When a disease outbreak occurs, Chaisson explained, “the norm is panic, for people to demand testing from the health department, and you can’t do it fast enough.” But the Hill has never been much for demands. The town of Marion sits in the belly of the Black Belt — historically, a ribbon of seventeen counties in central Alabama and parts of northeastern Mississippi, where whites enslaved black people to farm cotton in the dark, fertile soil; the term has come to refer broadly to predominantly African-American areas in the rural South. Across the Black Belt, there is grave poverty; Alabama is the fourth-most-impoverished state in the nation, and Perry is its worst-off county — 47 percent of residents live below the poverty line. The burden is shouldered unequally, as the poverty rate in Perry County is three times higher for black people than for whites. Jim Crow is gone, yet segregation lingers, along with its associated injustices. While Black Belt districts typically go blue, the rest of their states are deep red; last year, after the state of Alabama enacted a law requiring photo identification to vote and then promptly closed D.M.V. offices in Black Belt counties, a federal investigation confirmed that this targeting amounted to discrimination.