Written By: Walt Lewellyn

UAB President Ray L. Watts Shakes Hands with City of Selma Mayor James Perkins

Live HealthSmart Alabama (LHSA), the University of Alabama at Birmingham’s strategic initiative to improve health outcomes across the state, has spent its first five years investing in the health and well-being of nearly a dozen Birmingham neighborhoods.

Now, with the generous assistance of local, state, and national partners, LHSA is expanding to serve Alabama’s Black Belt. Building on the pioneering work of LHSA Chief Executive Officer Mona Fouad, M.D., MPH—founding director of the UAB Minority Health & Health Equity Research Center and former member of the state’s Black Belt Commission—and applying lessons learned in the Magic City, LHSA is working to make good health simple in the region.

“We are excited to work together with leaders in Selma, Demopolis, Camden, and other Black Belt communities to realize our vision for a healthier Alabama,” said Fouad, whose extensive experience addressing health disparities in the region dates back to Selma Mayor James Perkins Jr.’s first term in the early 2000s. “We seek to expand access to nutritious food and health screenings, foster exercise and civic pride in revitalized public spaces, and prepare rising leaders in these towns, laying the groundwork for lasting positive change."

The LHSA Method

LHSA works holistically to make good health simple and accessible for all Alabamians:

• Helping people take control of their health by offering free, comprehensive health screenings
• Encouraging physical activity and neighborhood pride by revitalizing and beautifying public spaces
• Increasing access to affordable, nutritious groceries through the Mobile Market and pop-up farmers markets
• Promoting healthy choices through educational outreach and community health coaches, who provide active navigation to reduce barriers to receiving appropriate health care
• Sustaining progress by investing in neighborhood stakeholders who will advocate for their communities

A Resilient Region

Live HealthSmart Alabama’s Black Belt expansion was made possible by a $2.47 million gift from globally founded health care company Novo Nordisk Inc. According to Apurva Patel, Director of Corporate Sustainability and Social Impact with Novo Nordisk, a shared emphasis on the social determinants of health—e.g. physical activity, access to equitable health care, availability of nutritious food, and housing—made LHSA a natural partner.

Live HealthSmart Alabama and Novo Nordisk in Selma“Our mission is really about the prevention of chronic diseases like obesity, diabetes, and cardiovascular disease, particularly in the vulnerable communities where disease burdens are highest,” Patel said. “By partnering with Live HealthSmart Alabama to invest in these communities to improve access to the social drivers of health, we hope to empower residents and establish an enduring foundation for improved health outcomes.”

Despite its vibrant community spirit and rich history—including its central role in the Civil Rights Movement—Selma’s challenges are reflected in Dallas County’s public health statistics. Already burdened by generational cycles of poverty, high crime rates, and a lack of access to transportation and health care, the county is still recovering from the impact of the COVID-19 pandemic, where the mortality rate was 50 percent higher than the rest of Alabama. Those issues only intensified in the wake of the destructive EF2 tornado that swept through Selma, the county seat, on January 12, 2023.

J. David McCormack, CEO of Vaughan Regional Medical Center, estimates that the tornado that hit Selma in 2023 destroyed as many as 1,500 homes. Many of the families who were displaced left the community rather than attempt to rebuild. “People kind of lose hope,” McCormack said, drawing on more than eight years’ experience leading the only hospital serving Selma.

Although McCormack was quick to cite resources available to the community, such as healthy meals and medicine provided by the Edmundite Missions, he noted that a lack of accessibility and awareness about these resources creates a “vicious cycle.”

Irfan Asif, M.D., associate dean for primary care and rural health and chair of the UAB Department of Family and Community Medicine, echoed McCormack’s concerns about “fragmented” resources.

“Any sustainable improvements will require a holistic approach that actually recognizes the everyday limitations people are facing,” Asif said.

Rejuvenating Selma

LHSA’s work in Selma is rooted in a collaborative approach that prioritizes the daily experiences of residents. Rather than administering solutions from the top-down, UAB staff—led in Selma by Thamar Taylor, manager of LHSA’s community engagement program in Selma—work with local leaders to identify strategic priorities, build trust, and develop sustainable answers to long-term issues.

One of the town’s most pressing needs: new, wind-resistant roofs in Ward 8, the East Selma neighborhood hardest hit by the tornado and most threatened by future storms. Dr. Craig Scott, pastor of Mount Ararat Missionary Baptist Church, raised his community’s concerns with Taylor. Together with Ward 8 City Councilor Michael Johnson, they went door-to-door to connect homeowners with Strengthen Alabama Homes, an Alabama Department of Insurance program that assists with roof fortification and replacement.

Since February, LHSA has helped to facilitate home inspections, grant applications, and roof replacements for 40 houses in east Selma—a total of $400,000 in grant funding. According to Travis Taylor, director of the Alabama Office of Risk and Resilience, these roofs will not only protect against wind damage, but also reduce insurance premiums, offering area homeowners immediate relief and long-term peace of mind.LHSA and Selma Officials Conduct Site Visit During Roof Installation

“These improvements have given the people of Selma hope that they can have better and do better,” Scott told the Black Belt News Network. “It is invigorating to see the joy on the faces of those who have had their roofs replaced, a joy that I hope remains in the city for a long time.”

