced research and treatments and give its patients smoother access to Duke’s specialized services and clinical trials.

“Novant could act as a navigator to make it easy and seamless for people to access that type of high-end care,” he said.

Just a partnership or a step toward a merger?

Joint ventures like Duke and Novant’s are increasingly common in North Carolina and nationwide as hospitals look for ways to expand while avoiding the regulatory hurdles associated with mergers.

Such partnerships, which can include joint hospital ownership or operations, allow partners to share both the work and the risks of growth, Lawler said. He pointed to the recently announced children’s hospital in Apex, a joint project between Duke and UNC Health, as another example.

Other hospitals, in their quest for expansion, have gone beyond shared ownership to fully integrated combinations. Atrium has perfected this approach, combining first with Navicent Health in Georgia, then with Wake Forest Baptist and finally with Advocate Aurora Health in 2022 to form the country’s third-largest public health care system.

In its financial filing, Duke hinted at the possibility of deeper integration with Novant, saying the partnership “could serve as a launching point for future collaborative opportunities between the organizations.”

Hanis said he doesn’t have any inside information, but he wouldn’t be surprised if the alliance was the first step in the systems coming together. “Both have the need to build scale” to compete, he said.

He noted that Duke also partners with Tennessee-based Lifepoint Health, which owns nine smaller community hospitals in North Carolina. “Combine Duke, Lifepoint and Novant and you have serious scale and brand,” he said.

For now, many questions remain about the partnership: Will Duke doctors actually practice in Novant hospitals, or will Novant doctors collaborate with Duke specialists virtually? Could Duke alone, or the two systems together, open new hospitals in the Charlotte region? And how will Duke’s debut in Charlotte affect health care costs and access to care?

For Marlene Tontodonato of Charlotte, the stakes are personal.

Tontodonato, 77, said she traveled to Duke for a third opinion after two local doctors disagreed about whether she should get spine surgery and a rod for her scoliosis — a curvature in her spine. Duke doctors suggested a more conservative approach, she said, and she still sees a spine specialist in Durham.

Tontadonato said she would welcome the chance to get that same level of care closer to home. But she said she hopes Duke brings its own doctors to Charlotte rather than absorbing local physicians.

“I have more faith in Duke because it’s a teaching hospital,” she said, “and they have expertise that I think we are lacking in Charlotte.”

This article is part of a partnership between The Charlotte Ledger and North Carolina Health News to produce original health care reporting. You can support this effort with a tax-deductible donation.

This article first appeared on North Carolina Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

Duke Health sets its sights on statewide expansion
Duke Health’s first hospital outside the Triangle and its new partnership with Novant could shake up a market long ruled by Atrium Health.

‘Catastrophic Failures’: Why Dozens of Killings In Mississippi Prisons Go Unanswered

by Daja E. Henry, The Marshall Project and Mina Corpuz, Mississippi Today
September 11, 2025

At least 42 people have been killed inside Mississippi prisons in the past decade, leaving scores of grieving families questioning a system that fails to protect people in its custody or hold anyone accountable.

There are sisters wracked with guilt, mothers with depression, and children struggling to fill the voids in their lives. Former prison employees talk about lying sleepless in bed, replaying the killings they’ve witnessed but could not stop.

In Mississippi, prison homicides are the culmination of long-documented festering problems: chronic understaffing, lax oversight, gangs that rule by violence and delays in treating life-threatening injuries, an investigation by a statewide reporting team found.

Murders signal “catastrophic failures” of prison administrators, whose number one job is to keep incarcerated people safe, said David Fathi, director of the ACLU National Prison Project.

The perpetrators haven’t faced justice in most cases. Just six of the 42 homicides have led to convictions. 

And the killings show no sign of ending. In the first half of this year, there were five homicides in three Mississippi prisons.

Sydney Miller said her family was given almost no details by prison officials after her elder brother, Gregory Emary, was stabbed to death at the Chickasaw County Regional Facility in Houston in 2020. 

Over the past five years, they have received no contact from prison investigators or prosecutors about what happened or if someone would be held responsible. Miller did not know Emary’s death had been deemed a homicide by a medical examiner until a reporter told her. She wonders if her family would have been treated the same way if her brother had been killed on the outside. 

“So why is this any different?” Miller asked. “Just because it was committed inside prison walls?”

‘No one deserves to die like this’

Uncovering the toll of Mississippi’s prison homicides took a team of reporters from five news organizations: The Marshall Project - Jackson, Mississippi Today, the Clarion Ledger, Hattiesburg American and The Mississippi Link. The team scoured thousands of pages of court records, corrections documents, federal and state government death records, and interviewed families, formerly incarcerated people, former guards, attorneys and corrections experts. 

The investigation found that the Mississippi State Penitentiary in Parchman, which holds about 2,500 people, has had the most killings in the past decade. At least 19 people died in homicides at Parchman from 2015 through 2024.

For most of this time period, the homicide rate among people inside Parchman was five times higher than the state as a whole, which already had the highest rate in the country in 2023.

