Humble Beginnings (1730s-1880s)
Bellevue is largely recognized as the oldest public hospital in the United States. Opening as an infirmary in a small almshouse in 1736, it catered to a poor, immigrant population in lower Manhattan. Eventually, it moved northward, away from the settled city, and amassed inexpensive, unoccupied urban land at Kips Bay Belle Vue Farm in 1811 under Mayor DeWitt Clinton. The city grew up around Bellevue, and by 1825, the existing group of buildings at First Avenue between 26th and 27th became known as Bellevue Hospital. As the wealthier moved further uptown, Bellevue remained serving an underprivileged population downtown. As many as 8 general hospitals moved north alongside the wealthy, including Mount Sinai and Presbyterian. These hospitals took advantage of new buildings to advance hospital architecture generally, retrofitting them to incorporate new technologies becoming commonplace (Kisacky, 2019).
“By 1870, Bellevue had 1,200 beds, an outpatient department, and a 24 hour horse-drawn ambulance service. It adopted the reformist Nightingale principles architecturally, and by 1873 opened a nursing school attached to the hospital to be run by Florence Nightingale’s Nursing Principles.” (Gold, 1975).
Pictured: Nightingale inspired Hospital Room at the Children’s Ward at Bellevue (spaced beds, windows allowing natural light and fresh air)
Credit: Bellevue Hospital, New York City: a ward for children, with patients, doctors and nurses. Photograph. Date: 1885-1898
Turn of the Century (1900s-1930s)
Expansion was inevitable by the early 1900s. In 1904, construction of a new Bellevue began, and these buildings still stand today. Many other hospitals at the time were giving culturally-specific medical treatments depending on the communities they were embedded in (Presbyterian serving Protestant immigrants, Mount Sinai serving a Jewish immigrant population). Bellevue, as a public hospital, saw a diverse patient body, and was able to push the envelope of medical discoveries forward, for better or for worse. As the hospital began to modernize and profligate, variations of culturally embedded systems of knowledge were lost in favor of uniform, westernized science.
Decline of the Hospital (1930s-1970s)
In 1931, construction of the Psychiatric Ward at Bellevue was completed, representing Bellevue’s iteration of what Verderber (2000) considers “the urban ghetto hospitals and insane asylums of the Industrial Revolution.” Institutionally, the hospital was firmly centered within the healthcare system during these years, but in subsequent years this image would diminish, with the advent of private insurance, the revamping of holistic movements, and the general decline of care in the hospital.
Medical Industrial Complex (1970s-Current)
In 1970, Bellevue’s management was taken over by the NYC Health and Hospitals corporation (Gold, 1975). Countless corporate acquisitions were taking place in the health care sector in the 80’s, raising the value of the health care industry by millions. This era also brought large-scale, austere and complex postwar modern machine hospitals (Verderber, 2000). Health care privatization played a role in redefining the hospital as a last resort option. Still, by law, Bellevue was required to accept all patients who sought medical aid. In 1975, 75% of Bellevue’s patients lived in Manhattan, the vast majority of those in lower Manhattan. And, the majority of Bellevue patients were Puerto Rican and Black (Gold, 1975). By 2009, statistics show that that Bellevue’s Natural Birth Center served a majority of Chinese- and Spanish-speaking mothers (Sulzberger & Pinto, 2009).