In the meantime, LHSA is coordinating with architecture and engineering firm Goodwyn Mills Cawood (GMC), general contractor Caddell Construction, and local contractor Frasier-Ousley Construction and Engineering, to rejuvenate east Selma’s community pond and park.

“Our team was really inspired by the connection between helping address health disparities and improving the built environment. We were also drawn to Dr. Watts’ commitment to bringing Alabama up from the bottom of national health statistics, specifically through investments in safe and inviting parks, sidewalks, and other public spaces.” – GMC CEO Jeffrey Brewer

According to Caddell construction executive Michael Lewis, LHSA’s work in the Ward 8 community pond is focused on addressing erosion problems, building new walkways to improve connectivity, planting trees for shade, making the pond fishable again, and repairing (or replacing) sidewalks in the surrounding neighborhood.

“Investing in parks can help raise the self-esteem of children because they’re proud of where they live,” said Jane Reed Ross, senior landscape architect with GMC. “They recognize this is an investment in them and their future. Investing in public spaces like parks also helps parents because it provides opportunities for their children and provides them safe places to go, supporting healthy and active lifestyles."

Healthy Living

Improvements to the built environment are only the first step in LHSA’s model for community revitalization and preventive health. Partnering with HEAL United, a nonprofit that promotes healthy eating and exercise at more than 200 schools across Alabama, LHSA is working to change lives at Selma’s Sophia P. Kingston Elementary.

“Areas in which we have Title I schools also represent the highest risk for early disease, chronic disease, financial instability—all of the high-risk things that we really want to see change,” said Christy Swaid, HEAL founder and CEO. “A lot of chronic diseases become established by age 10, and at that point, you’re treating diseases instead of preventing them.”

A longtime UAB partner, HEAL impacts more than 48,000 students across Alabama by offering teachers lesson plans, materials like heart rate monitors and informative posters, and intensive professional development seminars at no charge.

“Within six months’ time, if a teacher takes our lesson plans and all of our tools and services, 75 percent of their students will experience statistically significant improvement in their cardiovascular test scores, knowledge, and behavior scores,” Swaid said.

“I’ve never seen this kind of reaction before. Kids would run up to me during breakfast and lunch and say, ‘Coach T, look at my food groups!’” – Tevin Rudolph, P.E. teacher at Sophia P. Kingston Elementary

Swaid credits Thamar Taylor and LHSA for connecting HEAL with Kingston Elementary in east Selma, a community where HEAL had previously failed to make inroads. Kingston educators like Tevin Rudolph, a coach and P.E. teacher, traveled to HEAL training seminars in 2023, implemented their lesson plans during the fall semester, and have been amazed by the early returns.

“This was a real learning experience for me as a teacher,” said Rudolph. “The kids were really impressed when I told them you can be strong at 50 and 60 years old if you start doing these things now. These kids don’t see a lot of people in their community at that age vibrant and fit. And they really were blown away.”

A Model for Progress

Although LHSA’s expansion into the Black Belt is still in its early stages and the challenges facing Selma are entrenched and longstanding—as McCormack put it, “We didn’t get here overnight; we’re not going to get out of it overnight”—locals, strategic partners, and UAB staff alike are optimistic about the initiative’s potential to make a lasting difference in Dallas County and beyond.

Mobile Wellness Team at Selma Rising Mural Festival“They’ve recognized that they are the leaders in this state,” McCormack said of UAB, noting that being associated with the university has already encouraged more residents to attend Vaughan Regional Medical Center’s health fairs. McCormack hopes that by removing obstacles to healthier lifestyles and promoting early identification of disease instead of “waiting until it’s a crisis,” LHSA will improve health outcomes and ease the burden on the county’s strained medical infrastructure.

That kind of transformation takes time, but Fouad and other UAB leaders believe that Selma is on the path to significant improvements in nutrition, fitness, and access to regular medical care and testing, all built on a foundation of trust with medical professionals.

“We are honored to have the trust and partnership of so many people in Selma and across the region,” Fouad said. “Our work to positively impact the incidence of chronic disease depends on the support and advocacy of local leaders. With their help, we can make lasting improvements in the Black Belt, as well as gather data to inform future community outreach initiatives that will touch countless lives in Alabama and beyond.”

For Patel and Novo Nordisk, the big picture is even more ambitious. If LHSA’s integrated, collaborative approach demonstrates that it can scale and adapt to communities’ unique needs, Patel believes it can provide a model for public-private partnerships around the nation.

“Part of what we're proving with UAB is that private companies, states, and municipal governments can take on some of this investment in health outcomes, because it ultimately becomes cheaper than paying for the disease or paying for it down the road,” Patel said. “I think the learnings from Selma are starting to lay a seed that can truly transform public health in some of the most vulnerable communities in the country. And that would be an awesome legacy for UAB, and hopefully Novo Nordisk, to have some influence on.”

To learn more about Live HealthSmart Alabama’s efforts across the state, visit its official website.