Lack of consistent and accurate reporting nationwide makes a state-by-state comparison of prison homicides difficult. The reporting team identified three Mississippi homicides that were not listed in federal and state reports.

Most of the 42 killings throughout the state prison system involved beatings or stabbings, sometimes involving multiple assailants. Three in five victims were Black. The age of the victims ranged from 23 to 62. 

Mississippi Department of Corrections officials declined multiple requests for an interview about killings across the prison system, but released an emailed statement. “MDOC remains committed to ensuring the safety of inmates in its custody,” the agency wrote.

Many of the people who were killed in Mississippi’s prisons were sent there after being convicted of offenses that included parole and probation violations, as well as more serious crimes, including robbery and murder. At least a quarter were serving life sentences. Although prison officials have a legal duty to protect all incarcerated people from harm, they could not protect them from death at the hands of cellmates, rival gang members or other incarcerated people.

In one case, a corrections officer pleaded guilty to accessory after the fact in a 2021 murder.

Detrick Munford, who served as deputy warden of Parchman until 2022, said the number of unprosecuted homicides doesn’t surprise him.

Mississippi officials didn’t install many of the cameras at Parchman until after 2020, so in many cases, there was no way to prove who was responsible for a death, he said. Anyone who witnessed a killing “is not going to talk,” he said, alluding to the prison culture of violent retribution, “because he knows what might happen to him.”

MDOC often shares sparse details about prison homicides, if any at all, even with the families of the victims. Nearly all internal investigations into the killings are hidden from the public because the state’s open records law exempts all law enforcement investigative files.

Although many of the recent homicides were filmed by security cameras and some of those responsible are known to corrections officials based on internal reports, local prosecutors filed charges against suspects in 36% of the homicides in the past decade.

MDOC officials responded in their email that prison officials take “every death of an inmate in its custody seriously. Each suspected homicide is investigated…The remaining investigations that are closed did not support a referral (for prosecution).”

In one criminal case, a charge was filed, but the Marshall County District Attorney’s office essentially forgot to prosecute the suspect nearly four years after the prison killing. The indictment had gotten lost in the bureaucracy, District Attorney Ben Creekmore later acknowledged in an interview. It was reactivated only after a reporter from the news team called him about the case.

The prospect of criminal prosecution, however, is likely of little concern to someone already serving a multi-decade sentence. The continued killings show how the prison system has not significantly addressed its failures to prevent homicides. The reporting team identified one person who pleaded guilty to manslaughter for a killing in one prison, then allegedly went on to kill again in another prison. He is awaiting trial on the second homicide charge and is currently serving a 40-year sentence.

DeAndre Davis was serving a life sentence when he was stabbed to death in 2017 in the Wilkinson County Correctional Facility in Woodville, months after he was stabbed in another attack at the same prison. At the sentencing hearing for the man convicted of the killing, Davis’ mother, Victorra Williams, said she didn’t understand why her son died, because he was supposed to be in isolation after he received a death threat. 

“No one deserves to die like this,” she told the judge.

“I understand that they are in prison, and I understand that they are (caged), but I don’t understand you are in prison and you are steady killing each other for no reason,” Williams said. “That’s just — that’s crazy.” 

Punishment after killing: loss of privileges

Growing up, Marcie Harper protected her baby brother, Joshua Odom. He was smaller than the other kids, so she fought his fights. She called him her Cabbage Patch Kid because of his big blue eyes and bald head. Her brother grew into a wiry man who loved to fish, gaining him the nickname Catfish.

“I was always there for him,” Harper said.

But Odom developed a drug problem that landed him in and out of prison, locked away from his big sister, who couldn’t always afford to visit or talk to him on the phone. 

She could not be there to protect her brother on Jan. 12, 2025. 

He died, a casualty of prison violence, lax security and questionable medical care that gave superficial treatment to a head wound that would prove fatal. 

Odom was incarcerated at South Mississippi Correctional Institution in Leakesville. His friend Shelby Peevyhouse, who has a pacemaker, had just gotten into a fight and been kicked in the chest. As Odom came over to check on his friend, Peevyhouse said later, another incarcerated person punched Odom, knocking him to the ground, where he hit his head and fell unconscious.

When Odom came to, guards were restraining him, Peevyhouse said from prison.

“Don’t kill him. He needs your help,” Peevyhouse pleaded with the guards as they wrestled Odom. Both men were taken to the medical wing.

“Catfish was laying there screaming for help in a medical gurney to the left of me, calling for his mama,” Peevyhouse said. 

Guards declined to call an ambulance and went home, as their shifts were ending, Peevyhouse said. Instead, he said, a medical staffer glued Odom’s head wound shut and sent both injured men back to their housing unit. 

Odom, though, was dazed. He couldn’t even say his name. Peevyhouse tried to keep his friend awake. 

“I did not know what to do,” Peevyhouse said. “I was so scared.”

