Community Context

The historic City of Mobile sits at the head of the Mobile Bay, an inlet of the Gulf of Mexico. As the 12th largest port in the United States, the Port of Mobile has been an economic engine for the area since it was first established in the 1700s. Today, the port continues to supply a significant job opportunities within the fishing, shipbuilding, and tourism industries. The city’s economy has historically been driven by manufacturing, steel production, and oil and gas drilling.  

Similar to the state of Alabama, the City of Mobile is politically conservative. Having elected Sandy Stimpson in 2013, and again in 2017, Mobile’s political divisiveness has not shifted much despite Mayor Stimpson’s pledge to “unite Mobile.” Diabetes and hypertension continue to be key health issues for residents, with significant impacts in Mobile’s Black population. Furthermore, Mobile is still recovering from the explosion of the Deepwater Horizon oil rig on the Alabama coast in 2010. Though some Mobile County residents feel that the county did not receive commensurate compensation, the community has begun to utilize some of the settlement funding from BP to build disaster resilience. With some funding at the state level to continue through at least 2033, Mobile is beginning to invest in environmental resilience and undertaking essential conservation projects that would normally be unachievable due to high cost.

Mobile’s Journey to Promote Health, Well-Being, and Equity

Five years into the Sentinel Communities Surveillance Project, limited community capacity to focus on health and health equity outside of the health sector has created challenges in Mobile’s ability to make strides in advocating for public health policies and programs.

Despite a growing number of cross-collaboration between institutions, difficulties remain in bringing various groups together. Ongoing initiatives focus on addressing well-being while some new initiatives focus specifically on health. Regarding the health narrative in Mobile, the limited community capacity and relatively limited motivation to address issues related to health equity are reflected in the city’s lack of set priorities around health and well-being. Recent walkability and improvements in the built environment have been key focus areas. However, there are challenges in having clear leadership and community-wide consensus on the establishment of a fuller set of health priorities going forward. In terms of health equity, Mobile’s approach has been progressing slowly over the past five years, mostly through the nonprofit and academic sectors. More effort is needed to center health equity policy in city government.

Lessons Learned: Where is Mobile Five Years Later?

Mobile’s journey to promote health, well-being, and equity underscores how difficult it is to move political will and policy changes in a community, requiring consistent focus on health objectives and coordinated efforts among government and nonprofit, academic, and other sectors. The new conversations that are happening on equity among pockets of Mobile community leaders along with the potential to link disaster resilience to health offers a window of opportunity to accelerate local health actions. Other communities can learn from Mobile’s approaches on this health and disaster linkage, as well as the challenges Mobile has encountered, to inform their own journeys. Future research could consider whether this new momentum around discussions of health equity translates to sustained government action and investment across Mobile.  

Mobile continues to capitalize on various facilitators and has become increasingly resilient. There are some partnerships and efforts that are facilitating health progress in the city, but significant barriers remain with respect to health promotion and healthcare access, as well as other social issues.

Facilitators:

  • Established partnerships and collaborations 

  • External funding to address health equity

  • Nonprofit and community-based organization leaders focusing on equity

  • Increased focus on disaster resilience

Barriers:

  • Public health leaders stuck in traditional health promotion efforts

  • Minimal support for policies to improve healthcare access 

  • Data access issues

  • Social inequality issues outside of health

  • Politics and culture inhibit equity discussions and funding

  • Lack of community voice and trust in government