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.

Community Actions: A First Look

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.

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.

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?