The Urban Biomedical District: Health Care and Economic Development in American Cities

To date, little scholarship has directly examined health care as both a distinctive, complex institution and a motive force in the economies of cities. This dissertation focuses on a phenomenon at the intersection between urban development and the transformation of the health care system: concentrations of hospitals, academic medical centers, and other related land uses in close proximity. Variations of this phenomenon -- which I define as the "urban biomedical district" -- have become increasingly prominent features of the urban landscape, focal points for organizational adaptations to a changing regulatory environment, and strategic targets of planning and economic development policy. Empirically, the research begins with the first formal establishment of development districts that combined multiple health care institutions in Chicago and Houston in the 1940s. The comparison then extends toward the contemporary transformation of the biomedical district into a multi-faceted urban economic engine, and ecosystem for innovation, and a model that has been replicated to varying extends across a range of different urban contexts. This process is examined primarily through a third case study of New Orleans, where long-standing aspirations to create a thriving biomedical corridor on the edge of downtown shaped a sequence of landmark decisions over the future of the city's economy and safety-net health care system after Hurricane Katrina.