In February of 1903, the Birmingham News reported on per pupil expenditures in the city’s public schools. Birmingham was perennially at or near the bottom of the list of educational spending among major American cities, but rather than view this as a problem that needed to be addressed, local school officials instead trumpeted as evidence of their good stewardship. Over the previous 20 years, they pointed out, the amount spent per pupil each year had dropped from $17.20 to $11.41.
As the retired Birmingham-Southern professor and historian Ed LaMonte pointed out in his indispensible book, Politics and Welfare in Birmingham, 1900-1975, the News appeared to accept this spin at face value. “Lest [the reduced expenditures] be interpreted as regression,” LaMonte wrote, “the News assured its readers that because of better teaching methods and superior physical facilities, students received ‘vastly more’ from their schooling than they had twenty years earlier.”
On the upside of media engagement in — or at least acknowledgement of — pressing local issues, the year prior to its story on school expenditures, the News had advocated for the establishment of a municipal charity hospital. “There are few cities in the country so large as Birmingham without a city hospital and a city ambulance corps,” the paper editorialized.
In health care as in education, Birmingham lagged behind not only the nation as a whole and the South as a region, but also within Alabama: A 1904 survey showed Memphis allocating more than 12 times as much as Birmingham to public health needs, Nashville eight times more, and both Chattanooga and Mobile spending more than twice as much. And, as LaMonte noted, the situation was even grimmer than statistics suggested, as the statistics did not account for the “vast differences between services and conditions in the black and white communities.”
Fast forward to the post-World War II era. Birmingham was, ostensibly, back and better than ever. After being silenced by the Great Depression and brought roaring back to life by Birmingham’s emergence as a major wartime manufacturing center, local factories were running three shifts a day — and, not coincidentally, creating upward mobility into the middle class, even for workers who were paid less on average than their counterparts in other areas of the nation.
Even amid the general prosperity, however, the city of Birmingham continued to provide an appallingly low level of public services. LaMonte found that the public schools during this period were “[a]mong the most financially starved” of the city’s institutions. Back in 1941-42, the U.S. Department of Health, Education and Welfare had reported that Birmingham ranked last in per pupil expenditures among 34 cities with a population above 100,000; when the report was updated after the 1951-52 school year, Birmingham’s position had not changed.
Meanwhile, as they had been a half-century before, public health and welfare programs were “dismally inadequate…in comparison with other urban areas,” LaMonte wrote, adding the observation that this state of affairs did not “[stimulate] concern on the part of public officials.”
By 1958, the situation was bad enough that the Birmingham Chamber of Commerce appointed a blue-ribbon citizens’ committee on indigent medical care. The resulting report was issued with the terse comment that, “It is not an exaggeration to indicate that the results of this study have shocked the membership.”
The detailed study compared Birmingham’s indigent care facilities and programs to those in Atlanta, Memphis, Miami, New Orleans and Richmond. The Magic City did not fare well, with the report emphasizing “the failure of Birmingham and Jefferson County to even remotely approach the health care benefits provided the sick-poor of these…communities.” Among many areas commented on with something approaching guilty revulsion was that the heavily used emergency room for poor and indigent patients had not been expanded since…wait for it…1903.
Which is where we started this little historic review, the point of which is how little distance our community truly has traveled toward the ideal of serving all of its residents with basic fairness and something approaching equality. It’s sobering and sad, how the very issues in play in the current battle for the soul of the Birmingham City Schools can be viewed as just the latest echo in a litany of shortcoming and failure that dates back more than a century.
Likewise, the ongoing problems with Cooper Green Mercy Hospital and public health in general are, at bottom, the same problems that were present in 1902 and 1958 and every year before, between and since. That points up the wretched irony of living in a community that is home to one of the world’s greatest medical centers and as much medical and scientific talent as almost any place on the globe — and yet one whose population is among the unhealthiest in the nation, riddled with heart disease, pulmonary disease, obesity, diabetes, teen pregnancy, infant mortality, socially transmitted disease, and probably a dozen other markers of bad public health.
What all of this tells me is that we in Birmingham are awfully good at defining and acknowledging the issues that confront us. Where we clearly have fallen short is in the area of solutions. I take comfort in the fact that countless people in the public, private, educational and nonprofit sectors — more, I would venture, than at any time in our city’s history — are becoming engaged in these persistently troublesome issues with the same idea, the idea that we can do better, and that it’s past time to be about the vital work of finding solutions at last.
Mark Kelly is the publisher of Weld. Write him at mark@weldbham.com