Rural Hospitals

  • Medicine & Health
  • 1927

When the Harkness family established the Commonwealth Fund in 1918, health care was one of their highest priorities. More than half of all counties in the United States lacked a hospital and overcrowding was a threat in many places that did have a facility. As early as 1919, Edward Harkness, the foundation’s first president, expressed interest in building new hospitals. Fund officers eventually became convinced that hospitals in rural areas or predominantly black communities were particularly urgently needed. The fund decided to require recipient communities to raise one third of the construction costs themselves, and to cover all future hospital expenses—similar to what Andrew Carnegie had demanded to make sure each locality was invested in the libraries he built.

In 1927, the Commonwealth Fund built a pilot hospital, the Southside Community Hospital, in rural Farmville, Virginia. The $180,000 facility was charged with providing medical care regardless of economic status or background, with each patient paying what he was able to. During the next 20 years, the Commonwealth Fund established 15 more rural hospitals with $6.8 million in grants. The resulting facilities provided medical care to millions of people, and every one of the facilities is still operating today.

  • Harvey McGehee and Susan Abrams, For the Welfare of Mankind: The Commonwealth Fund and American Medicine (Johns Hopkins University Press, 1986)