As Odom began vomiting a “pink foam,” Peevyhouse banged on a window. He says he told a guard coming around for a count to call medical or else he would start a fire. 

A medical worker took Odom away in a wheelchair. “Hey, smile a little,” Odom said before being wheeled off. Peevyhouse lit a cigarette for his friend, told him he loved him, and that he would be there when Odom got back. This time, an ambulance was called. It was too late. 

The next morning, Peevyhouse found out Odom was dead. 

“He was my best friend. This is really hard for me,” Peevyhouse said repeatedly.

The state medical examiner ruled Odom’s death a homicide by blunt force trauma. Because his alleged attacker was never criminally charged, the reporting team is not naming him. Imprisoned on a domestic violence conviction, he is scheduled for release by 2028.

The suspect was issued a disciplinary citation for assaulting another person. Prisons use a rules violation book that outlines dozens of actions that are prohibited inside prison walls, from hoarding food to attacking others. According to a rule violation report obtained by the reporting team, guards used security camera footage to confirm the assault.

The suspect’s punishment was the loss of 180 days of earned time — time that would have reduced his sentence for good conduct — as well as lost phone and visitation privileges for 60 days, and he was held responsible for Odom’s medical costs, which were not listed. He did not receive a higher violation for causing Odom’s death. The next day, he was transferred to another facility, which is MDOC’s standard procedure.

Rep. Becky Currie, a Brookhaven Republican photographed during a hearing at the state Capitol in Jackson, Miss., in 2020, has criticised VitalCore, the company MDOC contracts with to provide medical in the state prisons.

State Rep. Becky Currie, a registered nurse, has publicly criticized VitalCore, the company contracted to provide medical care in the state’s prisons, after meeting and receiving letters from incarcerated people who claim they were not getting care for treatable illnesses and injuries. 

“It is hard for me to hear that (MDOC) feels that they provide adequate care,” Currie told Mississippi Today. 

A spokesperson for VitalCore told Mississippi Today that the company provides “comprehensive and competent health care services in accordance with prevailing standards of care.”

After Odom’s death, his sister said the family could not get a clear story from prison officials.

The official who called their mother said Odom had been found hurt and died at the hospital. It wasn’t until someone connected to Peevyhouse sent her a Facebook message that she found out that her brother died waiting for an ambulance.

The 40-year-old Odom, incarcerated since 2018 after being convicted of burglary and credit card fraud, was supposed to be released in a few weeks, his family said.

“I just wish I had something of his,” Harper said. Instead, all she has left are memories and his ashes, which the family plans to scatter in the Gulf, where he loved to fish, on his birthday. 

Soon, she’ll also have a tattoo of a catfish on a hook with a phrase he always told her: “Keep your head up.”

Constitutional violations, few answers

Odom’s death came less than a year after the federal Department of Justice found that three Mississippi prisons — including the South Mississippi prison where he had been held — violated the constitutional rights of the more than 7,400 people housed in them by failing to protect them from widespread violence. The investigation listed numerous failures: gross understaffing, assaults that are likely undercounted because of this lack of staff supervision, gang brawls involving dozens of people, violent incidents that go uninvestigated, and bungled investigations that lead nowhere.

The Justice Department had found similar violations in a 2022 investigation of the Mississippi State Penitentiary in Parchman. 

What Odom’s family experienced is common. The reporting team found that the families of other incarcerated people killed in prison were often left without answers. Many of those interviewed learned details about their loved ones’ deaths through a whisper network of incarcerated people, insiders, advocates, and, in some cases, from journalists. 

Some families contacted lawyers, attempting to file civil suits, only to find out that no one would take their cases.

“I literally just gave up on it,” said Dale Graham, whose brother was killed in the Central Mississippi Correctional Facility in 2021. “Nothing happened.”

Currie, a Brookhaven Republican, who chairs the state’s House Corrections Committee, has raised questions about how the prisons are run, including the health and safety of the incarcerated.

She said prison killings show that violence is rampant inside the state’s prisons, and that it’s amplified by issues such as contraband and gangs. 

“Whatever the cause of death is, I think the families are owed an answer,” she said. “Was my loved one killed? Was it that their diabetes wasn’t tended to? What was the cause of death?” Currie asked. “And I do not know of one family that's ever received that answer.”

She has wondered how seemingly healthy men die in Mississippi’s prisons. Currie said she plans to introduce legislation to create a group of lawmakers and prison officials to look into all prison deaths, which can serve as a guide on how to prevent future deaths. 

In a written response to reporters’ questions, MDOC said the department has taken several corrective measures since the Justice Department began investigating the prison system in 2020, including improved training, facility upgrades and increased staffing.

MDOC said the Justice Department’s investigation is ongoing, and both sides are engaged in confidential settlement negotiations. 

A deadly prison economy

Violent deaths in Mississippi prisons tend to lead back to the same factors: understaffing, poor training, and gang control, according to lawyers, experts, former corrections staffers interviewed, and the Justice Department reports. 

