The District has reached long elusive agreements for hospitals to replace the troubled United Medical Center and Howard University facilities, changes that have the potential to transform health-care access in heavily African American parts of the city.

D.C. Mayor Muriel E. Bowser (D) said the operators of George Washington University Hospital will run a new hospital in Southeast Washington scheduled to open in fall 2024.

The $375 million deal, which must be approved by the D.C. Council, would include new ­urgent-care clinics east of the Anacostia River, an area home to some of the District’s poorest and sickest residents.

The mayor also said the District would offer nearly $300 million to help Howard University build a new hospital campus, long sought by the nation’s historical training ground for black doctors.

Although the developments are not directly related to the coronavirus pandemic, city officials say agreements for the first new hospitals in the city in decades are a way to achieve the mayor’s vision for targeting health, economic and racial disparities.

“Generations of racism and discrimination have put thousands of black Washingtonians at a major health disadvantage,” Bowser said at a news conference on Thursday. “We also know that today our hospitals are not entirely evenly distributed across our city, with most of our health-care centers concentrated in Northwest Washington.”

D.C. residents who have succumbed to covid-19, the disease caused by the novel coronavirus, overwhelmingly have been black, which officials attribute to African Americans disproportionately having other medical conditions such as asthma and hypertension that can increase the risk of dying of covid-19.

The hospital agreements come after a number of disruptions to health care in the city’s eastern sector.

Providence Hospital in Northeast Washington shut down last spring after more than 150 years in operation, while the D.C. Council voted last year to close the public United Medical Center by 2023. D.C. General, a former public hospital in Southeast Washington, shut down in the early 2000s and was demolished in 2018.

Officials for years sought a ­private-sector partner for the public hospital’s successor, United Medical Center, which struggled to stay financially stable and required city bailouts.

Pressure grew in 2017 after The Washington Post reported about lapses in care at the facility, including the deaths of nursing home and obstetric patients under questionable circumstances. The council in late 2017 ousted a management company led by Bowser campaign donors that had been given a contract to operate the hospital.

Bowser then tapped George Washington University Hospital as a partner to replace United Medical Center, but negotiations stalled at various points.

Under the new agreement, George Washington University and its partner, Universal Health Services, would operate the new hospital as part of the same network as the Foggy Bottom hospital.

The facility in Southeast Washington would have 136 beds — with the ability to add 60 more — down from more than 200 available at United Medical Center.

It would operate as a Level III trauma center instead of the highest Level I, even though the hospital would serve some of the city’s most violent neighborhoods. City officials said the hospital would still be able to stabilize gunshot victims and others before they are transferred elsewhere for advanced care.

But the new facility would also offer services such as cancer care and an obstetrics ward, which was permanently shut down at United Medical Center three years ago.

The city would cover the bulk of the construction and capital costs, and offer up to $25 million to cover operating expenses for the first 10 years. Universal Health Services would pay $75 million for other costs, such as building new urgent-care clinics and a medical records system.

City Administrator Rashad M. Young said details of the agreement would be presented to the council in about two months.

Council member Vincent C. Gray (D-Ward 7), who chairs the Health Committee, said he was satisfied with the mayor’s projected timeline for opening the new hospital, even though it comes later than he would like.

“I wish the ribbon-cutting were going to be taking place at the end of 2022. But we want this done right,” said Gray, who has championed expanding health-care options east of the Anacostia River throughout his political career. “It’s not just the hospital. . . . It’s really the kind of system that I have wanted to see us do for people who live on the east end of the city.”

Lawmakers in 2018 wanted the new hospital to honor union contracts and employ health-care workers from United Medical Center, which prompted George Washington University to threaten to pull out of the deal.

D.C. officials said the new agreement does not have explicit provisions requiring the new hospital to hire staff from United Medical Center, but they said they instructed hospital operators not to interfere with labor-organizing efforts.

“This is not a successor hospital or a sort of UMC 2.0,” Young said. “But we want to have the highest-quality employees and best employees to be able to service this hospital, and we absolutely want to start by working with the current set of employees we have at United Medical Center.”

Wala Blegay of the D.C. Nurses Association said the lack of any guarantee of new jobs at the Southeast hospital for UMC ­nurses is troubling.

“It doesn’t look like there’s any protection of the workers,” Blegay said.

United Medical Center will not close until the new hospital is ready to open, city officials said.

While negotiating the 2018 hospital deal, the city also drew objections from Howard University, which feared competition from a new facility and wanted medical students and doctors to be able to practice there. Those concerns were largely rendered moot after Adventist HealthCare took over operations at Howard in February.

That agreement was seen as a first step in a potential acquisition and replacement of the historical hospital on Georgia Avenue in Northwest Washington. Wayne A.I. Frederick, the university president, said in February that hospitals of Howard’s size “just cannot survive” without the help of a larger health system.

Howard officials are looking to partner with Adventist to build a new 225-bed teaching hospital by 2025 on university grounds.

In a statement released by the mayor’s office, Frederick said the project also has national implications “because of Howard’s role as the primary pipeline of African American healthcare professionals.”

The D.C. government wants to support the expansion by providing $225 million in tax abatements, along with $26 million over six years to help Howard establish specialized centers and an additional $25 million for capital expenses, Young said.

That support must be approved by the council as part of an upcoming budget cycle where lawmakers face projected revenue declines of $800 million related to the coronavirus pandemic.

Young said the mayor’s administration had to make “difficult choices” to preserve hospital funding.

“While we have an incredibly difficult challenge with us with this budget, we cannot afford to do anything different but to make sure our residents and communities have what they need for health services and health care,” he said.

Peter Jamison contributed to this report.