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Many leading hospitals and medical centers in the United States are located in large urban centers. This has meant that the post–World War II growth of the U.S. health care sector has been deeply intertwined with wider changes in the political economy of American cities. Through an examination of Boston’s Tufts-New England Medical Center (T-NEMC) and the surrounding Chinatown neighborhood, this article explores the implications of this relationship by assessing the spatial, economic, and community consequences of the growth of a major urban academic medical center. It treats the history of health care and health care policy as a key part of urban history, using the T-NEMC case to tell a larger story about the role of local and federal policy in transforming urban health care institutions.. T-NEMC deployed federal urban renewal and hospital construction programs to finance an ambitious expansion program designed to allow it to compete with Boston’s many prestigious medical centers. T-NEMC faced determined opposition from Chinatown residents who forged political alliances that helped them gain concessions from the medical center, including housing, schools, and health care and community centers—even as their neighborhood was transformed. Ultimately, T-NEMC’s larger strategy proved problematic. It took on excessive debt during the period of its expansion and then, in the 1990s, failed to form critical network alliances with other hospitals. The story of health care redevelopment in Boston thus proves to be deeply enmeshed in the changing political economy—and politics—of health care in the United States. [ABSTRACT FROM AUTHOR]

In January 1974, Philadelphia's Somerset Knitting Mills Company announced plans for a new factory in the Franklin-Callowhill East Urban Renewal Area. The project received assistance from the Philadelphia Model Cities Administration and the Philadelphia Industrial Development Corporation—on the condition that Somerset employ neighborhood residents, mostly African Americans and Puerto Ricans, in its new plant. Confounding processes of deindustrialization and urban disinvestment, Somerset remained in its new building until 1992. This article contextualizes the project (and a related "Garment Center" for the local apparel industry) within the ideological and policy history of urban renewal. It argues that with their focus on countering deindustrialization and establishing community partnerships, the Somerset and Garment Center projects offered models of how urban renewal should have proceeded from its inception. The two projects also demonstrated that the local state can reconfigure supposedly "natural" market forces and counter the purportedly inevitable process of urban economic decline. [ABSTRACT FROM AUTHOR]