Cities have been laid out in a variety of methods, but one of the most common formats is concentric: there is a downtown, and everything flows from the city center. When cities were small, this format was effective only because everyone knew where to go and populations were relatively small. Now, having everything in the center of town is difficult because there are so many different concentrations of population within cities–a fact well-demonstrated by business placement. Having hospitals only in one place means a world of frustration when a loved one is out of commission, and visitors are without personal vehicles, which is happening more often based on people not having cars.
Most of the public transportation is scheduled around “work.” As logical as this may seem, what this means is that between the hours of seven and nine in the morning, and between four and six in the evening, public transportation allows people to commute in a somewhat efficient manner. Currently, much work is in the service sector and even more work is found in a gig economy, both of which mean irregular hours for ridership. Despite this, much transit scheduling is timed poorly after traditional work hours and what used to be a sixty- to ninety-minute commute becomes a two- or three-hour commute after the rush hours. After all, even though the economy has changed, hospitals are still located mostly in the city center.
Hopefully, the patient will need nothing other than nutrition during the hospital stay because there are almost no other facilities located near hospitals. Some have gift shops, but with the increasing expectation of shopping online, there is frequently nowhere to buy innocuous things such as underwear or pair of reading glasses. In theory, healthcare megaplexes exist for the ease of healthcare professionals who would have access to multiple facilities in one location but as it turns out, all people want the ease of resources within walking distance in the off chance emergencies occur.
Finally, even though hospitals are located within the center of town, so is the most expensive property, and many people from marginalized locations are unable to attend to family members without losing a great deal of time from work. If someone lives alone, attending to that person’s household frequently requires a car based on where affordable housing and medical care are located. Should someone who lives between suburbs have a problem, that potential patient better have friends or a healthy budget because it would cost a great deal of money to get that person medical care.
Because the healthcare system is unquestionably broken, many of these problems will remain unaddressed for a time. All constituents can do is point out the trends that indicate how little the locations of healthcare serve them. Until decision makers consider how marginalized populations access healthcare, it becomes incumbent upon private industry to respect the demographic shift from personal vehicles.