Hospital Closures: The Sociospatial Restructuring of Labor and Health Care

Since 2003, more than twenty hospitals in New York City have closed because of debt and a state-driven downsizing program. During this same time period, the labor market for nurses has tightened substantially, shifting from an overall nurse shortage since the 1980s to a job shortage since the mid-2000s. Drawing on an analysis of media and government publications on hospital closures since 2003 and interviews with nurses working in the metropolitan area, I argue that hospital closures and the new job shortage are intertwined. By pushing an austerity agenda in the wake of the 2008 economic crisis, New York City and state government agencies as well as private health care institutions are actively restructuring—or “rightsizing”—the health care sector. Ultimately, this is a downsizing of care provisions by another name. Capitalism's continued devaluation of social reproduction manifests in New York City as a restructuring of the spaces and work of health care. Hospital closures are central to this restructuring that involves the mutually constituted transformations in the built environment, health care provisioning, and the nursing profession. In conclusion, this process risks making good health and good jobs less accessible.