Prison guards, many of whom are young and female, are poorly trained and sometimes left alone to oversee units holding as many as 180 men, according to Catina Washington, a former MDOC case manager who said she was assaulted in December 2020 by an incarcerated person at the South Mississippi prison. Her attacker was charged with simple assault, but the charge was later dropped due to conflicting witness testimony.

Guards make decisions on whether a sick or injured person can see a prison nurse or even go to a hospital. 

“We don’t realize how much trust of another person’s life we put into the hands of correctional officers,” said Greta Kemp Martin, formerly the litigation director of Disability Rights Mississippi. “They literally hold your life in their hands.”

Poor oversight allows gang members to take advantage of the security gaps, buying and selling illegal drugs and cellphones, sometimes with the help of prison guards whom they recruit to smuggle contraband in. The reporting team identified several criminal cases in which corrections officers were charged with bringing in drugs or cellphones. Martin said some incarcerated clients have told her about correctional officers who share gang affiliations with them. 

The gangs run a brutal underground economy. A debt to the wrong person can cost a life, as it did for 31-year-old Jeremy Irons, who was killed over $40 in Parchman, federal and state reports showed. 

The Justice Department’s investigations found that the facilities operated at dangerously low staffing levels. In 2022, the Central Mississippi prison was operating with 44% of the employees needed to run the facility. At the South Mississippi prison, where Odom was later killed, the facility ran with 36% of the necessary employees. And in Wilkinson County’s prison, a human resources manager told investigators that the officer vacancy rate hovered around 50%.

Chronic understaffing is a key factor in prison homicides across the nation, said Fathi, of the ACLU National Prison Project. And what staff there is may be poorly trained to handle violence.

Former MDOC staffers reported that their training was rushed, leaving them unprepared for the dangers of the job. 

“Parchman is all about ‘We're gonna hurry up and get you out of class, throw your ass out there, because we need people to watch the inmates,” a former correctional officer, who did not want his name used for fear of retaliation, told a reporter. “Many times I’ve seen people get killed right in front of me, and it really wasn’t nothing you could really do, because you ain’t but one person.”

Chuck Mullins, a lawyer who has represented Mississippi families in wrongful prison death cases for decades, said in many of the death cases he has litigated, he found that staff were either not present or poorly trained.

Chronic understaffing and poor training endanger both the incarcerated people and corrections staff, leaving many who remain fearful to do their jobs. The Justice Department’s reports cited multiple instances of staff failing or refusing to do security counts and falsifying count sheets. 

Disciplinary reports reviewed by the reporting team show corrections officers being overpowered, beaten, choked, stabbed, spit on and sprayed with human waste. 

Fatal beating overlooked for five hours

Army veteran Ronnie Graham survived combat in Iraq. He survived cancer.

He did not survive nine days inside the Central Mississippi Correctional Facility in Pearl. 

In the early hours before dawn in December 2021, prison security camera footage captured a man attacking Graham near his bunk, choking and kicking him in the head, according to federal and state records reviewed by the reporting team. 

Throughout the night, Graham passed in and out of consciousness. Later, another person punched him in the face. More than five hours later, an officer found Graham and called for help. By then, his body was rigid, and he was foaming at the mouth. Graham died soon after help arrived. 

For at least five hours, Graham suffered. And for most of that time, guards were nowhere to be found. An investigative report noted that an officer turned the lights off in the unit about 45 minutes after Graham was attacked, but no officer walked through to check on the welfare of the men held there. 

“If someone would have done their job that night, he would still be alive today,” his brother, Dale Graham, said. “But because someone didn't do their job, my brother is now dead.”

No one was charged in Graham’s death.

Lawsuits and internal prison reports show that, on multiple occasions, guards did not find a dead person for hours.

Earlier this year, Jonathan Havard was strangled in the Wilkinson County Correctional Facility. A parent, who found out about the death through unknown means, notified the prison that someone in Havard’s cell was dead, according to an internal MDOC report. 

Last year, a group of roughly 10 people beat and stabbed 28-year-old Edward Boyd to death at East Mississippi Correctional Facility in Lauderdale County, according to a lawsuit his family filed against the private prison company that operates the lockup, Management & Training Corp. The suit stated that the attackers killed him “in plain view of surveillance camera” and then “dragged (Boyd) into a cell, where they left him to die.” 

He was found covered in blood during a morning count. The lawsuit alleges that a correctional officer wrote in a report that they had last seen Boyd alive and well during a 4 a.m. count. However, there was no evidence of a count being conducted at 4 a.m., according to the lawsuit.

In response to the lawsuit, MTC denied any negligence or wrongdoing. The case is pending in federal court.

Dead-end investigations

When someone is killed in a Mississippi prison, typically, the department conducts an investigation. It interviews staff, witnesses, sometimes confidential informants, people it believes to be complicit in the death, and reviews camera footage.  

MDOC sometimes requests help from the Mississippi Bureau of Investigation. 

However, the U.S. Justice Department found many investigations by the department were incomplete, failed to answer key questions or were mishandled. 

