In the shadow of academic medical centers: a systematic review of urban health research in Baltimore City

Abstract

The city of Baltimore is a typical, large, urban center in the United States with several major academic medical institutions surrounded by disadvantaged neighborhoods with multiple poor health indices. In order to understand the extent to which academic research agendas reflect the health concerns of Baltimore's local population, a systematic review was conducted to identify research about four key, health-related topic areas. We classified papers on: disease prevalence and health status, utilization of health services, population-based interventions, and the unmet health needs of Baltimore City residents. Approximately 4,150 citations were identified in the search and two levels of screening yielded a total of 288 papers. The majority of articles (n = 189) examined prevalence of health conditions such as Human Immunodeficiency Virus (HIV), mental health and mental disorders, and sexually transmitted diseases. Papers about specific target populations focused primarily on adults, African Americans, and females. Despite a significant body of research concerning several health conditions and priority populations, significant gaps in knowledge about health services utilization, community interventions, unmet health needs, and the prevalence of specific health issues remain. This review provides valuable insight into the extent of health research conducted about the city of Baltimore and whether community health priorities have been investigated. It provides a basis for examining the potential directions of academic research centers to effectively identify and address collective, urban health priorities of the communities in which they reside.