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Health Colonialism: Notes

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table of contents
  1. Cover
  2. Half Title Page
  3. Series List
  4. Title Page
  5. Copyright Page
  6. Contents
  7. Introduction
  8. 1. Urban Brownfields and Health Policy
  9. 2. Hospital Growth Machines and Colonizing Brownfields
  10. 3. Global Medical Entrepôts and U.S. Health Care Inequality
  11. Conclusion: Decolonizing Health
  12. Notes
  13. About the Author

Notes

Introduction

  1. U.S. Department of Health and Human Services, “Social Determinants of Health,” accessed November 7, 2022, https://health.gov/healthypeople/priority-areas/social-determinants-health.

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  2. Mishal Khan, Seye Abimbola, Tammam Aloudat, Emanuele Capobianco, Sarah Hawkes, and Afifah Rahman-Shepherd, “Decolonising Global Health in 2021: A Roadmap to Move from Rhetoric to Reform,” BMJ Global Health 6, no. 3 (2021): 1.

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  3. I use “biomedicine” and “medicine” interchangeably in this text, but biomedicalization temporally marks the shift in medicine toward privatization and corporatization, increasingly technoscientific practices, and intensification of health/biomedical knowledges across social domains. See Adele E. Clarke, Laura Mamo, Jennifer Ruth Fosket, Jennifer R. Fishman, and Janet K. Shim, eds., Biomedicalization: Technoscience, Health, and Illness in the U.S. (Durham, N.C.: Duke University Press, 2010).

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1. Urban Brownfields and Health Policy

  1. Sarah de Leeuw, Sean Maurice, Travis Holyk, Margo Greenwood, and Warner Adam, “With Reserves: Colonial Geographies and First Nations Health,” Annals of the Association of American Geographers 102, no. 5 (2012): 908.

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  2. Neil Nunn, “Toxic Encounters, Settler Logics of Elimination, and the Future of a Continent,” Antipode 50, no. 5 (2018): 1333.

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  3. I follow Alyosha Goldstein’s insight that in “the United States, colonialism and the legacies of racial slavery remain actively constitutive for capitalist accumulation. Colonialism in this context is not or not only a process of expansion and incorporation, but is a primary social, economic, and political feature of the United States itself; a retrospective and prospective feature that works in tandem with U.S. imperial exploits globally.” Alyosha Goldstein, “On the Reproduction of Race, Capitalism, and Settler Colonialism,” in Race and Capitalism: Global Territories, Transnational Histories (Los Angeles: Institute on Inequality and Democracy, University of California, Los Angeles, 2018), 45.

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  4. Nunn, “Toxic Encounters,” 1336, 1342.

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  5. Wendell E. Pritchett, “The ‘Public Menace’ of Blight: Urban Renewal and the Private Uses of Eminent Domain,” Yale Law and Policy Review 21, no. 1 (2003): 26.

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  6. Sara Safranksy, “Rethinking Land Struggle in the Postindustrial City,” Antipode 49, no. 4 (2017): 1090.

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  7. This chapter draws on Shiloh Krupar, “Brownfields as Waste/Race Governance: U.S. Contaminated Property Redevelopment and Racial Capitalism,” in The Routledge Handbook of Waste Studies, edited by Zsuzsa Gille and Josh Lepawsky (London: Routledge, 2022), 238–53.

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  8. Matthew Dull and Kris Wernstedt, “Land Recycling, Community Revitalization, and Distributive Politics: An Analysis of EPA Brownfields Program Support,” Policy Studies Journal 38, no. 1 (2010): 120.

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  9. Michael R. Greenberg and Justin Hollander, “The Environmental Protection Agency’s Brownfields Pilot Program,” American Journal of Public Health 96, no. 2 (2006): 277–81.

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  10. Kris Wernstedt and Robert Hersh, “‘Through a Lens Darkly’—Superfund Spectacles on Public Participation at Brownfield Sites,” Risk 9, no. 2 (1998): 157; Dull and Wernstedt, “Land Recycling,” 136.

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  11. Dull and Wernstedt, “Land Recycling,” 120.

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  12. Dull and Wernstedt, “Land Recycling,” 119.

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  13. Alan Berger, Drosscape: Wasting Land in Urban America (New York: Princeton Architectural Press, 2006), 70.

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  14. Berger, Drosscape, 74.

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  15. Jason W. Moore, “Ecology, Capital, and the Nature of Our Times: Accumulation and Crisis in the Capitalist World-Ecology,” Journal of World-Systems Research 17, no. 1 (2011): 139.

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  16. Lindsey Dillon, “Race, Waste, and Space: Brownfield Redevelopment and Environmental Justice at the Hunters Point Shipyard,” Antipode 46, no. 5 (2014): 1209.

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  17. Dillon, “Race, Waste, and Space,” 1209.

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  18. Jenna Loyd, Health Rights Are Civil Rights: Peace and Justice Activism in Los Angeles, 1963–1978 (Minneapolis: University of Minnesota Press, 2014), 28.

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  19. Loyd, Health Rights, 28.

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  20. Loyd, Health Rights, 28; David M. P. Freund, Colored Property: State Policy and White Racial Politics in Suburban America (Chicago: University of Chicago Press, 2007), 77–78, 118; Cheryl Harris, “Whiteness as Property,” Harvard Law Review 106, no. 8 (1993): 1707–91.

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  21. Max Liboiron, Pollution Is Colonialism (Durham, N.C.: Duke University Press, 2021).

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  22. Leigh Johnson, “The Fearful Symmetry of Arctic Climate Change: Accumulation by Degradation,” Environment and Planning D: Society and Space 28, no. 5 (2010): 828–47.

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  23. Max Liboiron, “Waste Colonialism,” Discard Studies, November 1, 2018, https://discardstudies.com/2018/11/01/waste-colonialism/.

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  24. Georgette C. Poindexter, “Separate and Unequal: A Comment on the Urban Development Aspect of Brownfields Programs,” Fordham Urban Law Journal 24, no. 1 (1996): 5.

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  25. Wernstedt and Hersh, “Through a Lens Darkly,” 160.

