Hospitals, Neighborhoods and COVID-19: A Uniquely Geographic Perspective

Authors: Mark Rosenberg*, Queen's University
Topics: Medical and Health Geography, Geography and Urban Health, Canada
Keywords: health geography, hospitals, COVID-19, neighborhoods
Session Type: Virtual Paper
Day: 4/11/2021
Start / End Time: 9:35 AM / 10:50 AM
Room: Virtual 40
Presentation File: No File Uploaded

In countries like Canada, hospitals were originally located in central locations or in peri-urban park-like locations to isolate or hide the sick from the rest of the population. Post World War Two, several dynamics brought direct or indirect changes to these locations and architectural styles. Although the central city hospitals retained their independent boards of trustees, they effectively became public hospitals dependent on public funding for both their capital projects and operating costs from provincial and territorial governments. In addition, private or third-party payments disappeared as virtually all patients’ costs were covered by provincial or territorial health insurance plans. Hospitals in peri-urban locations, especially in the form of asylums and sanatoria, were slowly closed as the 1970s progressed as medical treatment practices (e.g., tuberculosis treatment) and philosophies (e.g., increasing emphasis on human rights) changed. Beginning in the 1990s, a third wave of locational and organizational change began. The growing costs of health care led provincial and territorial governments to close and/or repurpose central city hospitals and as the 2000s progressed, build new suburban facilities.

Using the city of Kingston, Ontario, Canada, as a case study, these changes will be illustrated. It will be argued that the new geographies of hospitals are particularly ill-suited to provide access to the most vulnerable parts of the population and neighborhoods during the COVID-19 pandemic. A second argument will be made that only through re-thinking the nature of “inertia” in location can the barriers to access be addressed.

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