This report is a selective analysis and assessment of quantitative data and field studies that reflect the economic role of the Academic Health Center (AHC) in the urban economy and in neighborhood revitalization. It describes the effect of a variety of cooperative efforts between local community organizations and AHCs, which usually include a medical school and a teaching hospital. The first part of the report describes revenue-creating activities of the Academic Health Center as a purchaser of durable and nondurable goods from a large number of industries, including construction, pharmaceuticals, and hospital supplies, and from local producers of commodities and services such as utilities, laundry, and food. This macroeconomic analysis is derived from a sample of AHCs in nine metropolitan centers (Baltimore, Boston, Chicago, Denver, Houston, Los Angeles, New York, Philadelphia, and St. Louis). The second part examines the role of eight urban AHCs in collaborative neighborhood development efforts, primarily initiated in the 1960s and located in Boston, New York, Baltimore, Pittsburgh, Indianapolis, St. Louis, Los Angeles, and Irvine (California). A concluding section examines the likely directions of such cooperative efforts in the decades ahead. Seven tables display supporting data, and an appendix discusses the concept of "export income" in the context of the urban economy. (JDD)