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  26. Wernstedt and Hersh, “Through a Lens Darkly,” 172.

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  27. La paperson, A Third University Is Possible (Minneapolis: University of Minnesota Press, 2017), 14–15; Liboiron, Pollution Is Colonialism, 65.

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  28. Dull and Wernstedt, “Land Recycling,” 119.

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  29. Dull and Wernstedt, “Land Recycling,” 134.

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  30. Nunn, “Toxic Encounters,” 1337.

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  31. Loyd, Health Rights, 30.

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  32. Colin M. McNiece, “A Public Use for the Dirty Side of Economic Development: Finding Common Ground between Kelo and Hathcock for Collateral Takings in Brownfield Redevelopment,” Roger Williams University Law Review 12, no. 1 (2006): 230–36.

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  33. Pritchett, “Public Menace,” 4.

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  34. Pritchett, “Public Menace,” 6, 18.

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  35. Rachel Weber, “Extracting Value from the City: Neoliberalism and Urban Redevelopment,” Antipode 34, no. 3 (2002): 527.

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  36. Berger, Drosscape, 75.

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  37. Pritchett, “Public Menace,” 26.

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  38. Pritchett, “Public Menace,” 21, quoting sociologist Scott Greer’s 1965 assessment of the urban renewal program.

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  39. McNiece, “Public Use,” 230–36.

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  40. Berger, Drosscape, 75.

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  41. Rick DelVecchio, “Urban Renewal Atop Sacred Past/Ohlone Protest Emeryville Project,” SFGate, November 20, 2002, https://www.sfgate.com/bayarea/article/Urban-renewal-atop-sacred-past-Ohlone-protest-2752176.php.

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  42. Rob Arias, “2005 ‘Shellmound’ Documentary Exposes the Truth Behind, and Under, Bay Street Development,” E’ville Eye, January 15, 2014, https://evilleeye.com/history/2005-shellmound-documentary-exposes-the-truth-behind-and-under-bay-street-developement/.

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  43. Seven hundred bodies were previously taken from the site to the University of California, Berkeley. Allison Griner, “‘On My Ancestors’ Remains’: The Fight for Sacred Lands,” Aljazeera, December 16, 2019, https://www.aljazeera.com/features/2019/12/16/on-my-ancestors-remains-the-fight-for-sacred-lands; Sara Zaske, “Emeryville Officials Will Honor Ohlone Site before Destroying It,” East Bay Express, May 18, 2001, https://www.eastbayexpress.com/oakland/emeryville-officials-will-honor-ohlone-site-before-destroying-it/Content?oid=1065448. Urban Indigenous women–led Sogorea Te’ Land Trust (https://sogoreate-landtrust.org/) reclaims the shell mounds and unceded Lisjan territory of Huchiun (known as Oakland, Berkeley, Alameda, Piedmont, Emeryville, and Albany, California).

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  44. Paperson, Third University, 4.

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  45. I use Orlando Patterson’s framework of social death to emphasize land seizures that underpin property in the United States and the colonial fantasy of land as unmarked rather than a politicized/violent set of relations between property owners and others. Orlando Patterson, Slavery and Social Death: A Comparative Study (Cambridge, Mass.: Harvard University Press, 1982).

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  46. Max Liboiron, Manuel Tironi, and Nerea Calvillo, “Toxic Politics: Acting in a Permanently Polluted World,” Social Studies of Science 48, no. 3 (2018): 331–49.

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  47. Danielle M. Purifoy and Louise Seamster, “Creative Extraction: Black Towns in White Space,” Environment and Planning D: Society and Space 39, no. 1 (2020): 51; Cedric J. Robinson, Black Marxism: The Making of the Black Radical Tradition (Chapel Hill, NC: University of North Carolina Press, 1983). Here I use “colonial” and not “settler-colonial” to refer to the property enclosure process pertaining to multiple forms of colonialism, not only the specific settler-colonial project that is the United States.

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  48. Brenna Bhandar, Colonial Lives of Property: Law, Land, and Racial Regimes of Ownership (Durham, N.C.: Duke University Press, 2018).

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  49. Liboiron, “Waste Colonialism,” discussing Jessie Goldstein, “Terra Economica: Waste and the Production of Enclosed Nature,” Antipode 45, no. 2 (2013): 357–75.

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  50. Goldstein, “Terra Economica,” 371, 368.

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  51. Sharon Stein, “A Colonial History of the Higher Education Present: Rethinking Land-grant Institutions Through Processes of Accumulation and Relations of Conquest,” Critical Studies in Education 61, no. 2 (2020): 213.

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  52. Purifoy and Seamster, “Creative Extraction,” 56, 52.

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  53. Karina Czyzewski, “Colonialism as a Broader Social Determinant of Health,” International Indigenous Policy Journal 2, no. 1 (2011): 2, drawing on Sherene Razack, “Violence against First Nations: On Ongoing Colonialism,” paper presented at University of British Columbia, Okanagan, October 22, 2008.

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  54. Land reciprocity and reparations, however, remain essential to decolonizing brownfields and settler environmentalism.

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  55. U.S. EPA, “Incorporating Health Monitoring Activities into an EPA Brownfields Grant,” EPA 560-F-18-187 (2018), https://www.epa.gov/sites/production/files/2015-09/documents/finalphandbffact.pdf.

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  56. U.S. EPA, “Brownfields to Healthfields,” accessed November 7, 2022, http://www.arcgis.com/apps/MapSeries/index.html?appid=76cd82c0c167480799ab9e6f6f144e36.

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  57. U.S. EPA, “From Brownfields to Healthfields,” 2019, https://epa.maps.arcgis.com/apps/Cascade/index.html?appid=fa7b68b3075a4340970b1e5c00c76cf4.

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  58. Ronda Kaysen, “Health Centers Find Opportunity in Brownfields,” New York Times, December 11, 2012, http://www.nytimes.com/2012/12/12/realestate/commercial/health-centers-find-opportunity-in-brownfields.html?_r=1&.

