New Neighbor
In the Neighborhood: Insights on life in a small town.
My family and I are getting settled into our new home here in North Brainerd. We've enjoyed meeting and getting to know all of our neighbors, with just one notable exception. That exception, however, is a pretty big deal since they own more property and have more influence over the direction of the neighborhood than any other neighbor I have. I've not had a chance yet to really meet my neighbor, St. Joseph's Hospital.
Technically, in the age where medical care is the city's -- and perhaps the nation's -- leading growth industry, their name is Essentia Health - St. Joseph's Medical Center. For me, growing up it was simply "the hospital." That is where I was born. Where my wife gave birth to both of our children. That was the emergency room where I was brought after my car crash back in 2004. It is where both of my grandmothers were diagnosed with, and treated for, the cancer that would claim them. We've known each other as service provider and patron, but never as neighbor. I hope that changes soon.
I generally have a positive impression of the hospital. Growing up I always associated it with my church since we had a large presence there. I thought our Sunday collection tray helped pay for the treatment of sick people. Maybe it did, but probably not. I do know that the hospital is still served by some Benedictine sisters who are pretty amazing people.
Our house is one block east and half a block north from the front door of the hospital. This summer I've spent a fair number of days working from my front porch. I've seen a continual stream of hospital people walk by, from mothers who I suspect are in one stage or another of labor to doctors and nurses out for a walk on their break. It creates a cheerful presence that I've come to appreciate.
I also know that Essentia Health shares my concerns about people being able to walk and bike. They have been involved with supporting walking and biking initiatives from a health standpoint, which aligns nicely with my advocacy of the same from a financial standpoint. Improvements to make biking and walking easier in our core neighborhoods and downtown are the highest returning investments my city can make. It also empowers families and businesses who want to lower their financial burn rate. And cities that have a culture of biking and walking are also healthier places. The hospital and I share a lot of goals in this regard.
Unfortunately -- and this is why I hope to meet them soon as a neighbor -- we seem to have a couple of places where our interests are not currently aligning. Despite their stated commitment to biking/walking and the health outcomes that creates, they have been very aggressive in converting large parts of my neighborhood into parking lot. I acknowledge that most of their patrons come from outside the neighborhood and therefore arrive by car, but the approach they have taken has done a lot to devalue the neighborhood. Their buying up of additional properties for ostensibly more parking lot expansion has a Sword of Damocles effect where my neighbors and I are waiting for the next round of teardowns and property value declines.
What does this have to do with public health? It's clear that the more people who live in neighborhoods that are walkable and bikeable, the fewer people that commute long distances, the healthier we are. North Brainerd is the neighborhood with the most potential in a city that has not added any population since 1950 (and our overall population has only held steady through annexation). The more the hospital's actions devalue the neighborhood, the more locked into decline it will be, along with the city's other neighborhoods that could really benefit from a renaissance in Brainerd's North side. How do we get people to move here -- how do we create a culture of health, of biking and walking -- when our prime neighborhood for healthy living is a poor investment?
“Hospitals around the country are realizing that it is good policy and good business to take an interest in the welfare of the neighborhoods they are in.”
Of course, it doesn't have to be this way. Hospitals around the country are realizing that it is good policy and good business to take an interest in the welfare of the neighborhoods they are in. One of my good friends, Tommy Pacello, is the president of the Medical District Collaborative in Memphis, Tennessee. The Memphis Medical Center has plans to spend millions making the neighborhood they are in a better place to live, work, be a patient and visit a loved one. Here's how this was described in the Memphis Daily News:
In summer 2014, the area’s eight anchor institutions hired consulting firm U3 Advisors to design and help implement an “anchor strategy” to redirect the area’s massive economic resources and defensive property holdings into something that lifts up the entire district.
Tommy Pacello, president of the MDC and a team member with U3 Advisors, said that change will be apparent in May of this year, with plans that include streetscaping, public art projects and wayfinding signs initially, followed by real estate development and parking management further down the line.
And let's be clear: Tommy is a brilliant guy who cares deeply for Memphis and the people of that community, but this is also good business. That quote described "defensive property holdings" which is the same kind of thing I see Essentia Health doing outside my door. In Memphis, they are changing their orientation from defensive to proactive and everyone is benefiting:
“People don’t do this just because they’re good citizens and it’s good for the area, but because it helps their individual organizations,” said Omar Blaik, CEO and co-founder of U3 Advisors, which has applied similar strategies in converting research and medical districts in Detroit and Philadelphia.
Gary Shorb, CEO of Methodist Le Bonheur Healthcare and chair of the MDC, said his goal is to have 15 to 20 percent of his employees living in the area.
“Imagine the better life — shorter commute, less stress, healthy walk, fewer auto expenses — the many nurses and support staff could have if it was a good investment for them to live here? ”
Imagine if North Brainerd were so nice that a large percentage of the hospital's doctors wanted to live within a few blocks instead of out of town? Imagine the better life -- shorter commute, less stress, healthy walk, fewer auto expenses -- the many nurses and support staff could have if it was a good investment for them to live here? What impact would this have on the hospital's recruiting and retention efforts in a very competitive market?
What if overnight visitors to the hospital could stay in a cozy hotel across the street from the entrance instead of sleeping in a waiting room chair (done that - not fun) or driving to a hotel miles away in Baxter? What if families and patients could visit a nice coffee shop or book store just up the block while they wait for test results? These things are very possible and being done elsewhere.
Essentia Health - St. Joseph's Medical Center does not have to gut blocks and blocks of our neighborhood for more and more surface parking. A more thoughtful, sophisticated and -- yes -- respectful approach would better serve the hospital while also improving the neighborhood. I'd love to work with them to make that happen. So would a lot of other people here.
Now, I'm quite aware that many of my new neighbors would not agree with this vision. They don't want more parking lots, but the idea of a hotel, a coffee shop or a book store will also freak them out. Rightly so; they are used to investments of this sort being done throughout the community in ways that are even more disrespectful than the parking lots. A lot of that fear can be overcome if not only I get to meet my neighbors at the hospital, but the entire neighborhood has that chance. From the Memphis Daily News article:
“Built environment communicates something to you,” said Omar. “Five years from now, the district will look like a place we care about and invest in.”
Brainerd would be a much stronger place if the North Brainerd neighborhood looked like an area that the hospital really cared about and invested in.
Charles Marohn—known as “Chuck” to friends and colleagues—is the founder and president of Strong Towns. He is a land use planner and civil engineer with decades of experience. He holds a bachelor’s degree in civil engineering and a Master of Urban and Regional Planning, both from the University of Minnesota.
Marohn is the author of Strong Towns: A Bottom-Up Revolution to Rebuild American Prosperity (Wiley, 2019) and Confessions of a Recovering Engineer: Transportation for a Strong Town (Wiley 2021). He hosts the Strong Towns Podcast and is a primary writer for Strong Towns’ web content. He has presented Strong Towns concepts in hundreds of cities and towns across North America.