Mobile, Alabama

Located on the Gulf of Mexico, Mobile is a southern seaport city with a history as rich as it is complex.

Alabama’s third largest city, Mobile* was established as a trading center in the early 1700s around the Port of Mobile, which has long played a role in the city’s economic health. Within the city of Mobile—where more than half the residents are Black, and 44% are white—complex race relations and their resulting health, social, and economic disparities have a long legacy. Originally built by newly arrived slaves in 1860, the north Mobile neighborhood of “Africatown” remains a predominantly Black area, with higher poverty than the city’s newly, largely white communities like College Park, Country Club, Parkhill, and Claremont.

In 2005, Hurricane Katrina caused catastrophic damage to the city, including $245 million in statewide damages and tens of thousands of displaced citizens. In 2010, tragedy struck once more, with the Deepwater Horizon oil disaster spilling 4.9 million barrels of crude oil into the Gulf, crippling the local fishing industry.

*Mobile refers to the city of Mobile, unless Mobile County is specifically stated.

Overview

Population and Demographics

Population: 195,111

SOURCES:
U.S. Census Bureau; photography courtesy Wikimedia Commons, DXR_CC BY-SA 4.0.

Context and Actions

Community Context and Challenges

In addition to an overall 25% poverty rate for Mobile, significant income inequality exists between Black and white residents, with Black households earning about half the median income as white ones.
While educational attainment has increased among white residents, the percentage of Black residents with a bachelor’s degree or higher declined between 2010 and 2014.
Despite progress, Mobile residents have a lower life expectancy and higher rates of teen pregnancy, obesity, smoking, and uninsurance than the national average.
Even with the introduction of a new Regional Care Organization that may improve insurance coverage for residents, Mobile remains a federally designated health care shortage area.

SOURCES:
U.S. Census Bureau. (2014). 2010-2014 American Community Survey 5-Year Estimates.

Alabama Department of Public Health. (2013).

Taking Action

Today, Mobile is setting its sights on a brighter future, beyond historic inequity, inequality, and environmental disasters.

Residents, local government, and community-based organizations are collaborating across sectors to forge consensus on the city’s next steps, from building a stronger downtown to reducing the rate of teen pregnancy. A recent series of ambitious initiatives aim to engage the city’s diverse community and leverage its assets to cultivate a healthier, safer Mobile. Some ongoing efforts to improve health and well-being are showing early signs of success, while measurable progress has yet to be made in other areas.

NOTE:
These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

One Mobile

A citizen run non-profit organization, One Mobile focuses on improving well-being for all residents of the city. Through extensive community engagement, city residents proposed more than 50 ideas, several of which were implemented, including hosting community festivals and adopting highways for litter control.

Live Better Mobile

A health coalition founded in 2012, Live Better Mobile partners with community-based organizations to improve residents’ health and well-being. The coalition comprises more than 40 academic, political, community-based and government organizations. Its members range from middle school to senior leadership. Using county level data, the coalition has focused on reducing obesity, teenage pregnancy and smoking.

Map for Mobile

Led by the mayor, the Map for Mobile is a comprehensive framework for growing a safe and healthy community for all residents. It includes ongoing community engagement to promote the city’s diversity as an asset. Residents and stakeholders posed ideas about how the city infrastructure could be improved to better promote health, foster stronger neighborhoods, and increase options for physical activity.

High Uninsurance Rates, Health Care Shortage Area

High uninsurance rates and designation as a health care shortage area contribute to problems with access to health care. Additional data and information gathering will explore the health care infrastructure and how issues of access are being addressed.

Going Forward

Questions for Consideration

Additional surveillance, data and information gathering, analysis, and reporting will examine the extent to which Mobile’s local initiatives are engaging all sectors of the community. Future reports will also examine how stakeholders are working to create a healthier, more equitable community; the impact of new and ongoing initiatives to address priority health concerns; and whether gaps are emerging in priority areas.

Questions for further consideration include:

To what extent are local initiatives making progress toward their goals? What are the key markers of success for each of the local initiatives? What barriers have these efforts faced as sponsors work to promote health and health equity?
What processes are in place to ensure that residents from all sectors of Mobile are represented and heard as a part of new or ongoing health initiatives? To what extent do these efforts reveal how health is valued in different racial/ethnic and income subpopulations?
What are the interactions among race/ethnicity, chronic disease incidence, disease-specific mortality rates, and life expectancy that can explain lower mortality from heart disease and cancer among Black residents in Mobile compared with whites?
Since Mobile’s recent initiatives largely address root causes of disease and lack of well-being, to what extent are residents with poor health outcomes getting appropriate care from the health care system?
What is the structure of the broader health system, and how do representatives from key sectors work to address shared challenges?
Are there other coalitions or collaborations in Mobile addressing the social, structural, and economic drivers being leveraged to consider their role in health and well-being, and what efforts have been made to link the community together? What are key facilitators and barriers to initiating and/or maintaining those linkages?
What are the interrelationships among economic, educational, and other social drivers of health in Mobile, and how are leaders planning for them in a coordinated way, particularly in the context of equity and opportunity discussions?
What is contributing to racial disparities in college graduation rates? Why have Black residents increased attainment of high school and some college and/or associates education but decreased attainment of bachelor’s degrees, especially compared with white counterparts who have recently experienced rising rates of high school and college graduation? Given the widening disparities gap in attainment of bachelor’s degrees, are there any strategies that are successfully increasing college readiness among Black youth in Mobile?