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  59. U.S. EPA, “Improving Public Health in Brownfields Communities,” EPA-560-F-07-253, January 2008, https://archive.epa.gov/socal/web/pdf/public_health08.pdf.

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  60. U.S. EPA, “Improving Public Health.”

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  61. Miles Ballogg in partnership with U.S. EPA and the City of Tampa, Florida, “‘Healthfields’: Improving Access to Healthcare through Brownfields Redevelopment,” paper presented at EPA Brownfields 2013 conference, May 16, 2013, http://www.georgiaenet.com/wp-content/uploads/2015/01/23MilesBallogg.pdf (access via the 2013 Georgia Environmental Conference).

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  62. U.S. EPA, “Improving Public Health.” In 2019, the nonprofit occupant community health centers of Pinellas spent $3.95 million to move to a new headquarters and renovate Johnnie Ruth Clarke.

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  63. Ballogg, “Healthfields.”

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  64. Paperson argues that “the ghetto serves as an interior frontier to be laid waste in order to renew.” La paperson, “A Ghetto Land Pedagogy: An Antidote for Settler Environmentalism,” Environmental Education Research 20, no. 1 (2014): 116. My term “Jim Crow tax shelters” refers to the tax-exempt, nonprofit shadow of the state—humanitarian philanthrocapitalist organizations and services—that maintain a financial color line.

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  65. Liboiron, Pollution Is Colonialism, 22.

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  66. Richard Briffault, “The Most Popular Tool: Tax Increment Financing and the Political Economy of Local Government,” University of Chicago Law Review 77, no. 1 (2010): 72.

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2. Hospital Growth Machines and Colonizing Brownfields

  1. Vernellia Randall, “Institutional Racism in U.S. Health Care,” Institute on Race, Health Care and the Law, University of Dayton School of Law, 1993, 2008, https://academic.udayton.edu/health/07humanrights/racial01c.htm.

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  2. Steven J. Diner, “The Land-Grant Analogy and the American Urban University: An Historical Analysis,” Metropolitan Universities 23, no. 3 (2012): 61–77; Robert Lee and Tristan Ahtone, “Land-Grab Universities,” High Country News, March 30, 2020, https://www.hcn.org/issues/52.4/indigenous-affairs-education-land-grab-universities; Sharon Stein, “Confronting the Racial-Colonial Foundations of U.S. Higher Education,” Journal for the Study of Postsecondary and Tertiary Education 3 (2018): 77–98.

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  3. Guian A. McKee, “Health-Care Policy as Urban Policy: Hospitals and Community Development in the Postindustrial City,” Working Paper 2010-10, Center for Community Development Investments, December 2010, https://www.frbsf.org/community-development/publications/working-papers/2010/december/health-care-policy-urban/, 5.

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  4. Guian A. McKee, “The Hospital City in an Ethnic Enclave: Tufts–New England Medical Center, Boston’s Chinatown, and the Urban Political Economy of Health Care,” Journal of Urban History 42, no. 2 (2016): 260.

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  5. Davarian L. Baldwin, In the Shadow of the Ivory Tower: How Universities Are Plundering Our Cities (New York: Bold Type, 2021), 7–12.

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  6. McKee, “Health-Care Policy,” 5.

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  7. This act is popularly known as the U.S. urban renewal program.

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  8. McKee, “Hospital City,” 262.

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  9. Malini Ranganathan, “Thinking with Flint: Racial Liberalism and the Roots of an American Water Tragedy,” Capitalism Nature Socialism 27 (2016), https://doi.org/10.1080/10455752.2016.1206583, 6.

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  10. McKee, “Health-Care Policy,” 7.

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  11. Bobby M. Wilson, “Racial Segregation Trends in Birmingham, Alabama,” Southeastern Geographer 25, no. 1 (1985): 32–33.

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  12. McKee, “Health-Care Policy,” 5–6.

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  13. McKee, “Hospital City,” 263.

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  14. Briffault, “Most Popular Tool,” 86.

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  15. Weber, “Extracting Value,” 520, 524.

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  16. Rachel Weber, “Selling City Futures: The Financialization of Urban Redevelopment Policy,” Economic Geography 86, no. 3 (2010): 258.

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  17. Weber, “Selling City Futures,” 258.

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  18. Briffault, “Most Popular Tool,” 71–72.

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  19. Derek S. Hyra, “Conceptualizing the New Urban Renewal: Comparing the Past to the Present,” Urban Affairs Review 48, no. 4 (2012): 505.

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  20. DURA Renew Denver, “St. Anthony Block 3,” accessed November 7, 2022, https://renewdenver.org/projects/st-anthony-block-3/; Ed Sealover, “EFG Brownfield Buying Centura’s Old St. Anthony Hospital Site,” Denver Business Journal, November 11, 2011, https://www.bizjournals.com/denver/news/2011/11/10/denver-buyer-found-for-old-st-as.html.

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  21. U.S. Department of Defense, “Fitzsimons Army Medical Center, Colorado Redevelopment Profile,” October 2020, https://oldcc.gov/project/fitzsimons-army-medical-center-colorado-redevelopment-profile.

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  22. Matrix, “Fitzsimons (Sand Creek) Parkway and Landfill Remediation,” accessed November 7, 2022, https://www.matrixdesigngroup.com/fitzsimons-sand-creek-parkway-landfill-remediation; “Notice of Record of Decision for the Disposal and Reuse of the Former Fitzsimons Army Medical Center,” 63 F.R. 16770, Federal Register 63, no. 65 (1998), https://www.govinfo.gov/app/details/FR-1998-04-06/98-8854.

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  23. Robert Mark Silverman, Jade Lewis, and Kelly L. Patterson, “William Worthy’s Concept of ‘Institutional Rape’ Revisited: Anchor Institutions and Residential Displacement in Buffalo, N.Y.,” Humanity and Society 38, no. 2 (2014): 163.

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  24. Henry Louis Taylor Jr. and Gavin Luter, “Anchor Institutions: An Interpretive Review Essay,” Anchor Institution Task Force, 2013, https://community-wealth.org/content/anchor-institutions-interpretive-review-essay, 8.

