Nov. 13 2018

How One Hospital Responded to Urban Unrest

An article in the American Journal of Public Health by historian Merlin Chowkwanyun at Columbia University’s Mailman School of Public Health examines the response by the Cleveland Clinic to the 1966 riot in the predominantly low-income, African-American East Side neighborhood. Chowkwanyun, PhD, assistant professor of Sociomedical Sciences, argues that the riot forced the Clinic to reevaluate its community relations. Whether its response went far enough is an open question.

Into the early 1960s, the Cleveland Clinic rapidly expanded, building on formerly residential areas that had been cleared through federal urban renewal efforts and framed as a health measure. In the aftermath of the riots, community advocates characterized those efforts in a very different light, criticizing the medical center for “hospital-based slum clearance” that ignored the needs of local residents in favor of a more affluent clientele. Taken by surprise, the Clinic was initially concerned with security measures, including plans to protect its facilities using fire hoses and firearms. Eventually, under pressure from advocates, medical center leadership proposed opening a community clinic. However, due to changes in city leadership, it took nearly a decade to open.

While the community clinic improved access to healthcare on the East Side of Cleveland, Chowkwanyun argues that the Cleveland Clinic’s efforts “were a minor remedy for a city and neighborhood riven with entrenched inequality.” As pressure from community advocates waned, the medical center’s attention once again turned to city revitalization and institutional expansion, though never in as brazen a manner as happened in previous decades.

Urban medical centers across the country saw similar trajectories in relations with their communities, Chowkwanyun writes. “The Cleveland experience is part of a larger—and still ongoing—debate on social obligations of medical centers.”