A new ranking of over 3,200 U.S. hospitals has revealed major disparities in how racially inclusive health care systems are—with some of the nation’s most and least segregated hospitals located just blocks away from one another, the Lown Institute reports.

For the study, the Massachusetts-based think tank looked at hospital systems across all 50 states, assessing how well the demographics of a facility’s Medicare patients matched the demographics of its surrounding communities.

Hospitals were then ranked based on the ratio of this difference—revealing that while some hospitals in urban markets seemed almost to specialize in serving a whiter, wealthier patient population, others predominantly served Black and Latino patients with lower incomes, many located mere blocks from their more affluent counterparts.

Overall, Lown found that in the United States’ most inclusive hospitals, people of color made up about 61% of patients on average, compared with just 17% at the nation’s least inclusive hospitals.

Atlanta, Baltimore, Chicago, Cleveland, Detroit. Los Angeles, Manhattan, Newark, Philadelphia and Washington, DC were found to have some of the most segregated hospital systems.

Meanwhile, the most inclusive hospitals in the United States included New York City’s Metropolitan Hospital Center, Boston Medical Center, St. Charles Madras Hospital in Oregon and Newark Beth Israel Medical Cen. Of note is the fact that many of the cities listed with the most segregated systems also are home to some of the most inclusive hospitals in the country. 

“The difference between the most and least inclusive hospitals is stark, especially when they are blocks away from each other,” said Vikas Saini, MD, president of the Lown Institute, commenting on the report. “As the nation reckons with injustice, we cannot overlook our health system. Hospital leaders have a responsibility to better serve people of color and create a more equitable future.” 

Researchers also found that just three hospitals from the U.S. News Best Hospitals Honor Roll, a ranking of the nation’s top facilities, appeared on the top 200 list for inclusivity. 

To learn more about how communities of color are affected by racism and discrimination in the health care system, see “How Race Influences Medical Diagnoses and Treatment.”