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  25. McKee, “Health-Care Policy,” 3.

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  26. McKee, “Health-Care Policy,” 3; Marla Nelson, “Are Hospitals an Export Industry? Empirical Evidence from Five Lagging Regions,” Economic Development Quarterly 23, no. 3 (2009): 248.

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  27. Howard K. Koh, Amy Bantham, Alan C. Geller, et al., “Anchor Institutions: Best Practices to Address Social Needs and Social Determinants of Health,” American Journal of Public Health 110, no. 3 (2020): 311.

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  28. Carolyn Adams, “The Meds and Eds in Urban Economic Development,” Journal of Urban Affairs 25, no. 5 (2003): 578.

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  29. Adams, “Meds and Eds,” 578.

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  30. Taylor and Luter, “Anchor Institutions,” 13.

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  31. Diane Sicotte, From Workshop to Waste Magnet: Environmental Inequality in the Philadelphia Region (Newark, N.J.: Rutgers University Press, 2016).

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  32. U.S. EPA, “Camden, New Jersey Uses Green Infrastructure to Manage Stormwater,” accessed November 7, 2022, https://www.epa.gov/arc-x/camden-new-jersey-uses-green-infrastructure-manage-stormwater.

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  33. Nadine Ehlers and Shiloh Krupar, Deadly Biocultures: The Ethics of Life-making (Minneapolis: University of Minnesota Press), 46–68.

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  34. New Jersey Department of Health, “Camden County Public Health Profile Report: Asthma Hospitalizations and Emergency Department Visits, 2020,” data updated February 10, 2022, https://www-doh.state.nj.us/doh-shad/community/highlight/profile/NJASTHMAHOSP.countyAAR/GeoCnty/4.html.

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  35. Nancy Solomon and Jeff Pillets, “How Companies and Allies of One Powerful Democrat Got $1.1 Billion in Tax Breaks,” ProPublica, May 1, 2019, https://www.propublica.org/article/george-norcross-democratic-donor-tax-breaks.

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  36. Dan Diamond, “How the Cleveland Clinic Grows Healthier While Its Neighbors Stay Sick,” Politico, July 17, 2017, https://www.politico.com/interactives/2017/obamacare-cleveland-clinic-non-profit-hospital-taxes/.

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  37. Diamond, “How the Cleveland Clinic.”

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  38. Steven Litt, “Opportunity Corridor Is Back on Track for 2021 Completion after Delay Caused by Taxpayer Lawsuit,” Cleveland.com, February 14, 2018, https://www.cleveland.com/architecture/2018/02/opportunity_corridor_on_track.html.

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  39. Cleveland Clinic does support the nearby Langston Hughes Community Health and Education Center.

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  40. More than $200 million in state money will support the new building and job creation tax credits, buoying the partnership between the Cleveland Clinic, University Hospitals, MetroHealth, Case Western Reserve University, and Cleveland State University.

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  41. Charles Belfoure, “$1 Billion in Projects for Johns Hopkins in Baltimore,” New York Times, February 6, 2000, https://www.nytimes.com/2000/02/06/realestate/1-billion-in-projects-for-johns-hopkins-in-baltimore.html.

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  42. Ed Gunts, “Johns Hopkins Health System Unveils Plans for $400 Million, 12-Story Research Tower,” Baltimore Fishbowl, November 7, 2019, https://baltimorefishbowl.com/stories/johns-hopkins-health-system-unveils-plans-for-400-million-12-story-research-tower/.

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  43. Jason Richardson, Bruce Mitchell, and Juan Franco of National Community Reinvestment Coalition, “Shifting Neighborhoods: Gentrification and Cultural Displacement in American Cities,” March 19, 2019, https://ncrc.org/gentrification/; Lawrence T. Brown, The Black Butterfly: The Harmful Politics of Race and Space in America (Baltimore, Md.: Johns Hopkins University Press, 2021).

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  44. Steve Hendrix, “Johns Hopkins Hospital Inspires Mistrust and Fear in Parts of East Baltimore,” Washington Post, February 2, 2017, https://www.washingtonpost.com/local/johns-hopkins-hospital-inspires-mistrust-and-fear-in-parts-of-east-baltimore/2017/01/25/a4f402c2-bbf3-11e6-91ee-1adddfe36cbe_story.html; Siddhartha Mitter, “Gentrify or Die? Inside a University’s Controversial Plan for Baltimore,” Guardian, April 18, 2018, https://www.theguardian.com/cities/2018/apr/18/gentrify-or-die-inside-a-universitys-controversial-plan-for-baltimore.

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  45. Mitter, “Gentrify or Die?,” drawing on Dax-Devlon Ross, “The Great East Baltimore Raze-and-Rebuild,” Next City, July 29, 2013, https://nextcity.org/features/the-great-east-baltimore-raze-and-rebuild; Baltimore Department of Planning, “Description of Housing Market Typology Map,” accessed November 7, 2022, https://planning.baltimorecity.gov/housing-market-typology/descriptions-housing-market-typology-map; Sara Safransky, “Rethinking Land Struggle in the Postindustrial City,” Antipode 49, no. 4 (2017): 1079–100.

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  46. Lillian Reed and Tim Prudente, “Johns Hopkins University to Move Forward with Private Police Force,” Baltimore Sun, July 27, 2021, https://www.baltimoresun.com/education/bs-md-hopkins-public-safety-20210727-20210727-djzghhbaebczpi52yaudzfhs5q-story.html. JHU students, faculty, and community residents engaged in a month-long sit-in at the university’s main administration that led to numerous arrests.

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  47. David Armstrong, “The Startling Reach and Disparate Impact of Cleveland Clinic’s Private Police Force,” ProPublica, September 28, 2020, https://www.propublica.org/article/what-trump-and-biden-should-debate-at-the-cleveland-clinic-why-the-hospitals-private-police-mostly-arrest-black-people.

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  48. Nic John Ramos, “Solving Our Urban Crisis Involves Addressing Hospitals in Addition to Policing,” Washington Post, June 1, 2020, https://www.washingtonpost.com/outlook/2020/06/01/solving-our-urban-crisis-involves-addressing-hospitals-addition-policing/.

