Abstract

The redevelopment of urban spaces by hospitals and universities, often aided by the public sector, has been heralded by academic researchers and policy-makers as a public good, especially in deindustrializing cities. Expansion of such service institutions is claimed to boost the local economy and stabilize depopulating neighborhoods in the urban core. As hospitals affiliated with universities expand, they trigger broader consolidation across the entire health care sector, intensifying the acquisition of independent hospitals. Examining hospitals within their health care systems in Rochester, New York, we introduce two new concepts, “medical gentrification” and “medical transposition,” to capture the changes underway. As a mid-sized city, in Rochester it is possible to see how organizations intersect across the entire landscape. We argue that in some neighborhoods change is connected to the distinct characteristics of health care system restructuring. We explore differences in resident mobilization to confront health care-related redevelopment of the spaces they occupy and use, and analyze their meaning and significance.

摘要

医院和大学在公共部门的协助下对城市空间的重新开发，已被学术研究人员和政策制定者视为公共物品，特别是在去工业化城市中。据称，扩大这类服务机构可以促进当地经济发展，并稳定城市核心地区人口稀少的地区。随着大学附属医院的扩张，它们触发了整个医疗保健部门的更广泛整合，从而加剧了对独立医院的收购。在检查位于纽约州罗切斯特市医疗系统内的医院时，我们引入了两个新概念：“医学高档化”和“医学转位”，以捕捉正在发生的变化。作为罗切斯特的中型城市，可以看到组织如何在整个景观中相交。我们认为，在某些社区中，变化与医疗保健系统重组的独特特征有关。我们探讨了居民动员方面的差异，以应对与他们居住和使用的空间有关的医疗保健相关重建问题，并分析其含义和意义。