Under the Gun, Chicago Finally Re-Commits to South Side Trauma Center

Under The Gun, Chicago Finally Re-Commits To South Side Trauma Center

Public demand: Last spring, demonstrators blocked Michigan Ave. to call for the overdue facility. (Scott L / Flickr)

by JOHN GREGERSON | Jan 7, 2016

With gun violence perpetually in the news, and Chicago even earning special mention in President Obama's challenging speech this week, it is hard to believe that one of his hometown's roughest areas has been without a trauma center of its own for the last 25 years. But that will soon change.

After years of increasingly frustrated and desperately pointed community activism, the University of Chicago Medical Center (UCMC) last month announced plans to build a $40-million Level 1 adult trauma center on its Hyde Park campus, south of downtown. Due to open in 2018, the new facility will serve the city's predominately African-American South Side, where gun-related homicides per year have approached 60 per 100,000 residents. Of note, according to the Chicago Tribune, the city saw 2,986 shootings in 2015, and it is already averaging more than eight shootings per day in 2016!

"UChicago Medicine has a deep ongoing commitment to serving the health care needs of the South Side," said UCMC in a statement. "Unprecedented growth in inpatient admissions and emergency department volume has created serious capacity constraints, and as a result, medical facilities are operating at capacity."

Amid the controversy, U of C opened a new 10-story, $700-million, 1.2-million-sf "hospital for the future" in 2013. 

In recent years, the area's lack of resources to treat the seriously injured has earned it the dubious distinction of being a “trauma desert.” In one infamous 2010 incident, 18-year-old Damian Turner was shot just blocks from UCMC, but was taken to a trauma center at Northwestern Memorial Hospital, some 10 miles away, where Turner later died. It's never been clear whether that delay contributed to his death, but the situation riled locals and sparked protests that alleged racial health care inequity.

As gang-related gun violence escalated, so did public pressure. “The fact that a community that’s home to about 750,000 people on the greater South Side of Chicago – an overwhelming portion of which sits in my congressional district – does not have one, not one, Level I trauma care center literally results in the needless loss of life,” said U.S. Rep. Bobby Rush (D-IL) in 2011, testifying before Congress.

Pressure builds

A year ago in Crain's Chicago Business, columnist Joe Cahill urged U of C to step up. "Most other leading medical centers atop U.S. News & World Report's list of 'best hospitals' have Level 1 adult trauma centers, including Johns Hopkins in Baltimore, the UCLA Medical Center in Los Angeles, New York-Presbyterian in New York, and Massachusetts General in Boston," wrote Cahill. "This is one area where U of C appears to have slipped back from 'the forefront of medicine'... With an endowment of about $7 billion, U of C could afford to subsidize a Level 1 adult trauma center."

Last fall, in partnership with Sinai Health System, UCMC unveiled a scheme that would have sited the trauma center at an alternative location, on the city's southwest side. But last month, UCMC reversed its decision, indicating that Hyde Park was a more appropriate location for the center, given potential efficiencies and economies of scale with an existing Level 1 pediatric trauma center on campus. Of note, protesters had objected to the westerly location favored by the proposed joint effort with Sinai.

Another factor hinted at by local media may be the city's interest in further bolstering the resources that will be available to the area that will one day also house the new Obama Presidential Center. 

As planning now proceeds at U of C, more details on the selection of a building team are expected soon.

Traumatic history

So-called "trauma deserts" are not unique to Chicago, of course. Over the years, several cities -- from Cleveland to Detroit to Los Angeles -- had also closed trauma centers in low-income areas due to costs that often went unreimbursed since they were incurred by uninsured patients and others on Medicare. As a result, an American Hospital Association survey of the nation's 25 largest cities showed that a dozen hospitals and trauma centers were closed between 2006 and 2011. 

The concept of trauma centers gained traction in the U.S. in the 1950s and 1960s. In 1986, six Chicago hospitals were designated as such, including two on the South Side. One, Michael Reese Hospital, closed its trauma center in 1991. The other was UCMC, which pulled the plug in 1988, just two years after opening it. At the time, UCMC cited $15 million in annual losses.  

Given this history, not to mention the future facility's proximity to the future Obama Library, it will be interesting to see if Obamacare can help to make this form of urban triage any more sustainable.

Deep in the red, Michael Reese Hospital closed Chicago's last dedicated south side trauma center in 1991.