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  49. Ramos, “Solving Our Urban Crisis.”

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  50. Christopher Ingraham, “14 Baltimore Neighborhoods Have Lower Life Expectancies than North Korea,” Washington Post, April 30, 2015, https://www.washingtonpost.com/news/wonk/wp/2015/04/30/baltimores-poorest-residents-die-20-years-earlier-than-its-richest/.

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  51. Harriet A. Washington, Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (New York: Anchor, 2008).

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  52. Nick Anderson, Lauren Lumpkin, and Susan Svrluga, “Johns Hopkins, Benefactor of Namesake Hospital and University, Was an Enslaver,” Washington Post, December 9, 2020, https://www.washingtonpost.com/local/education/johns-hopkins-slavery/2020/12/09/cf0744f6-3a30-11eb-98c4-25dc9f4987e8_story.html.

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  53. These political and financial mechanisms are much older than the neoliberal era. See Albert M. Spragia, Debt Wish: Entrepreneurial Cities, U.S. Federalism, and Economic Development (Pittsburgh, Pa.: University of Pittsburgh Press, 1996).

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  54. Carolyn Adams, “Urban Governance and the Control of Infrastructure,” Public Works Management and Policy 11, no. 3 (2007): 164–65.

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  55. Destination Medical Center, “Development Plan, Vol. 1—Executive Summary and Phase I Strategies,” April 23, 2015, https://dmc.mn/wp-content/plugins/pdf-viewer-for-wordpress/web/viewer.php?file=/wp-content/uploads/2018/07/Executive-Summary.pdf.

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  56. Weber, “Extracting Value,” 531; Adams, “Urban Governance,” 165.

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  57. Weber, “Extracting Value,” 537.

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  58. Clyde Woods, “Les Misérables of New Orleans: Trap Economics and the Asset Stripping Blues, Part 1,” American Quarterly 61, no. 3 (2009): 769–96.

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  59. Silverman, Lewis, and Patterson, “William Worthy’s Concept,” 163–64.

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  60. Weber, “Selling City Futures”; Adams, “Urban Governance,” 171.

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  61. John Carreyrou and Barbara Martinez, “Nonprofit Hospitals, Once for the Poor, Strike It Rich,” Wall Street Journal, April 4, 2008, https://www.wsj.com/articles/SB120726201815287955. The IRS adopted the community benefit standard in 1969.

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  62. Andrew T. Simpson, “‘We Will Gladly Join You in Partnership in Harrisburg or We Will See You in Court’: The Growth of Large Not-for-Profits and Consequences of the ‘Eds and Meds’ Renaissance in the New Pittsburgh,” Journal of Urban History 42, no. 2 (2016): 308.

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  63. Carreyrou and Martinez, “Nonprofit Hospitals.”

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  64. Michael A. Pagano, “Financing Infrastructure in the 21st Century City,” Public Works Management and Policy 13, no. 1 (2008): 29–30. PILOTs started as early as the 1960s.

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  65. U.S. Internal Revenue Service, “Requirements for 501(c)(3) Hospitals Under the Affordable Care Act—Section 501(r),” last reviewed July 15, 2022, https://www.irs.gov/charities-non-profits/charitable-organizations/requirements-for-501c3-hospitals-under-the-affordable-care-act-section-501r.

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  66. Marla Nelson and Laura Wolf-Powers, “Chains and Ladders: Exploring the Opportunities for Workforce Development and Poverty Reduction in the Hospital Sector,” Economic Development Quarterly 24, no. 1 (2010): 42.

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  67. Silverman, Lewis, and Patterson, “William Worthy’s Concept,” 161.

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  68. Timothy J. Bartik and George Erickcek, “The Local Economic Impact of ‘Eds and Meds’: How Policies to Expand Universities and Hospitals Affect Metropolitan Economies,” Brookings, December 10, 2008, https://www.brookings.edu/research/the-local-economic-impact-of-eds-meds-how-policies-to-expand-universities-and-hospitals-affect-metropolitan-economies/, 14.

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  69. Baldwin, In the Shadow, 48.

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  70. Silverman, Lewis, and Patterson, “William Worthy’s Concept,” 163; Nelson, “Are Hospitals an Export Industry?”

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  71. Koh et al., “Anchor Institutions,” 313. The antagonistic relationship between East Cleveland neighborhoods and the development citadel of University Circle spans decades. See J. Mark Souther, “Acropolis of the Middle-West: Decay, Renewal, and Boosterism in Cleveland’s University Circle,” Journal of Planning History 10, no. 1 (2011): 30–58.

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  72. Randall R. Bovbjerg and Jill A. Marsteller, “Health Care Market Competition in Six States: Implications for the Poor,” Occasional Paper 17, Urban Institute, November 1998, https://www.urban.org/sites/default/files/publication/66621/307916-Health-Care-Market-Competition-in-Six-States.PDF, 2.

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  73. Carreyrou and Martinez, “Nonprofit Hospitals,” drawing on a Wall Street Journal analysis of data from the American Hospital Directory.

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  74. Carreyrou and Martinez, “Nonprofit Hospitals.”

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3. Global Medical Entrepôts and U.S. Health Care Inequality

  1. McKee, “Health-Care Policy,” 3.

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  2. Matthew J. Eckelman and Jodi Sherman, “Environmental Impacts of the U.S. Health Care System and Effects on Public Health,” PLoS One 11, no. 6 (2016): 2.

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  3. Howard Waitzkin, Medicine and Public Health at the End of Empire (London: Routledge, 2016), 125.

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  4. Waitzkin, Medicine and Public Health, 2–4.

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  5. Simpson, “We Will Gladly Join You,” 307. Academic medical centers are uniquely situated in U.S. global health at the intersection of research, clinical care, medical education, global partnerships, and policy.

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  6. Figures are quoted from Simpson, “We Will Gladly Join You,” 307, who draws on Kenneth M. Ludmerer, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care (New York: Oxford University Press, 1999), 141–42.

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  7. Simpson, “We Will Gladly Join You,” 307.

