A rapidly growing body of research in the social sciences relates to the development and distribution of human services. Medical care is an especially important service, but analyses of how and where care is available have been limited by the absence of theory regarding the development of medical care delivery systems that would integrate findings from numerous case studies. This project will develop the theoretical basis for future research by building on findings in the extant scholarly literature through a detailed analysis of the reciprocal development of primary medical care and residential patterns in San Francisco between 1870 and 1930. Information on the provision of medical care and on the changing geography of people and housing will be gathered from archival sources as well as from public data sources. This information will be analyzed statistically and cartographically to determine how changing population and housing patterns affected and were reflected in changing patterns of primary medical care. Following the conclusion of the San Francisco historical study, theory about the geographic evolution of urban medical care will be explicitly reevaluated and enhanced in order to better explain and interpret how urban and medical transformations have evolved. This research will provide one of the most rigorous and well documented case studies of medical care system development ever conducted, but even more important, it will explicitly expand the general theoretical framework relating to service system development and residential development. This theory will more effectively focus future research projects, and the methodology used in the San Francisco case study will be replicable in other locales and over different time periods to permit ongoing reevaluation of the theory.
