How Urban Investment Patterns Fuel Healthcare Inequities

[Updated January 18, 2019] For Green Inequalities, the blog of the Barcelona Laboratory for Urban Environmental Justice and Sustainability, public health researchers Helen Cole and Emily Franzosa explore how access to hospitals and medical care fit into cities' ongoing move toward gentrification. "In much the same way that urban gentrification continues to see the exclusion of poorer residents from once-disinvested and now newly desirable neighborhoods, so are these residents increasingly excluded from accessing healthcare and the health care jobs in these neighborhoods that have long been a steady source of employment," according to the article.

One problem is that large medical companies—sources of both medical services and local employment—are shuttering full-service hospitals in favor of expensive practices serving higher-income clientele in gentrifying areas. "These shifts in the provision and cost of basic healthcare reflect the same patterns as those in the cost of living in gentrifying neighborhoods: when goods and services are increasingly provided for the new, wealthy class, they often leave behind less affluent residents," according to the article. 

For a case study, Cole and Franzosa turn to Dallas, Texas, where extreme income inequality and high rates of uninsurance collide. She also points to the successful campaign by Chicago activists to open a trauma center in the South Side—the area's first in 30 years. 

[Updated to include both researchers credited for the project.]