Tuskegee resident Elise Tolbert hasn’t had a hospital in her city in her lifetime. Macon county, where her family has lived for generations and where four out of five residents are Black, once had two hospitals, but both were closed by the late 1980s.

That has forced locals to travel a half hour or more to other larger towns to get treatment – a long trip during a medical emergency, especially since calling for an ambulance can lead to a long wait. Residents often have to drive themselves, or find someone to take them if they don’t own a car – which is common in a town where 29% of residents live in poverty.

The lack of local medical services is a serious problem for her ageing relatives. Tolbert also worries about her asthmatic nephew.

“If he needed to go to the emergency room, the closest was either in Montgomery or [near] Auburn,” said Tolbert, an environmental scientist and political activist. “It’s a big concern for people, particularly older people who are thinking about their ability to age in place.”

Tuskegee is one of many Black-majority Alabama communities where the legacies of segregation and systemic racism, including intentional political disenfranchisement, have led to dramatically underfunded public resources. The town’s population has dropped from 12,000 to 9,000 residents in the past two decades – a vicious cycle where lack of jobs and resources force people to move away, making it harder for the town to maintain the community services it does have. But now, the community that tends to historically vote for Democratic candidates has a glimmer of hope for representation in a state that overwhelmingly votes Republican.

After a two-year legal battle led to a surprise supreme court victory for civil rights advocates, a federal court ordered Alabama to implement a new congressional map in October and create an additional district where Black voters can elect a candidate of their choice.

The congressional map for the 2024 elections will provide Black Alabamians with the opportunity to elect two of the state’s seven congressional representatives, thanks to a new second district where Black voters make up 48.7% of the population. That means they can elect a lawmaker to Congress who will not only represent their political views on national issues – but be more attuned to the local needs and problems of the communities and more willing to fight for earmarks for specific projects like funding for local medical care.

Democratic congresswoman Terri Sewell, who currently represents the state’s lone Black-majority district, said she was excited that she “won’t be the only D in the state of Alabama” for long – and that there will likely be another colleague who will focus on helping Alabama’s Black community with constituent services.

“My office gets tons of calls all across the state but yet we only represent Alabama’s 7th congressional district,” she told the Guardian. “The constituents of this new district will be excited to be able to have a person in that seat that they can actually relate to and feel comfortable enough to ask them to help.”

Evan Milligan, the executive director of progressive civic organization Alabama Forward, was one of the plaintiffs in the redistricting lawsuit. He agreed to join the case after growing frustrated with lawmakers who he said took advantage of Black communities without fighting to get them the services they need.

“[Legislators are] using census data to get millions, sometimes tens of millions of dollars, for infrastructure projects. [They’ll] use numbers of Black people to get low-income housing funding, stuff for bridges and stuff like that and will never put [those funds] where these people are,” he said.

The court win was just the first step.

Now, advocates will need to convince Black voters who have been ignored for so long to turn out and cast their ballots.

“It’s time to shift into raising awareness,” said Anneshia Hardy, executive director of the grassroots progressive organization Alabama Values. “What does it mean to have this second district? What does it mean to turn out and vote?”

The court case in Alabama is one of several redistricting cases being considered by courts throughout the country in southern states where the Voting Rights Act once forced local white politicians (from both parties) to create more Black-majority districts.

That landmark 1965 law helped end a century of Jim Crow policies that had all but banned Black political participation in the south, and created a bevy of Black-majority districts throughout the country. Recent supreme court decisions chipping away at the law’s enforcement mechanisms have weakened this, however, and led to plenty of GOP gerrymanders that diluted Black voting power – especially in southern states like Alabama, which has some of the most racially polarized partisan voting patterns in the country.

But the supreme court’s recent decision to ban the most extreme racial gerrymanders – like the ones that Alabama Republicans had used for their most recent congressional map – have opened the door to more Black political power as well as more Democrats in Congress.

Judges recently ruled in Florida, Georgia and Louisiana that the states’ congressional maps need to be redrawn, which could create more Black representation throughout the region – as well as give Democrats an easier path to a House majority in the next election. The court’s ruling is no guarantee of new maps, however: A court recently ruled that South Carolina Republicans didn’t have to draw a second Black-opportunity in that state.

While nationally the conversation has mostly centered on how creation of the second district in Alabama and potential new congressional maps in other states could help Democrats secure a majority in the US House, a new congressional map could have much more tangible impacts for the voters of central Alabama’s Black Belt communities.

Alabama is ranked among the worst states in terms of overall child wellbeing as well as life expectancy – and Black people face significantly worse outcomes than their white neighbors. The residents of state’s lone Black-majority district that Sewell represents have the shortest life expectancy of any House district in the country, according to a recent Harvard study. The infant mortality rate for Black Alabamians is 11.9 deaths per 1,000 births, more than double the national infant mortality rate as well as that of white Alabama infants, according to data from the Equal Justice Initiative.

Additionally, a recent report by the nonprofit thinktank the Milken Institute found Alabama has the worst mortality rate in the country, with outcomes being significantly worse for Black women in the state. A national report conducted by Robert Wood Johnson Foundation and the University of Wisconsin’s Population Health Institute found that the predominantly Black Macon county is among unhealthiest counties – ranked 59th of 67 – in Alabama.

Healthcare, education, roads and infrastructure, sewage and access to clean water are all concerns for locals as they look ahead to the 2024 election. Black residents are hoping a new member of Congress will help secure federal funding for these issues through earmarks or community project funding.

Robert Turner, a Tuskegee native and local community organizer, said he often gets emotional when he thinks about how his access to healthcare has dwindled in his lifetime. He remembers back when the John A Andrews memorial hospital was still open. But even then, locals with the means to do so often traveled elsewhere to receive what they viewed as better care.

“The folks with money stopped utilizing it,” Turner said. Only poor people were using it. They were losing money.”

Residents’ issues haven’t been completely ignored. Republican congressman Mike Rogers, whose current district currently includes Macon County, was one of the Republicans who led the charge for Congress to bring back earmarks, where lawmakers can fight for money for local projects. His recent requests include $2,200,000 for the residents of Fruithurst in Cleburne county to get their water from a well after Auburn University attributed a “cluster of rare cancers” plaguing residents in the area to be related to water contamination.

But local Black activists are hoping that having a second lawmaker focused on Alabama’s Black communities will increase their pull in Congress – and help them find funding for crucial issues.

“We feel there is an opportunity that we have secured. A lot of those people are dealing with life and family situations where an infusion of federal resources is really going to decide if some of them live or die, and certainly if certain towns and communities stick around,” Milligan said.

Cameron Joseph contributed reporting