The National Public Health and Hospitals Institute, Washington, analyzed health and sociodemographic factors in the 100 largest U.S. cities and disseminated the findings.

The investigators examined changes that occurred between 1980 and 1990 (or in some cases 1993), using a database they had established under an earlier grant from the Robert Wood Johnson Foundation (RWJF) based on information about the 100 largest cities and 851 hospitals in these cities.

Key Findings

• From 1980 to 1990, the 25 largest cities fared better in the areas of child poverty, single female-headed households, violent crime, and incidence of some diseases than the nation as a whole.
• Mid-sized cities in the study (ranked 26–50 in population, including Wichita, Kan., Raleigh, N.C., and Rochester, N.Y.) experienced explosive population growth in the 1980s, outpacing growth in larger and smaller cities as well as in the nation as a whole.
• Between 1980 and 1990, the population of the cities in the West included in the study grew 21 percent, far faster than in cities in other regions and more than twice the rate of increase nationwide.
• Socioeconomically, the West showed mixed progress compared to other regions, faring better on female-headed households, births to teens, and infant mortality rates, but also experiencing the largest regional increase in child poverty and the slowest increase in high school graduation rates.
• On average, urban public hospitals provided more costly essential communitywide services than did non-public hospitals, as well as more emergency services and a disproportionate share of care to low-income populations.
• Public hospitals reported sharp increases in care for low-income populations since 1980, compared with other hospital sectors.

Funding

RWJF supported the research with a grant of $247,719 from May 1994 to January 1996.