Half the Jobs in University City Belong to Four Hospitals

Just under 52 percent of all the jobs in University City belong to four medical institutions.

The Hospital of the University of Pennsylvania. Penn Presbyterian. Children’s Hospital of Philadelphia. The Michael J. Crescenz VA Medical Center.

That figure comes from University City District’s 2026 State of University City report, and I have been turning it over for a week, because I think it is the best news in this city’s economy and also the risk we discuss the least.

First, the good half, because it is genuinely remarkable

The district holds nearly 85,000 jobs. That is roughly 11 percent of every job in Philadelphia, sitting on 1.69 percent of the city’s land.

Read that ratio again. One and a half percent of the ground, one in nine of the jobs.

Seventy nine percent of those jobs pay over $40,000 a year, which in a city with our poverty rate is not a small detail. In 2025 the district drew $1.02 billion in NIH funding, 45 percent of everything Pennsylvania received. Two hundred and five patents were issued. Cumulative research and development spending since 2000 has passed $33 billion.

Fifty three thousand people live there. The median age is twenty six. Sixty eight percent of the adults hold at least a bachelor’s degree.

If you were designing a knowledge economy district from scratch you would draw something that looks very much like this, and most American cities would trade a great deal to have one.

So nobody should read what follows as an argument against any of it. I would not change a brick. What I want is for us to be able to describe what we have built accurately, including the parts that are uncomfortable, because a city that can only say the flattering half of a sentence cannot plan.

Now the half we do not say at the ribbon cutting

We have a habit, in economic development, of celebrating anchor institutions for exactly one property: they cannot leave. A hospital is fixed in place. Its buildings, its staff and its patients are here. That immobility is real and it is why anchors are worth building strategy around.

But immobility is not the same thing as stability, and we keep using the two words interchangeably.

An institution that cannot leave can still shrink. It can freeze hiring. It can lose a research funding stream. It can face a reimbursement change decided in Washington or Harrisburg by people who have never been to Spruce Street. It can defer a capital plan. None of those require it to move a single building.

So here is the sentence underneath the 52 percent.

Half the payroll of Philadelphia’s most productive square mile now moves on federal research funding, on reimbursement rates set elsewhere, and on the capital decisions of four organisations.

That $1.02 billion in NIH money is a triumph and a dependency at the same time. Forty five percent of a state’s federal research funding landing in one district is a concentration statistic whichever way you feel about it.

This is not a criticism of the hospitals

I want to be careful here, because this argument is easy to misread.

Penn Medicine, CHOP and the VA did not set out to concentrate a city’s employment. They grew because they are good at what they do and because demand for it grew. They employ tens of thousands of people, many of them well, and they are among the reasons this city still has a middle class attached to a growing sector.

The concentration is an emergent property of everyone’s success, not anybody’s plan. Which is precisely why nobody owns the risk. There is no meeting where somebody is responsible for the sentence “we are now half of a district’s employment.” Each institution is doing its own job well. The aggregate is nobody’s job at all, and that gap is where this kind of exposure lives in every city it has ever happened to.

What we already know about this shape

We have seen this shape before and we gave it a name we do not like.

A company town is not defined by a bad employer. It is defined by an economy where one decision maker’s calculations determine whether a place has work. Steel towns were not badly run for most of their history. Textile towns were not either. They were concentrated, and concentration only reveals itself as a problem on the day the concentrated party changes its mind.

Nobody described those places as concentrated at the time. They described them as anchored.

University City is not fragile today. I want to be plain about that. It is thriving. Which is exactly the moment you can afford to look at it clearly, because every conversation about diversification is easier to have when nothing is on fire.

The useful ask, which is smaller than the alarm

I am not proposing that anybody shrink a hospital. That would be idiotic. The growth is the good part.

What I would ask for is much duller and much more achievable.

A district this concentrated should publish its supplier geography and its hiring geography, annually, in public.

Where do the contracts go. What share of the spend stays inside Philadelphia. Which zip codes do the 85,000 jobs actually go home to at night. How much of the food, the laundry, the construction, the IT and the security is bought from firms in this city rather than from national vendors.

Because here is the thing about concentration. If half a district’s jobs sit with four institutions, then the way you spread the base is not by conjuring a fifth institution. It is by making sure the money those four already spend circulates through as many Philadelphia firms and Philadelphia households as possible.

That is a purchasing decision long before it is a zoning one. It is the same argument as anchor procurement, which this city already has an apparatus for, and it is the mechanism Preston used when it decided its institutional spending was a policy lever rather than an accounting entry.

And you cannot manage what you cannot see. Right now nobody outside those procurement offices can tell you where the money goes, which means nobody can tell whether it is getting better or worse. The city’s commerce department publishes some of this. The institutions could publish the rest.

One report a year. No legislation, no new spending, no lawyers. And I would expect the first one to be encouraging rather than damning, which is another reason to publish it: institutions doing better than people assume have the most to gain from showing their working.

What I actually want

I want us to be able to hold two things at once, because both are true.

University City is the best economic development story Philadelphia has told in thirty years.

And half of its payroll depends on four organisations and a federal funding line.

Celebrating the first while never saying the second out loud is not optimism. It is just an unexamined position, and unexamined positions are the ones that surprise you.