Abstract

The real estate assets of healthcare systems represent critical social infrastructure. In the wake of major regulatory transformation in the United States, hospitals are shifting how they’re positioned in communities, establishing themselves as true anchor institutions with a long-term stake in cities, and implementing mandatory community benefit programmes with neighbouring stakeholders.

This research focuses on three institutional case studies to understand the various ways urban non-profit hospitals and local stakeholders work together towards civic goals: Henry Ford Health System in Detroit (MI), Bon Secours Health System in Baltimore (MD), and Stamford Hospital in Stamford (CT). Interviews with hospital administrators and local community members explore different perspectives on their engagement experiences and help map local programme activities, planning timelines, governance authorities, and accountability mechanisms. Stakeholders’ planning documents, media reports, tax records, demographic data, and 17 interviews demonstrate where efforts overlap and highlight significant resource mobilisation across neighbourhoods.

Findings provide insight on three different models of hospital anchor relationships – a neighbourhood redevelopment model, an integrated care delivery model, and a community collaborative model – as well as implementation lessons for professionals working at the evolving intersection of health and urban planning.