West End: The Building with the Green Roof

Let me paint you a picture.

Birmingham, Alabama. The Magic City.

This most populous city in Alabama has made its way into history in numerous ways since its founding in the 1870s. It was the primary industrial center in the southern United States - a hub for the iron and steel industry as well as for the railroad industry. Currently, it is the home for one of the more well-known hospital systems and medical schools - University of Alabama at Birmingham (UAB) - that is on the cutting edge in many areas of medical research and is providing quaternary medical care for the majority of the state.

Despite this history, Birmingham may best be known for the decades of the 1950s and 1960s when it was the center of the Civil Rights Movement and the struggle of African-Americans to obtain equality in education, voting rights, use of public facilities, and in healthcare.

Although the Civil Rights Movement as it existed in the 1960s is no longer present, Birmingham is still a place of great inequality. Despite the existence of the wealthy suburbs and the large hospital systems in Jefferson County, there still exists an island of disparity that has remained unserved and untouched by the current healthcare system. This “island,” as seen in the maps below, stands as a discrete tangible sign of the “Forgotten City” that is not touched by the wealth and healthcare advances happening all around. It stands as a sign of another overlooked community of people without access to comprehensive and ongoing healthcare or good educational or economic development opportunities that is creating the cycle of ongoing inequality.

Note this “island” in the middle of Jefferson County that encompasses the West End neighborhood. This map is showing the enduring health professional shortage areas in the midst of Jefferson County, despite the UAB mecca close by.

*In the map below, note we are looking at the same “island” within Jefferson County. The darker the color, the higher the percent of the population lives in poverty.*

*Now, for this map…. note that the same areas in the map above that show the health professional shortage areas and higher levels of poverty also show a higher rate of African Americans.*

On this map, the same areas that have the higher levels of poverty and the greater African American population and are health professional shortage areas are also the same areas with worse life expectancy. (Red means people die younger than average. Dark blue means people live longer than average. Look how close these two ends coexist…)

Hopefully you’re seeing the pattern. Here is another. The same area where there is more poverty, fewer health providers, a lower life expectancy, and a greater population of African-Americans is also a known food desert.

And there are more maps that show this same region, this same “island,” has higher infant mortality, higher all cause mortality, worse health outcomes, and so many other health indicators that continue to prove this disparity.

However, in our few years in the West End community of Birmingham, we’ve witnessed so much more than the health outcomes, statistics, and shootings that the media reports - we’ve witnessed life. We’ve witnessed resilience. More than that, we’ve been a part of it.

-***JohnQueta Bailey Archie****, Community Development Coordinator, Cahaba Medical Care*

“This is my home.”

The building with the green roof at 1308 Tuscaloosa Avenue, Birmingham, Alabama, 35211, has been home to a host of medical facilities since it was built in 1996. Originally Chris McNair Health Center, it later became Western Health Center; but it, too, eventually closed. Princeton Baptist Medical Center has been serving Birmingham from the West End community since 1922, offering a full range of services. As a matter of fact, they were ranked as the third best hospital in the state. But there’s more to healthcare than hospitals; primary, preventive care - like Cahaba - is often what keeps people out of hospitals and in good health.

In 2017, the building with the green roof became the home of Cahaba Medical Care - West End, our sixth location, in partnership with Cooper Green Mercy Health Services. Many were thrilled to have access to local, affordable healthcare. Before, most uninsured patients and patients with Medicaid had to take a bus ride across town, and in many cases, walk a fair distance to get to the doctor’s office.

But others were wary. Those who had been around long enough - which, in West End, is most - remembered the history of the building with the green roof at 1308 Tuscaloosa Avenue. These doctors, they may stick around a few years, but inevitably, for one reason or another, they’ll be gone before too long.

But this year, we celebrated the purchase of the building with the green roof at 1308 Tuscaloosa Avenue alongside our community stakeholders.

“We’re here to stay.”

And what makes us so sure that Cahaba is different?

We’re resilient.

Is the need huge? Yes. Is the work immense? Yes. And it is because of those truths that so many have backed down and backed away. How can you begin impacting decades of systemic racism, distrust in healthcare institutions, and generations of health inequity? Things are so entrenched. The inequities are so long-standing. And the fix is so complicated and multifactorial.

But we show up each day ready to put in the hard work of loving and serving. We live out the small things each day that can lead to the big changes that we know can be accomplished. And because the people of West End, and so many other communities, deserve nothing less. They deserve someone to stand up and stand beside them. To see them. And not just for their struggles. But for their strengths and their stories and what they have to say and to offer if they are given the chance to speak. They deserve a partner. They deserve someone to not care that the work is hard and long and complicated.

The vision?

That our communities will flourish as we partner with them as a catalyst of community healing and transformation, as we dismantle healthcare disparities, eliminate inequity in social determinants of health and well-being, and make health professional shortage areas obsolete.

This work is not a sprint but an ultra-marathon that will feature many setbacks and failures. But the end goal is worth it. We can help bring health and well-being to our communities - to West End. We can help bring partnership and collaboration. We can help bring a voice to our patients. And we can help bring a difference.

This is what we are striving for. This is our dent in the universe. For people to look back on West End and see its transformation into an area that is noted for its health and well-being, where our neighbors, friends, family, and patients can thrive - and be resilient.