Investigations of homicides that stemmed from fights over drug debts routinely ignored the source of the drugs or failed to conduct follow-up interviews.

During the 2022 Parchman investigation, a supervisor in MDOC’s investigative division told Justice Department officials that the caseload was too heavy and staffers were too overworked to conduct comprehensive investigations.

For example, after Jeremy Irons was stabbed to death in 2019, the internal investigation concluded that one incarcerated person stabbed him and flushed the weapon down the toilet. 

The investigation into Irons’ death relied on one written statement from a trainee officer. No other staff was interviewed. However, several other people took part in the fight, which stemmed from Irons’ $40 debt to another person, according to the Justice Department. 

After MDOC concludes its investigations, it may pass its findings along to local county district attorneys, who can then seek an indictment from a grand jury. 

In an August 2019 case, Samuel Wade was strangled to death at Parchman. The Justice Department’s investigation references an incarcerated person strangled with a bedsheet that month. The victim’s cellmate allegedly confessed to the killing, and MDOC referred the case to the Sunflower County district attorney, according to the investigation. After six years, however, no charges have been filed.

Sunflower County District Attorney Dewayne Richardson has not responded to multiple interview requests.

Criminal charges have only been filed in five of the 19 killings in Parchman over the past decade. Four of those cases are pending in the courts. The fifth was dismissed after the defendant died by suicide.

Other district attorneys with prisons in their counties did not respond to requests for comment or declined to comment on open cases. 

Experts said secrecy around prison operations and the lack of oversight, coupled with the general public’s lack of concern toward incarcerated people, allow the long-documented abuses and civil rights violations to continue. 

Reforms to reduce deaths in custody have been hampered by “the secrecy that pervades prisons and jails,” said Andrea Armstrong, a Loyola University New Orleans law professor and leading researcher on deaths behind bars.

Many of the prison incident records the reporting team obtained came with scant narratives or with entire sections blacked out, even though such records are public under the state’s open records law.

In the past decade, at least five families of people killed in Mississippi prisons have filed civil lawsuits against the Department of Corrections or Management & Training Corp. However, documents in these lawsuits, such as evidence and settlement details, are often sealed or protected by confidentiality agreements.

For the incarcerated people who have been killed, their families are left with little, other than despair. 

“This (is) an unimaginable pain you all gave me. This grief will last forever,” one victim’s mother wrote in a court statement for the upcoming trial of the prison murder of her son. 

“People talk about justice. They say it’s blind. But justice shouldn’t be silent. It shouldn’t turn away when someone dies in state custody,” she wrote. “If the state takes responsibility for a person’s life, it should also be held accountable when that life is lost.” 

Caleb Bedillion of The Marshall Project - Jackson, Grant McLaughlin of the Clarion Ledger, Jerry Mitchell of Mississippi Today, and Christopher Young of The Mississippi Link contributed to this report.

This story is part of a reporting collaboration with The Marshall Project, Mississippi Today, the Clarion Ledger, Hattiesburg American and The Mississippi Link.

This article first appeared on Mississippi Today and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.


Trump Cancels Study on Health Impacts of Industrialized Hog Farms That Produce Biogas

N.C. research would have provided crucial data on understudied effects of the burgeoning industry on predominantly Black, Indigenous and Latino residents.

By Lisa Sorg

September 6, 2025

This article originally appeared on Inside Climate News, a nonprofit, non-partisan news organization that covers climate, energy and the environment. Sign up for their newsletter here.

The Trump administration has cancelled a $417,000 federal grant that would have funded research on the social and economic impacts of biogas production from industrialized swine operations in North Carolina.

Over several years, scientists from RTI International in Durham and the Gillings School of Public Health at the University of North Carolina at Chapel Hill had planned to continuously monitor the air, and periodically sample rivers, streams, and private drinking water in Duplin and Sampson counties. The study would also have collected health data in the communities.

Duplin and Sampson rank first and second in the nation, respectively, in the number of swine farms, according to a University of Michigan study. They account for 4.2 million hogs on roughly 900 farms, state environmental data shows, a small percentage of which have received state permits to produce biogas.

Census data show tracts near these concentrated animal feeding operations—CAFOs—are predominantly Black, Indigenous or Latino. 

The research is important because swine gas operations are proliferating in North Carolina. Yet there is scant data on the environmental and health effects near these facilities, according to the RTI and UNC scientists.

The community research conducted in Duplin and Sampson counties on the biogas production project was sponsored by the U.S. Environmental Protection Agency and National Institute of Environmental and Health Sciences (NIEHS). 

The biogas study was one of at least 1,700 projects that lost funding earlier this year after the Trump administration terminated $783 million in grants at NIEHS’ parent agency, the National Institutes of Health. Although it is unclear if the biogas study was singled out for its environmental justice focus , similar projects were targeted. 

The U.S. Supreme Court last month upheld the administration’s cuts by a 5-4 vote. A lower court judge had blocked the cancellations on the grounds that they were discriminatory.

