Report Publish Date: November 2021
This report summarizes Mobile, Ala.’s health, well-being, and equity journey from 2016 to 2021, as part of RWJF’s Sentinel Communities Surveillance project.
Well-established organizations provide pivotal healthcare services in Mobile, the authors write, but the community has limited capacity for health and health equity work outside the health sector. During the period studied, the city lacked health and well-being priorities and leadership, and city government had little will to make a commitment to broadly improving health.
Equity and health equity had not been a focus for Mobile’s leaders, the authors say, though they made some progress, including establishing an equity task force, the authors say. And nonprofit leaders, social service providers, and academics in the community deeply understand the importance of health equity.
“There are some bright spots in terms of partnerships and efforts that are facilitating health progress in Mobile,” the authors write. “Yet, significant barriers remain with respect to health promotion and healthcare access, as well as social issues among different subgroups in the community.”
Begun in 2016, RWJF’s Sentinel Communities Surveillance project tracks how a Culture of Health is developing in 29 communities across the country. The authors wanted to describe key challenges, opportunities, and insights in Mobile.
The authors gathered information from phone interviews with Sentinel Community leaders; online, published, and local materials and media about the communities; and data sources including the Census Bureau’s American Community Survey, the CDC’s Behavioral Risk Factor Surveillance System, County Health Rankings, and state and local data collection systems. For this report, the authors conducted 25 hourlong, semi-structured interviews between late 2016 and summer 2021. Interviewees came from a number of different types of organizations and sectors.
“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.”
—RAND Corporation
“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,” the authors write. “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.”
Mobile, the third-largest city in the state of Alabama, has been characterized by significant action in the past few years to rebuild the city’s aging infrastructure, attract new businesses, and improve the quality of life among residents. Of note, Mobile has made strong investment in education. While education is a key driver of health outcomes, those education-to- health links are not always explicitly made through local programs and policies. The city has made some progress in health through an active public health department, but Mobile still grapples with high rates of chronic disease and issues that hampered some of the efforts to effectively address COVID-19 across all populations. Many of the local initiatives and research on health and well-being are driven by external funding, through government grants or philanthropy. There is less coherence about health priorities due to limited political will at the local government level to advance those health actions, a trend that seems consistent with where Mobile was in 2017. There has been some progress to examine issues of health disparities between populations. However, the health equity discussions are still relatively nascent with respect to the role of systemic racism in health. Some community organizations are actively working to expand those discussions.
Robert Wood Johnson Foundation, November 2021
Page 2: Figure 1: Population Characteristics for Mobile, Alabama
This study and report was conducted and created by RAND Corporation.
A library of research and perspectives about Sentinel Communities, 30 diverse communities around the country.