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  8. Simpson, “We Will Gladly Join You,” 308.

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  9. Simpson, “We Will Gladly Join You,” 316–17. See also Andrew T. Simpson, The Medical Metropolis: Health Care and Economic Transformation in Pittsburgh and Houston (Philadelphia: University of Pennsylvania Press, 2019).

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  10. Ramos, “Solving Our Urban Crisis.”

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  11. This is an encapsulation of several important points of Ramos’s argument in “Solving Our Urban Crisis.”

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  12. Devon M. Herrick, “Medical Tourism: Global Competition in Health Care,” No. 304, National Center for Policy Analysis, November 1, 2007, http://www.ncpathinktank.org/pub/st304, 11.

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  13. Bovbjerg and Marsteller, “Health Care Market Competition,” 1.

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  14. Robert A. Berenson, Thomas Bodenheimer, and Hoangmai H. Pham, “Specialty-Service Lines: Salvos in the New Medical Arms Race,” Health Affairs 25 (2006): w337.

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  15. Waitzkin, Medicine and Public Health, 103.

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  16. Adams, “Meds and Eds,” 578, 574.

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  17. Adams, “Meds and Eds,” 574.

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  18. Waitzkin, Medicine and Public Health, 103.

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  19. Howard Waitzkin and Rebecca Jasso-Aguilar, “Empire, Health, and Health Care: Perspectives at the End of Empire as We Have Known It,” Annual Review of Sociology 41, no. 1 (2015): 276.

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  20. James C. Robinson and Howard S. Luft, “Competition and the Cost of Hospital Care, 1972 to 1982,” Journal of the American Medical Association 257, no. 23 (1987): 3241–45; Kelly J. Devers, Linda R. Brewster, and Lawrence P. Casalino, “Changes in Hospital Competitive Strategy: A New Medical Arms Race?” Health Services Research 38 (2003): 450.

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  21. Sidney W. Wolfe, “The Destruction of Medicine by Market Forces: Teaching Acquiescence or Resistance and Change?,” Health Letter 18, no. 2 (2002): 1–3; Martin Donohoe, “Luxury Primary Care, Academic Medical Centers, and the Erosion of Science and Professional Ethics,” Journal of General Internal Medicine 19, no. 1 (2004): 92.

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  22. Jeannie Samuel, review of Medicine and Public Health at the End of Empire, by Howard Waitzkin, Journal of Public Health Policy 33, no. 2 (2012): 274.

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  23. Berenson, Bodenheimer, and Pham, “Specialty-Service Lines,” w337–38; Devers, Brewster, and Casalino, “Changes in Hospital Competitive Strategy,” 447.

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  24. Devers, Brewster, and Casalino, “Changes in Hospital Competitive Strategy,” 458.

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  25. Devers, Brewster, and Casalino, “Changes in Hospital Competitive Strategy,” 460.

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  26. Berenson, Bodenheimer, and Pham, “Specialty-Service Lines,” w339.

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  27. Nelson and Wolf-Powers, “Chains and Ladders,” 34.

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  28. Devers, Brewster, and Casalino, “Changes in Hospital Competitive Strategy,” 464.

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  29. Robert A. Berenson, Gloria J. Bazzoli, and Melanie Au, “Do Specialty Hospitals Promote Price Competition?,” Issue Brief 103, Center for Studying Health System Change, January 2006, http://www.hschange.org/CONTENT/816/.

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  30. Berenson, Bodenheimer, and Pham, “Specialty-Service Lines,” w342; Nelson, “Are Hospitals an Export Industry?,” 251.

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  31. Andrea A. Cortinois, Sarah Downey, Tom Closson, and Alejandro R. Jadad, “Hospitals in a Globalized World: A View From Canada,” HealthcarePapers 4, no. 2 (2003): 23.

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  32. Waitzkin, Medicine and Public Health, 40.

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  33. Olivia F. Lee and Tim R. V. Davis, “International Patients: A Lucrative Market for U.S. Hospitals,” Health Marketing Quarterly 22, no. 1 (2004): 51.

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  34. John J. Hutchins, “Bringing International Patients to American Hospitals: The Johns Hopkins Perspective,” Managed Care Quarterly 6, no. 3 (1998): 22, 24.

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  35. Herrick, “Medical Tourism,” 6; Lee and Davis, “International Patients,” 50.

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  36. Vertical Access, “Project Profile: Gonda Building, Mayo Clinic Rochester, MN,” accessed November 7, 2022, https://vertical-access.com/wp-content/uploads/2016/06/gonda_building_mayo_clinic.pdf; Christopher Snowbeck, “Mayo Expansion Would Create Rochester’s Tallest Building,” StarTribune, September 18, 2018, https://www.startribune.com/mayo-plans-190m-building-expansion-in-rochester/493592401/.

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  38. Hoekstra, “Rochester.”

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  39. Ridhika Naidoo, “Frank Gehry: The Cleveland Clinic Lou Ruvo Center for Brain Health,” Design Boom, May 28, 2010, https://www.designboom.com/architecture/frank-gehry-the-cleveland-clinic-lou-ruvo-center-for-brain-health/; Joseph Giovannini, “Cleveland Clinic Lou Ruvo Center for Brain Health,” Architect Magazine, April 7, 2011, https://www.architectmagazine.com/design/buildings/cleveland-clinic-lou-ruvo-center-for-brain-health_o.

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  40. David Basulto, “Cleveland Clinic Lou Ruvo Center for Brain Health/Frank Gehry,” ArchDaily, June 22, 2010, https://www.archdaily.com/65609/center-for-brain-health.

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  42. Lee and Davis, “International Patients,” 47.

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  43. Jacqueline S. Zinn, Roger J. Kashlak, and Edward R. Balotsky, “Selecting International Markets: Lessons from For-Profit Hospitals,” Hospital and Health Services Administration 39, no. 1 (1994): 23.

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  44. Altaf Virani, Adam M. Wellstead, and Michael Howlett, “The North–South Policy Divide in Transnational Healthcare: A Comparative Review of Policy Research on Medical Tourism,” Globalization and Health 16, no. 37 (2020): 12.

