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The urban transition and the evolution of the medical care delivery system in America

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  • Knox, Paul L.
  • Bohland, James
  • Shumsky, Neil Larry

Abstract

This essay traces the evolution of the American urban medical care delivery system and examines the implications in terms of social and spatial variations in accessability to medical care. It is suggested that the foundations of the present medical care delivery system were laid during the urban transformation which took place in the latter part of the nineteenth century, when changes in the division of labor, specialization, the role of the family, urban transportation technology and attitudes to social protectionism interacted with changes in science, medical technology and professional organization to produce radical changes in both the settings used to provide medical care and their relative accessability to different sub-groups of the population. The medical care delivery system is thus interpreted largely as a product of the overall dynamic of urbanization rather than of scientific discovery, medical technology and the influence of key medical practitioners and professional organizations.

Suggested Citation

  • Knox, Paul L. & Bohland, James & Shumsky, Neil Larry, 1983. "The urban transition and the evolution of the medical care delivery system in America," Social Science & Medicine, Elsevier, vol. 17(1), pages 37-43, January.
    • Handle: RePEc:eee:socmed:v:17:y:1983:i:1:p:37-43
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    Cited by:

    1. Vedia Dokmeci, 2002. "Spatial Analysis of Physicians' Offices with Respect to Population and Hospital Beds in Istanbul," European Planning Studies, Taylor & Francis Journals, vol. 10(3), pages 405-412, April.
    2. Frederick, Chad & Hammersmith, Anna & Gilderbloom, John Hans, 2019. "Putting ‘place’ in its place: Comparing place-based factors in interurban analyses of life expectancy in the United States," Social Science & Medicine, Elsevier, vol. 232(C), pages 148-155.

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