Rising Number of Hospital Mergers and Closures in Rural America Hurting Women’s Health, Economic Well-Being

Roosevelt Institute documents adverse effects of market power crisis


An issue brief released today by the Roosevelt Institute finds that corporate consolidation within America’s rural hospital sector is harming both rural women’s health and their economic security. Emerging research demonstrates how hospital mergers and closures affect rural women’s access to health care, particularly before, during, and after childbirth. However, the extent to which these shifts have affected women’s employment opportunities—particularly in rural areas where hospitals serve as anchor institutions in the community—has largely remained overlooked.

Authored by Roosevelt Fellows Andrea Flynn and Rakeen Mabud and their colleague Emma Chessen, the issue brief examines how structural changes in the health care system are affecting rural women—both as patients and as workers.

When jobs are eliminated or transferred to other localities due to corporate decision-making and other cost pressures to merge hospitals or close them entirely, rural women, who disproportionately hold jobs in the hospital sector, are disproportionately affected.

“The seismic shifts in the hospital sector have taken a disproportionate toll on women living in rural areas,” said Flynn. “The dual trends of consolidations and closures have not only limited their access to medical care—particularly reproductive health care—but these corporate choices have also eroded economic opportunity for women and affected entire communities.”

“Trends in the hospital industry mirror broader trends of outsized corporate and employer power in our society. Hospital closures and consolidation—particularly in rural areas—mean that workers have less power on the job and over their health, which means that health outcomes for women suffer,” noted Dr. Mabud. “What we are seeing within the health care sector underscores the cost that these shifting power dynamics have for the public, especially rural Americans.”

The authors argue that existing policy tools can be used to address consolidation in the health care sector. In particular, they urge the Federal Trade Commission to expand the criteria it considers in determining whether mergers in any sector are harmful, which currently does not take into account the potential effect mergers will have on the labor market and workers’ wages.

About the Roosevelt Institute

The Roosevelt Institute, a New York-based think tank, promotes bold policy reforms that would redefine the American economy and our democracy. With a focus on curbing corporate power and reclaiming public power, Roosevelt is helping people understand that the economy is shaped by choices—via institutions and the rules that structure markets—while also exploring the economics of race and gender and the changing 21st-century economy. Roosevelt is armed with a transformative vision for the future, working to move the country toward a new economic and political system: one built by many for the good of all.

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