The North Carolina scientists, led by Crystal Lee Pow Jackson, had conducted one round of private well sampling and collected initial air quality data, but had yet to sample near an active swine gas operation when the Trump administration canceled the grant.

“We couldn’t complete the full research but there is valuable baseline data in this,” said Courtney Woods, an associate professor in UNC’s Department of Environmental Sciences and Engineering. She also leads programs at the university in Environment, Climate and Health and Health Equity and Social Justice

Major pork producers tout biogas as a solution to the industry’s methane problem. In 2018, swine manure emitted 970,000 tons of methane nationally, federal data show, second only to dairy.

Methane is short-lived in the atmosphere, but it inflicts more damage to the climate than carbon dioxide. Over 20 years, methane is 86 times more potent at warming the planet than CO2, which remains in the atmosphere for centuries.

Swine CAFOs generate biogas by capping waste lagoons, capturing the methane they emit and injecting the gas into a pipeline. Some CAFOs use the gas to power farm operations.

Yet the industry’s position doesn’t account for pipeline leaks. And in North Carolina, swine biogas systems still pump extra feces and urine into a second open-air lagoon; from there, the waste is sprayed on fields as fertilizer. Fecal contamination can seep into the groundwater and private drinking water wells from the spraying; methane, ammonia and hydrogen sulfide from the lagoons still enter the air, unabated.

Align RNG, a partnership between Dominion Energy and Smithfield Foods, the world’s largest pork producer, receives swine gas from a half dozen CAFOs in Sampson and Duplin counties, according to state records from 2024. The farms ship their gas through 30 miles of low-pressure pipelines to Align RNG’s upgrading facility near Warsaw, a small town off Interstate 40 in Duplin County.

Align RNG did not respond to an email summarizing Inside Climate News’ reporting and inviting comment.

The upgrading plants are necessary because swine gas has a different chemical composition than gas derived from fossil fuels. Constituents such as hydrogen sulfide, nitrogen,ammonia and carbon dioxide must be removed before the gas can be injected into a traditional pipeline. These “tail gases” are scrubbed of hydrogen sulfide and burned in an enclosed flare.

Once the swine gas is upgraded, Align RNG injects it into a nearby pipeline owned by Piedmont Natural Gas, a subsidiary of Duke Energy, which uses it to generate electricity.

Align RNG estimates as many as 19 swine CAFOs could eventually ship their gas to the plant in Warsaw. Kraig Westerbeek, then-vice president of Align RNG, told the state Division of Air Quality in 2020 that the participating farms would reduce their collective methane emissions each year by 150,000 tons, measured as carbon dioxide equivalent. CO2 equivalent is a unit of measurement that standardizes the global warming potential of different greenhouse gases.

The company plans to build a second upgrading plant near Bowdens, also in Duplin County. It would accept gas from as many as 35 swine CAFOs, according to the Align RNG website. Construction is expected to finish by late 2026. The company has yet to apply for an air permit, according to a state database.

State records show that there are 55 swine CAFOs with biodigester permits. Of those, 14 have completed construction and are generating swine gas, or able to. Another 41 have yet to notify the state that they’ve finished construction. The state is reviewing permit applications for another 30 farms.

Since 2012, Duke Energy, municipal utilities and electric cooperatives have been legally required to generate or source a small percentage, up to 0.2 percent, of their prior year’s total retail electricity sales from swine waste. 

However, the N.C. Utilities Commission has delayed its implementation because “the technology of power production from swine waste continues to face challenges and that swine waste-to-energy projects continue to experience operational difficulties,” a commission report from 2020 reads.

Blakely Hildebrand, a senior attorney at the Southern Environmental Law Center, filed a civil rights complaint with the EPA Office of External Rights Compliance four years ago over the biogas permits. The law center submitted the complaint on behalf of its clients, the Duplin County NAACP and the North Carolina Poor People’s Campaign.
The complaint alleged that, in issuing the biogas permits, the N.C. Department of Environmental Quality discriminated against Black and Latino residents in eastern North Carolina because the facilities had a disparate, harmful impact on those communities.
Since 2022, SELC and the state have been negotiating to resolve some of the allegations, Hildebrand said. 

“We’ve not yet resolved the complaint,” Hildebrand said, “and the Trump administration has taken several steps to undermine civil rights law and environmental justice policy.”

In the spring, EPA Administrator Lee Zeldin canceled more than 400 environmental justice grants. In late August, the EPA fired more than two dozen remaining staffers in the now-defunct Office of Environmental Justice and External Civil Rights. 

Meanwhile, the U.S. Department of Agriculture announced last month it would stop funding wind and solar power installations on farmland.

The biogas conditioning plants are also sources of pollution. Align RNG’s Warsaw plant could emit 64 to 220 tons of pollutants each year, according to the company’s air quality permit. 

Sulfur dioxide accounts for more than 75 percent of the potential emissions produced during biogas processing. Short-term exposure to sulfur dioxide can harm the respiratory system and make breathing difficult, according to the EPA. People with asthma, particularly children, are sensitive to these effects.