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  47. UPMC, “Instituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT),” accessed November 7, 2022, https://www.upmc.com/about/international-services/locations/italy.

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  50. UPMC International, “Locations and Partnerships: Ireland,” accessed November 7, 2022, https://www.upmc.com/about/international-services/locations/ireland.

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  51. UPMC International, “Locations and Partnerships: China,” accessed November 7, 2022, https://www.upmc.com/about/international-services/locations/china.

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  52. UPMC International, “Locations and Partnerships: Kazakhstan,” accessed November 7, 2022, https://www.upmc.com/about/international-services/locations/kazakhstan.

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  53. Johns Hopkins Medicine International, “Johns Hopkins Aramco Healthcare,” accessed November 7, 2022, https://www.hopkinsmedicine.org/international/health-care-consulting/our-clients/emea/johns_hopkins_aramco_healthcare.html; Johns Hopkins Aramco Healthcare, “Johns Hopkins Aramco Healthcare—Our History,” accessed November 7, 2022, https://www.jhah.com/en/about-us.

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  54. Johns Hopkins Aramco Healthcare, “Specialty Care,” accessed November 7, 2022, https://www.jhah.com/en/care-services/specialty-care.

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  55. Johns Hopkins Aramco Healthcare, WellBeing, April 2017, https://www.jhah.com/media/2248/english-wellbeing-april-2017.pdf, 4.

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  56. Johns Hopkins Aramco Healthcare, “Johns Hopkins Aramco Healthcare—Our History.”

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  57. The facility replaces the existing Al Mafraq Hospital.

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  58. Karl Oestreich, “SEHA, Mayo Clinic Enter Joint Venture to Operate Sheikh Shakhbout Medical City,” Mayo Clinic News Network, November 24, 2019, https://newsnetwork.mayoclinic.org/discussion/seha-mayo-clinic-enter-joint-venture-to-operate-sheikh-shakhbout-medical-city/.

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  59. Oestreich, “SEHA, Mayo Clinic Enter Joint Venture.”

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  60. Anne DiNardo, “Sheikh Shakhbout Medical City,” Healthcare Design Magazine, March 24, 2020, https://healthcaredesignmagazine.com/projects/acute-care/photo-tour-sheikh-shakhbout-medical-city/.

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  61. G. Anton Decker, MBBCh, president of Mayo Clinic International, quoted in Oestreich, “SEHA, Mayo Clinic Enter Joint Venture.”

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  62. Gulf Medical University, “Gulf Medical University Tie Up with Sheikh Shakhbout Medical City, Mayo Clinic, Abu Dhabi,” accessed November 7, 2022, https://gmu.ac.ae/gulf-medical-university-tie-up-with-sheikh-shakhbout-medical-city-mayo-clinic-abu-dhabi-in-clinical-training-and-cancer-research/.

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  63. Elizabeth Evitts Dickinson, “Global Hospitals: The Cleveland Clinic Abu Dhabi,” Architect Magazine, February 16, 2010, https://www.architectmagazine.com/design/buildings/global-hospitals-the-cleveland-clinic-abu-dhabi_o.

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  66. Jordana, “Cleveland Clinic Abu Dhabi/HDR.”

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  67. Jennifer Bell, “Inside Cleveland Clinic Abu Dhabi: 5,500 Doctors Apply for 175 Positions,” National News UAE, June 28, 2014, https://www.thenationalnews.com/uae/health/inside-cleveland-clinic-abu-dhabi-5-500-doctors-apply-for-175-positions-1.308836.

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  68. Jordan Rau, “Hemmed in at Home, Nonprofit Hospitals Look for Profits Abroad,” KHN.org, June 22, 2021, https://khn.org/news/article/hemmed-in-at-home-nonprofit-hospitals-look-for-profits-abroad/.

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  69. Virani, Wellstead, and Howlett, “North–South Policy Divide,” 11.

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  70. Meghann Ormond and Neil Lunt, “Transnational Medical Travel: Patient Mobility, Shifting Health System Entitlements and Attachments,” Journal of Ethnic and Migration Studies 46, no. 20 (2020): 4179.

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  71. U.S. Census Bureau, “Health Insurance Coverage in the United States: 2018,” November 8, 2019, https://www.census.gov/library/publications/2019/demo/p60-267.html.

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  72. Figures were derived from the Institute for Health Metrics Evaluation “Global Burden of Disease Study” of 2019 (latest data collected in 2021) and World Health Organization analysis of 2016 (latest data collected in 2021), as cited by Max Roser, “Data Review: How Many People Die from Air Pollution?,” Our World in Data, November 25, 2021, https://ourworldindata.org/data-review-air-pollution-deaths. The estimated number of deaths from cancer attributable to occupational and environmental exposures has been controversial. The figure quoted is from Eckelman and Sherman, “Environmental Impacts,” 10.

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  73. “Cleveland Clinic Abu Dhabi Pushes to be ‘Greenest’ Hospital in GCC,” press release, Zawya.com, April 24, 2019, https://www.zawya.com/mena/en/press-releases/story/Cleveland_Clinic_Abu_Dhabi_pushes_to_be_Greenest_Hospital_in_GCC-ZAWYA20190424072012/.

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  74. W. E. B. Du Bois, “Prospect of a World without Racial Conflict,” American Journal of Sociology 49, no. 5 (1944): 452.

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Conclusion: Decolonizing Health

  1. Nick Culbertson, “How Hospitals are Handling Compliance in a Resource-Constrained Environment,” Forbes, December 7, 2020, https://www.forbes.com/sites/forbestechcouncil/2020/12/07/how-hospitals-are-handling-compliance-in-a-resource-constrained-environment/?sh=11160e672c77.

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  2. Roosa Tikkanen and Melinda K. Abrams, “U.S. Health Care from a Global Perspective, 2019: Higher Spending, Worse Outcomes?,” Issue Brief, Commonwealth Fund, January 30, 2020, https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019.

