PRESS RELEASE: America’s most segregated hospital markets are Detroit, St. Louis, Kansas City

Lown Institute Analysis Shows Hospitals Are More Equitable When Caring for COVID Patients

Boston, MA: Hospital markets in many large U.S. cities are racially segregated, according to a new report from the Lown Institute, a healthcare think tank. In Detroit, for example, nine out of ten hospitals contribute to its status as a segregated hospital market. The study also finds that patients receiving elective procedures skew disproportionately white and that may be a driver of inequity, especially at the least racially inclusive hospitals.

“Doing more elective procedures often means hospitals seeking to serve whiter and wealthier patients,” said Vikas Saini, MD, president of the Lown Institute. “Given the destructive impact of the pandemic on communities of color, a return to business as usual isn’t acceptable and almost guarantees slipping backwards on racial equity.”

The 10 cities with the most segregated hospital care are:

  1. Detroit, MI
  2. St. Louis, MO
  3. Kansas City, MO
  4. Atlanta, GA
  5. Philadelphia, PA
  6. Washington, DC
  7. East Long Island, NY
  8. Houston, TX
  9. Baltimore, MD
  10. Manhattan, NY

Cities were determined to have segregated hospital care based on the proportion of hospitals whose patients closely matched community demographics compared to hospitals whose patients did not. In the 10 most segregated cities, at least 50% of hospitals did not match the demographics of their communities. The study uses Medicare claims data from 2020, the first year of the COVID pandemic.

COVID Drove Some Hospitals Toward More Equitable Care

One bright spot of the analysis was the relatively equitable treatment of patients with COVID. The data show that many of the most segregated cities for hospital care had COVID patient populations that aligned with the racial makeup of their communities. Experts from the Lown Institute point to treatment of COVID patients as proof that hospitals can be more equitable in caring for other life-threatening chronic conditions.

“Hospitals deserve praise for stepping up to the plate and being more inclusive during COVID, but we need them to be more inclusive all the time,” said Dr. Saini. “There’s been a slow pandemic of chronic disease in our urban communities of color for decades. That crisis remains and demands attention regardless of where we are with COVID.” 

Additional ranking information, including an explanation of methods, is available at The full 2022 Lown Institute Hospitals Index for Social Responsibility, including rankings across more than 50 metrics, will be released in late June.

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How Inclusive Are America’s Hospitals?

Panel Discussion: Join us March 17, 2022 at 1pm EST for a live event as we discuss our racial inclusivity results with special guests:

  • Brenda Battle, MBA, BSN– Senior Vice President of Community Health Transformation and Chief Diversity, Equity & Inclusion Officer at the University of Chicago School of Medicine
  • Anthony Iton, MD, JD, MPH– Senior Vice President Of Building Healthy Communities at The California Endowment
  • Richard Allen Williams, MD, FACC– Founder of the Minority Health Institute and Association of Black Cardiologists, former President of the National Medical Association

About the Lown Institute 

Founded in 1973 by Nobel Peace Prize winner Bernard Lown, MD, developer of the defibrillator and cardioverter, the Lown Institute believes that a radically better system of health is possible and generates bold ideas towards that goal. The Lown Institute Hospitals Index for Social Responsibility is a signature project of the Institute and features measures never used before like racial inclusivity, avoidance of overuse, and pay equity.


Aaron Toleos, Lown Institute, (978) 821-4620,