Browsing by Subject "Racism in medicine"

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    The Detroit Medical Center: Race and Renewal in the Motor City
    (2019-05) Nickrand, Jessica
    In 1956, the City of Detroit began plans for the Detroit Medical Center [DMC]—the largest urban renewal project in the nation. This hospital campus, motivated by leadership at four inner-city hospitals, sought to use public funding to raze the surrounding “blighted” neighborhood to attract private patients, thus providing a new industry for a city in economic decline. This strategy was ultimately unsuccessful and instead further contributed to both the city’s economic decline and the continued poor health of Detroit’s residents. This dissertation argues that the development of the DMC, which largely used federal funding for its completion, was built for the city planners and officials hoped for rather than for the city that existed. In doing so, planners and officials ignored pleas from activists and demographic trends, pouring money into a project that did not serve the community that utilized this institution. This, in turn, further taxed the city’s municipal hospital, Detroit Receiving, as the city continued to experience economic decline and the population of poor and indigent patients grew. Even as the violence of the Detroit Riots in 1967 highlighted both the extreme unease of Detroit’s black community and the central importance of adequate medical provision for Detroit’s most vulnerable populations, the city was ultimately unable, or unwilling, to prioritize the needs of its residents. This stigma associated with medical provision for Detroit’s indigent population even resulted in the continued failure of the individual hospitals of the DMC to merge into one integrated medical center, which external marketing consultants had deemed essential for the success of the DMC. Ultimately, the development of the DMC contributed to Detroit's economic decline. Rather than investing in its immediate community, DMC planners continued to make choices and spend money in attempts to court suburbanites and private patients. This resulted in continued financial strain on the city when these investments were not recuperated because most of the center’s patients and clientele always remained near the hospitals of the DMC–an area of concentrated poverty. By not investing in its community through the largely publicly-funded DMC, the city of Detroit did not ensure adequate health provision for its neediest residents. This contribution to the creation of a perpetually unhealthy, and poor, populace. A community must be healthy to work, to become educated, to be engaged consumers; the city of Detroit was not interested in making its residents healthier, and this is demonstrated by its actions during the development of the DMC. Because of this, the DMC never fulfilled its potential, and caused the city even further financial stress. In the end, this development is a symbol of what could have been but never was. As a study of the ways in which a struggling city attempted to use medical care as an engine of economic recovery, this dissertation provides a case study for historians interested in health and medicine in American urban cities and encourages planners and contemporary urbanists to consider the consequences of not providing adequate health provision to a city’s most vulnerable residents.