Study: Emory, Grady rank high for inclusivity but city hospitals segregated

Large life expectancy gaps by race exist in many cities with segregated hospital markets

Credit: Natrice Miller / Natrice.Miller@

Credit: Natrice Miller / Natrice.Miller@

Editor’s note: This story has been updated to reflect comments from Emory Healthcare and Wellstar Health System.

Emory University Hospital Midtown and Grady Memorial Hospital rank among the nation’s 10 most racially inclusive hospitals, according to a report released Tuesday. The Atlanta metro area was listed as one of the most racially segregated hospital markets in the country, however.

The report, the 2023 Hospital Racial Inclusivity Report, from the Lown Institute, a non profit think tank based in Needham, Massachusetts, ranked Grady 8th and Emory Midtown 10th. The ranking seeks to examine how well U.S. hospitals serve people of color in their communities.

Lown Institute looked at Medicare Advantage data and traditional Medicare claims along with the U.S. Census Bureau’s American Community Survey from 2021 for 3,142 hospitals around the nation for the study. The institute measured how well each hospital’s Medicare patient demographics aligned with the demographics of the hospital’s surrounding communities. Each hospital was given a ranking from one to five stars.

“In Medicare, since everybody is getting paid the same, we wanted to really use that to get a sense of where people are actually going to get their care,” Dr. Vikas Saini, president of the Lown Institute, said. “There’s no incentive on the hospitals to turn somebody away, take somebody or not take somebody.”

Saini said Medicare data is the largest and most comprehensive dataset to use for the ranking due to it being made available by the federal government.

Grady did not respond to a request for comment for the story. Janet Christenbury, director of media relations for Emory Healthcare, said in an emailed statement to The Atlanta Journal-Constitution, “Emory Healthcare is dedicated to providing the safest and highest quality health care to the diverse patients and families we are privileged to serve. We strive to make our health care system a place of healing and a welcoming environment to everyone in our community who seeks our care.”

The study found that in some instances, the most racially inclusive hospitals were located in the same metro area as the least racially inclusive, which was a indicator of health care market segregation. In metro Atlanta, Emory Midtown and Grady ranked among the nation’s most inclusive, while Wellstar’s Kennestone Hospital and Northside’s Cherokee Hospital fell to to bottom of national rankings.

Of the metro hospitals, 21% received a one-star rating, meaning that those hospitals served fewer patients of color than lived in the community surrounding the hospital.

“In the Atlanta area, what it seems to imply is that there is a pattern of racial, class or economic inequalities,” Saini said. “Those patterns are such that different hospitals treat different segments of the population even when they are geographically in the same region.”

For example, 72% of the patients Grady served were people of color while 47% of the community surrounding Grady is made up of people of color. Emory Midtown’s patients were 65% people of color, while they made up 42% of the surrounding community.

In contrast, Wellstar Kennestone Hospital based in Marietta in Cobb County, was ranked last among Atlanta’s 35 hospitals examined for racial inclusivity. The Lown study found Wellstar’s hospital had a surrounding community in which people of color made up 36% of the population, but only 23% of the patients it served were people of color. Piedmont Newnan was ranked second-to-last with 39% of its community being people of color while 27% of the patients served were people of color.

Wellstar Health System said that the company is reviewing the report and its findings.

“Our long-standing dedication to serving diverse communities is a core part of our mission and is essential to our community benefit programs,” said Matthew O’Connor, Wellstar’s executive director of public relations in an emailed statement. “Through our Community Health Needs Assessments, we have identified areas of focus to reduce health disparities. By offering a variety of impactful clinical, health and wellness programs, we are improving access and the overall health of the communities we are honored to serve.”

Just last year, Wellstar’s former Atlanta Medical Center was ranked as the 25th most racially inclusive hospital in the U.S. Shortly after the release of the 2022 Hospital Racial Inclusivity Report last March, Wellstar closed its two Atlanta-area hospitals, AMC downtown and AMC South in East Point, that were unprofitable. Both hospitals served a patient population that included many low-income residents of color without insurance.

Since then, Wellstar has been under scrutiny by a litany of local lawmakers, including the Fulton County Board of Commissioners. In April the commission called for a closer look into the possibility of “health care redlining” by area health systems, which Chairman Robb Pitts has described as closing hospitals in majority black and poor areas.

Lown also noted that large life expectancy gaps by race exist in cities with segregated hospital markets, something that a report produced by Fulton County with Morehouse School of Medicine and consulting firm Ernst and Young in April showed. The report linked the lack of care options to a five-year reduced life expectancy in south Fulton compared to north Fulton. Additionally, south Fulton County residents have the lowest access to health care out of all of the county’s residents and lack health care facilities and providers for primary and specialty care needs.

“It took us decades, if not many many years to get to place where we are,” said Saini. “In order for the health care system and hospitals to be more inclusive and equitable, it’s going to take time and it’s going to take everybody on board and rowing in the same direction.”

10 Most Racially Inclusive Hospitals in the United States

1. Boston Medical Center (Boston)

2. John H. Stroger Jr. Hospital (Chicago)

3. UChicago Medicine (Chicago)

4. Penn Presbyterian Medical Center (Philadelphia)

5. Metro Nashville General Hospital (Nashville)

6. South Coast Global Medical Center (Santa Ana, Calif.)

7. St. Charles Madras (Madras, Ore.)

8. Grady Memorial Hospital (Atlanta)

9. Methodist Hospitals (Gary, Ind.)

10. Emory University Hospital Midtown (Atlanta)

Most Racially Inclusive Hospitals in Atlanta

1. Grady Memorial Hospital

2. Emory University Midtown Hospital

3. Emory Hillandale Hospital

4. Emory Decatur Hospital

5. Emory University Hospital

Least Racially Inclusive Hospitals in Atlanta

1. Wellstar Kennestone Hospital

2. Piedmont Newnan

3. Northside Cherokee Hospital (tie)

3.Northside Hospital Atlanta (tie)

3. Wellstar Douglas Hospital (tie)

Source: The Lown Institute

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