Medical gentrification and transposition: health care systems as urban redevelopers

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.