Escalated hospital closures in urban communities are raising concern about whether minorities can receive quality health care, especially trauma treatment, when emergency care facilities are miles from their neighborhoods.

Public officials in Cleveland and neighboring East Cleveland are waging a legal dispute with the renowned Cleveland Clinic, which sought to close a local trauma center. Other municipalities nationwide are taking steps to prevent hospitals from closing or moving to wealthier suburbs.

Public health advocates have long decried the steady closures of so-called safety-net hospitals in communities populated by low- or moderate-income people of color. For at least three decades, these advocates have joined community activists, social scientists and beleaguered city and county officials in warning that this trend threatens health outcomes in communities that need hospitals most.

“This problem has been escalating dramatically and is a consequence of a system where health care is a market commodity that is bought and sold by those who can afford it,” said Brian D. Smedley, vice president and director of the Health Policy Institute at the Joint Center for Political and Economic Studies in Washington, D.C.

The struggle of lower-income people, he continued, “will escalate as the health care crisis worsens and a population that has higher health care needs and problems gets worse and worse and ends up in emergency rooms to get treatment at much greater costs that we all will have to bear.”

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