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Study Finds Hospitals Don’t Always Have an Open Door Policy, Particularly When it Comes to Race

New data has exposed a concerning trend in American healthcare: a stark racial divide in patient populations. Contrary to claims of open access for all, dozens of hospitals exhibit significant racial exclusivity, a report from the independent healthcare think tank Lown Institute has shown.

The study identifies two Midwest hospitals and one in the South as the most segregated in the nation. According to federal patient data, the segregation has resulted in a nine-year gap in life expectancy between white and Black residents in a single county.

St. Louis, Detroit, and New Orleans residents, particularly those of Black ethnicity, find themselves grappling with pronounced racial disparities in their local hospitals. Among these cities, New Orleans emerged as the most affected, boasting the highest percentage of hospitals offering de facto segregated healthcare. Of its 14 hospitals, five exhibit the least inclusivity regarding racially diverse patient populations.

Conversely, individuals living near specific hospitals in Chicago, Newark, or Boston are positioned closer to more inclusive healthcare environments, offering a glimmer of hope for improved equity in medical services.

Founded in 1973 by Nobel Peace Prize winner Dr. Bernard Lown, who developed the defibrillator and cardioverter, the Lown Institute seeks to better the hospital system for all. Its comprehensive report highlights the cities with the highest degrees of racial segregation in their hospitals and provides insights into the institutions leading the way in inclusivity.

“It’s refreshing to see that some hospitals make caring for those most in need their top priority,” Vikas Saini, MD, president of the Lown Institute, said in a news release. “Inclusive hospitals show that it’s possible to serve everyone, even when it may be against their financial interest.”

The Lown Institute lists the following hospitals are the most racially inclusive in America:

  1. Boston Medical Center (Boston, MA)

  2. John H. Stroger Jr. Hospital (Chicago, IL)

  3. UChicago Medicine (Chicago, IL)

  4. Penn Presbyterian Medical Center (Philadelphia, PA)

  5. Metro Nashville General Hospital (Nashville, TN)

  6. South Coast Global Medical Center (Santa Ana, CA)

  7. Charles Madras (Madras, OR)

  8. Grady Memorial Hospital (Atlanta, GA)

  9. Methodist Hospitals (Gary, IN)

  10. Emory University Hospital Midtown (Atlanta, GA)

The Institute also found that many of the most and least racially inclusive hospitals are in the same U.S. cities, reflecting segregated healthcare markets. Of the 11 metro areas identified by the Lown Institute with significant market segregation, New Orleans stands out at the top of the list, with seven of its 14 hospitals (50%) ranking among the most or least inclusive.

The U.S. cities with the most segregated hospital markets are:

  1. New Orleans, LA

  2. Louis, MO

  3. Detroit, MI

  4. Milwaukee, WI

  5. Philadelphia, PA

  6. Kansas City, MO

  7. Chicago, IL

  8. Denver, CO

  9. Phoenix, AZ

  10. Dallas/Fort Worth, TX

  11. Atlanta, GA

The most segregated hospital markets were determined by examining the proportion of hospitals within a metropolitan statistical area receiving either 1 star (lowest score) or 5 stars (highest score) on Lown’s racial inclusivity ranking. All cities included on the list had more than 20% of hospitals at those extremes.

“Hospitals will say their doors are open to everyone and that they don’t turn anyone away, but that can be misleading,” Saini remarked. “If hospitals really want to undo structural racism’s hold on their communities, they can’t be bystanders. They need to act more systematically and with more intention.”


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