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During the 1960s, cities across the United States erupted with rioting. Subsequent inquiries into its sources revealed long-simmering discontent with systemic deprivation and exploitation in the country's most racially segregated and resource-scarce neighborhoods. Urban medical centers were not exempt from this anger. They were standing symbols of maldistribution, cordoned off to those without sufficient economic means of access. In this article, I examine the travails of the worldfamous and prestigious Cleveland Clinic after the 1966 riot in the Hough neighborhood on the East Side of Cleveland, Ohio. After years of unbridled expansion, fueled by federal urban renewal efforts, the riots caught the Clinic's leadership off guard, forcing it to rethink the long-standing insularity between itself and its neighbors. The riots were central to the Clinic's programmatic reorientation, but the concessions only went so far, especially as the political foment from the riots dissipated in the years afterward. The Cleveland experience is part of a larger-and still ongoing-debate on social obligations of medical centers, "town-gown" relations between research institutions and their neighbors, and the role of protest in catalyzing community health reform. (Am J Public Health. 2018;108:1494-1502. doi: 10.2105/AJPH.2018.304654)
In July 1966, the Hough neighborhood on the East Side of Cleveland, Ohio, exploded and saw nearly a week of rioting. It followed a 1964 riot in Harlem, New York-the largest up to that point in the post-World War II period-and other unrest throughout the decade in Philadelphia, Pennsylvania; Chicago, Illinois; and, most famously, Los Angeles, California, among others.1 Whether labeled "rebellions," "uprisings,' ' "civil disorders," or "riots," this tumult was a national wake-up call, particularly for powerful institutions that had insulated themselves from the rage stewing around them.2
Urban medical centers were among such institutions. Flush with resources from midcentury medical expansion, they were standing symbols of maldistribution, closed off to those without sufficient economic means of accessing them. Cleveland was no exception. This article tells the story of a gulf, one between a gilded medical institution and a racially segregated neighborhood right next to it: the Cleveland Clinic on one hand, the Hough neighborhood on the other. In the decade preceding the riot, the Clinic had expanded rapidly, displacing, alienating, and angering its neighbors as it made way for an ever-growing medical complex. It...