The urban ecology of hospital failure: Hospital closures in the city of Chicago, 1970-1991

Hospital closures occurred nationally with increasing frequency between 197 0 and 1990. In particular, large urban areas experienced a dramatic number of closures. Of the 61 general hospitals operating in Chicago in 1970, 22 ( 36%) had closed by 1991. While a growing body of literature has examined th e etiology and determinants of hospital closure over the last two decades, few empirical studies have focused on the neighborhood correlates of closur e, and none have examined specific health outcomes associated with hospital failure. This study uses census and Chicago hospital closure data to compa re and contrast different conceptual explanations of closure in an effort t o identify neighborhood correlates and health outcomes associated with hosp ital failure. The authors find that hospital closures in Chicago diminished an already low hospital bed-to-population untie and may have contributed t o a deterioration of critical health status measures in disadvantaged Afric an American neighborhoods.