Clinically promoting sprawl and poor health

Source: hospitalcenters.com

The last few times I have visited my home state of Indiana, I have noticed a number of new hospitals recently opened or being constructed along the I-69 corridor. Even when I was out West in California and Oregon, I didn’t notice the number of new suburban or exurban hospitals I have seen popping up in Indiana.

Along I-69 north of I-465 in Indianapolis, it seems like new hospitals are rising from the corn fields at each interchange. IU Saxony Hospital, Community Hospital, and St. Vincent Hospital have all recently migrated to this corridor between Indianapolis and Anderson. This map does not even include the pre-existing Riverview Hospital in Noblesville (just above the top of the map) or the two existing hospitals in Anderson (Community and Saint John’s) located about 10 miles to the east.

Source: ibj.com

Granted this area is growing very rapidly, but are all these satellite hospitals really necessary? Particularly in one narrow corridor? Indianapolis is not alone in this migration in Indiana. Below are multiple examples from Fort Wayne.

View of Parkview when it was under construction (I-69 in the foreground)
Source: fwdailynews.com

In Fort Wayne, both Lutheran-DuPont Hospital and Parkview Regional Medical Center have opened new facilities at the northern fringes of town at I-69 and DuPont Road (see photos above and below). Parkview’s campus is so large (just opened in March 2012) that a new interchange is being constructed to the north of the complex to accommodate the increased area traffic. On the southwest side of Fort Wayne, Lutheran Hospital completed a large multi-structure campus several years ago at the corner of the I-69 and U.S. 24 interchange (see campus map below).

Lutheran-DuPont Hospital campus
Source: fortwaynemoves.wordpress.com

Lutheran Hospital campus map
Source: lhnbariatrics.com

Each of these new campus facilities have been followed quickly by a myriad of hotels, restaurants, apartments, medical office buildings, and other ancillary facilities, creating economic development boomlets at the interchanges. Granted, being situated adjacent to freeway interchanges can provide speedy emergency access for these wealthy suburban areas (until gridlock develops there too) and the so-called “regional” reach of a hospital, but is promoting sprawl really beneficial to a community’s health? I doubt it.

And what about emergency services for inner city residents and the poor – doesn’t a suburban/exurban campus present the same reverse commuting difficulties that suburban employment centers do?

As a comparison, none of the major hospitals here in Greater Lansing have built suburban campuses in Mid-Michigan. Sparrow, McClaren-Lansing, and Sparrow-St. Lawrence are all situated at midtown locations. Personally, I see this as a very positive health and land use planning attribute for Greater Lansing because:

• The midtown locations help maintain the viability of the adjoining inner city neighborhoods.
• Staying put at midtown locations lessons the potential for continued suburban sprawl.
• Midtown locations are easier for the poor and disadvantaged to access by public transit, bicycle, or on foot.
• Far-flung suburban and exurban locations do nothing to promote active transportation options for employees. Try bicycling to a campus off an interstate exit – usually not easy or safe.
• The suburban/exurban locations promote greater use of automobiles thus contributing to greater pollution, more congestion, and poor sedentary lifestyles.
• Remaining at midtown locations helps promote revitalization, redevelopment, social justice, and social equity.
• A midtown location is more accessible regionally from all compass directions.

To me, all of these sound like they are complimentary to the purpose of a hospital – kudos to the Greater Lansing hospitals for remaining loyal to the city and for pursuing good health and land use planning in the community.