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This case provides an overview of how community activists persuaded the University of Chicago Medical Center (UCMC) to open a Level 1 trauma center on its Hyde Park campus. Previously, the South Side of Chicago did not have a Level 1 trauma center, forcing residents to travel up to nine miles for trauma care. UCMC had closed its previous Level 1 trauma center in the 1980s after only two years of operation due to financial losses and anticipated that the new trauma center would also lose money. The case explores the tension between the University of Chicago’s responsibilities to its community as an anchor institution and the possibility of a financially unsustainable project. It also examines the broader structural forces taking place within Chicago’s South Side, including disinvestment and structural racism. At the conclusion of the case, students must analyze the socioeconomic, racial, and financial dynamics involved in the decision to open the trauma center and assess whether the benefit to the community will be worth the financial trade-offs involved in the project.