Precise figures from the upgrading facility aren’t publicly available because Align RNG doesn’t have to file an emissions inventory until 2028, state records show.

Earlier Air and Water Testing

RTI and UNC scientists presented limited results from their study in August in Sampson County at a meeting of EJCAN, an environmental and social justice group in Clinton. The preliminary data reflected the baseline environmental conditions because the biogas project is not in full operation, an RTI spokesperson said.

All of the 11 surface water sampling sites tested before the grant cancellation contained total coliform and E. coli bacteria at least once. In some cases, levels of E. coli exceeded state surface water standards. 

(The N.C. Department of Environmental Quality currently uses fecal coliform as an indicator, but is switching to E. coli to align with EPA methods.)

Levels of nitrite, ammonia and nitrate concentrations were below surface water standards. However, phosphorus, which can supercharge harmful algal blooms, peaked at more than 30 times the levels at which algae could begin to multiply.

One-time air monitoring outside 13 homes within two miles of swine CAFOs, also conducted prior to the grant cancellation, detected nitrogen dioxide below National Ambient Air Quality Standards. 

The scientists also found ammonia and hydrogen sulfide at similar levels reported by other studies in North Carolina, although there are no state standards for those compounds in for community ambient air. There were brief spikes of fine particulate matter, known as PM 2.5, at unhealthy levels for a few hours, said Seung-Hyun Cho, the air monitoring project leader.

The scientists wanted to survey more community members about their views on swine gas operations, as well as the state of their physical and mental health. Yet despite the study’s limitations, residents were able to participate in the research, itself a valuable exercise. “We successfully engaged the community in environmental monitoring,” Courtney Woods, the UNC associate professor and researcher, said.

Most of the participants weren’t aware of the swine gas operations, Woods said. But they were concerned about persistent odor, health impacts and emotional stress of living near CAFOs in general. 

While those surveyed said the hog industry provided economic benefits, Woods said, “they wanted clear answers on health impacts.”

The deleterious health impacts of living near swine CAFOs—even those without biodigesters—have been well documented. A University of Michigan study released last month found that census tracts near these facilities had 11 percent higher levels of PM 2.5 than those tracts without them, even when accounting for urban and industrial sources.

Epidemiologists have found that exposure to elevated levels of PM 2.5 is linked to asthma, cardiovascular disease, bronchitis, leukemia and Alzheimer’s disease. Researchers at the American Medical Association have found increases in overall death rates, heart attacks and lung cancer corresponding with increases in PM 2.5 levels. These health effects have been observed in residents as far as 11 miles from the farms.

Julia Kravchenko, an assistant professor of surgery and of population health sciences at Duke University, discovered similar trends in 2018. North Carolina communities located near hog CAFOs had higher all-cause and infant mortality, deaths due to anemia, kidney disease, tuberculosis, septicemia, and higher hospital admissions of low-birth-weight infants, Kravchenko found, but the study did not establish causality. 

The Trump administration’s cancellation of the grant hampers the public’s ability to scrutinize the burgeoning industry. “I think communities have a right to know how their health is going to be affected,” Hildebrand, of the SELC, said. “And regulators need to know that as well, so that they can put protections in place to keep the environment safe and to ensure that the people who live near these facilities are kept safe as well.” 

Trump Cancels Study on Health Impacts of Industrialized Hog Farms That Produce Biogas - Inside Climate News
N.C. research would have provided crucial data on understudied effects of the burgeoning industry on predominantly Black, Indigenous and Latino residents.

Can Zohran Mamdani Really Freeze the Rent?

The mayoral candidate’s signature promise has given tenants hope — and rattled some landlords. Here’s a guide on what a possible Mayor Mamdani can and can’t do.

Sep 2 5:01am EDT

Democratic mayoral candidate and Assemblymember Zohran Mamdani speaks at Union square. Aug. 22, 2025

He’s said it over and over again on the campaign trail, a consistent drumbeat of a promise: If elected, Assemblymember Zohran Mamdani will freeze your rent.

“I’m running for mayor to freeze the rent for every rent-stabilized tenant,” he said in a campaign ad unveiled in late May. “Wait, you’re going to freeze my rent?” asks an actor playing a tenant. Mamdani comes back on screen: “Yes.”

But does the mayor of New York City actually have the power to stop rent increases in one of the most expensive cities in the world?

Not directly. But they definitely have the power to appoint people who could make it happen — and Mamdani wouldn’t be the first New York City mayor to oversee a rent freeze. Here’s what you need to know about the process:

Would Mamdani’s rent freeze apply to every renter — even me?

No. As the candidate has repeatedly said, a future rent freeze would apply only to apartments with rent-stabilized leases, not so-called “market rate” apartments with unregulated rent prices.

Still, his promise would cover a lot of people. There are 996,600 rent-stabilized apartments in New York City according to the 2023 Housing and Vacancy Survey, a once-every-three-years census of the city’s housing stock. They account for more than 4 in 10 of all rental apartments in the five boroughs.