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  3. Lenore Palladino and Rhianna Gunn-Wright, “Care and Climate: Understanding the Policy Intersections—A Feminist Green New Deal Coalition Brief,” Feminist Green New Deal, April 2021, http://feministgreennewdeal.com/wp-content/uploads/2021/04/FemGND-IssueBrief-Draft7-Apr15.pdf, 15.

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  4. Zeinabou Niamé Daffé, Yodeline Guillaume, and Louise C. Ivers, “Anti-racism and Anti-colonialism Praxis in Global Health—Reflection and Action for Practitioners in U.S. Academic Medical Centers,” American Journal of Tropical Medicine and Hygiene 105, no. 3 (2021): 557.

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  5. Sharon Stein, “What Can Decolonial and Abolitionist Critiques Teach the Field of Higher Education?,” Review of Higher Education 44, no. 3 (2021): 391.

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  6. Ruha Benjamin, “Black Skin, White Masks: Racism, Vulnerability and Refuting Black Pathology,” video, 30:48, Department of African American Studies, Princeton University, April 15, 2020, https://aas.princeton.edu/news/black-skin-white-masks-racism-vulnerability-refuting-black-pathology; Kim Gallon, “A Review of Covid-19 Intersectional Data Decision-making: A Call for Black Feminist Data Analytics, Part I,” Covid Black, September 18, 2020, https://covidblack.medium.com/a-reviewof-covid-19-intersectional-data-decision-making-a-call-for-black-feminist-data-analytics-da8e12bc4a6b.

    Return to note reference.

  7. Czyzewski, “Colonialism,” 10.

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  8. Paperson, “Ghetto Land Pedagogy,” 120.

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  9. James Tyner and Joshua N. Inwood, “Introduction to Nonkilling Geographies: Opening New Spaces,” in Nonkilling Geography, edited by James Tyner and Joshua N. Inwood (Honolulu: Center for Global Nonkilling, 2011), 11–18.

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  10. Shiloh Krupar and Amina Sadural, “Covid ‘Death Pits’: U.S. Nursing Homes, Racial Capitalism, and the Urgency of Antiracist Eldercare,” Environment and Planning C: Politics and Space 40, no. 5 (2022), https://doi.org/10.1177/23996544211057677.

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  11. Kim TallBear, “Caretaking Relations, Not American Dreaming,” Kalfou 6, no. 1 (2019): 26; Stein, “Confronting,” 90.

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  12. Stein, “What Can Decolonial,” 395.

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  13. Stein, “Confronting,” 82.

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  14. Stein, “What Can Decolonial,” 397.

    Return to note reference.

  15. Stein, “Confronting,” 89.

    Return to note reference.

  16. Stein, “What Can Decolonial,” 406.

    Return to note reference.

  17. Daffé, Guillaume, and Ivers, “Anti-racism,” 559; Stein, “What Can Decolonial,” 388.

    Return to note reference.

  18. Waitzkin and Jasso-Aguilar, “Empire, Health, and Health Care,” 274; Tim Lang, “Public Health and Colonialism: A New or Old Problem?” Journal of Epidemiology and Community Health 55 (2001): 162.

    Return to note reference.

  19. Sara Elisa Fischer, Poorvaprabha Patil, Chris Zielinski, et al., “Is It About the ‘Where’ or the ‘How’? Comment on Defining Global Health as Public Health Somewhere Else,” BMJ Global Health 5 (2020), https://doi.org/10.1136/bmjgh-2020-002567.

    Return to note reference.

  20. Daffé, Guillaume, and Ivers, “Anti-racism,” 558.

    Return to note reference.

  21. Jodi Melamed, Represent and Destroy: Rationalizing Violence in the New Racial Capitalism (Minneapolis: University of Minnesota Press, 2011), 4; Stein, “Confronting,” 87; Neil Singh, “Medicine and Public Health at the End of Empire,” Critical Public Health 25, no. 4 (2015): 507.

    Return to note reference.

  22. Frantz Fanon, The Wretched of the Earth, translated by Constance Farrington (New York: Grove, 1963), 44.

    Return to note reference.

  23. Stephanie Clare, “Geopower: The Politics of Life and Land in Frantz Fanon’s Writing,” Diacritics 41, no. 4 (2013): 69.

    Return to note reference.

  24. Clare, “Geopower,” 71; Frantz Fanon, Toward the African Revolution, translated by Haakon Chevalier (New York: Monthly Review Press, 1967), 125.

    Return to note reference.

  25. Clare, “Geopower,” 63, 69.

    Return to note reference.

  26. Palladino and Gunn-Wright, “Care and Climate,” 5. Huey P. Newton’s concept of “liberated territory” is discussed in Safransky, “Rethinking Land Struggle,” 1096.

    Return to note reference.

  27. Palladino and Gunn-Wright, “Care and Climate,” 24.

    Return to note reference.

  28. Hannah Arendt, Origins of Totalitarianism, 3rd ed. (New York: Harvest, 1994), 150; Sylvia Wynter, “How We Mistook the Map for the Territory, and Reimprisoned Ourselves in Our Unbearable Wrongness of Being, of Desêstre: Black Studies Toward the Human Project,” A Companion to African-American Studies, edited by Lewis R. Gordon and Jane Anna Gordon (Blackwell, 2006), 107–18.

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Portions of chapter 1 were previously published in a different form in “Brownfields as Waste/Race Governance: U.S. Contaminated Property Redevelopment and Racial Capitalism,” in The Routledge Handbook of Waste Studies, edited by Zsuzsa Gille and Josh Lepawsky, 238–53 (London: Routledge, 2022); copyright 2022 Taylor and Francis Group, LLC, a division of Informa plc; reproduced by permission. A modified section of chapter 1 also appears in “Brownfields as Climate Colonialism: Land Reuse and Development Divides,” in The Routledge Handbook of Architecture, Urban Space, and Politics, Volume 1, edited by Nikolina Bobic and Farzaneh Haghighi, 446–62 (London: Routledge, 2022); copyright 2022 Taylor and Francis Group, LLC, a division of Informa plc; reproduced by permission.

Health Colonialism: Urban Wastelands and Hospital Frontiers by Shiloh Krupar is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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