Keep in mind: Rent-stabilized apartments should not be confused with rent-controlled apartments. Stabilized units are nearly as plentiful as market-rate units, while rent-controlled apartments — with shockingly low prices, sometimes in the city’s toniest neighborhoods — are vanishingly rare. There are only 24,020 of rent-controlled units left as of 2023, which accounts for just 1% of all rental apartments, and that number is shrinking with each passing year.

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How could Mayor Mamdani freeze the rent?

On his own, he can’t.

To do it, he needs help from the nine people who set rent levels for those nearly one million rent-stabilized apartments: the Rent Guidelines Board.

The RGB dates back to the days of Mayor John Lindsay when it came into being to independently evaluate rent regulation. Every single member is appointed by the mayor.

But an incoming mayor — like Mamdani may be in January 2026 — cannot sweep the board and replace all nine members right away. The board members have staggered terms. 

Crucially, one current appointee of Mayor Eric Adams has a term that lasts through 2026 and, if he loses in November, Adams will still have the power to make new appointments for four of the current board spots before he leaves office.

If he does that, those members will remain in place through the end of 2026 — giving Adams’ appointees influence over stabilized rent levels beyond 2025..

Will Mayor Adams take that step? We don’t know, and his office did not reply to THE CITY when asked.

Has New York ever had a rent freeze before?

Yes, under Mayor Bill de Blasio the Rent Guidelines Board voted for a rent freeze in three of the eight years he was in office, in 2015, 2016 and 2020.

Like Mamdani, de Blasio campaigned on a rent freeze promise. But because of holdover Rent Guidelines Board members appointed by Mayor Michael Bloomberg, de Blasio didn’t get his wished-for freeze until his second year in office.

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Those three rent freezes have contributed to stabilized rent prices increasing at a slower rate than the overall cost of living. As THE CITY previously reported, rents for stabilized apartments in the past decade have increased slightly less than 12% while the New York area Consumer Price Index rose more than 27% in the same period.

Landlords and some housing experts say that spells major financial trouble, especially older rent-stabilized buildings in The Bronx.

On the other hand, tenants are under enormous pressure and need relief, said Leah Goodridge, a current member of the City Planning Commission and a former member of the Rent Guidelines Board appointed by de Blasio. She voted for a rent freeze then and supports another freeze under the next mayor.

“I’ve talked to thousands of tenants over the course of 12 years representing them in Housing Court, and almost all of these cases were because the rent was too high,” she said. “We have a huge homelessness population because of it.”

So, when could we see a rent freeze for stabilized apartments?

There are two scenarios to consider here:

First, if Mamdani wins and if Adams decides not to make new appointments to the board, the new mayor could replace the majority of the RGB right away in 2026.

That would mean Mamdani’s appointees — who would almost certainly align with his vision and would vote for a rent freeze — could make that happen in next year’s rent level vote.

That freeze would be in effect from Oct. 1, 2026, through Sept. 30, 2027, meaning price would stay the same on all rent-stabilized leases for that period.

Alternatively, if Mamdani wins and Adams decides to make new appointments to the board on his way out, a rent freeze would be delayed.

Adams appointees would have control of the board through 2026 and would likely not vote for a rent freeze. In all the years of the Adams administration, the RGB has voted for rent price increases for stabilized units. Most recently, the board voted for rent increases of up to 3% for one-year leases and 4.5% for two-year leases beginning Oct. 1.

If that happens, a vote for a rent freeze wouldn’t happen at the earliest until 2027, affecting leases between Oct. 1 2027 and Sept. 30 2028.

What have the other candidates said about a rent freeze?

No other mayoral candidate for the November election supports a rent freeze the way Mamdani does.

Former Gov. Andrew Cuomo has said he will appoint RGB members who take into account landlords’ rising costs including maintenance, insurance, taxes and utilities. Adams has already demonstrated through his board appointments that he does not support a blanket rent freeze.

Republican nominee Curtis Sliwa told THE CITY through our Meet Your Mayor survey that he would support a rent freeze if economic analysis determines it's feasible.

Independent candidate Jim Walden does not support a rent freeze. He has said he wants to “scrap” the board completely — something only the state legislature could do — and give more subsidies to landlords.

Am I rent stabilized? How can I check?

Many apartments or buildings in New York may have rent-regulated status that tenants may not be aware of — including newer buildings with certain tax breaks, or older buildings with newer tenants.

Watchdogs and journalists have blown the whistle on those instances many times, including in this 2015 ProPublica series and in THE CITY’s previous reporting.

The best way to get more information about whether you may be entitled to a rent-regulated apartment is to check your rent history. Read THE CITY’s guide about how to do that here.

Can Zohran Mamdani Really Freeze the Rent?
The mayoral candidate’s signature promise has given tenants hope — and rattled some landlords. Here’s a guide on what a possible Mayor Mamdani can and can’t do.
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