Book Links National Order and Public Health to Poor Inner-City Neighborhoods

How inner-city health problems affect metropolitan regions and the nation

From 1996 to 2000, Rodrick Wallace, PhD, and Deborah Wallace, PhD, conducted research and published a book addressing the social, economic and political decay that underlies the rise of AIDS, tuberculosis (TB), drug abuse and violent crime.

The project was part of the Robert Wood Johnson Foundation's (RWJF) Investigator Awards in Health Policy Research program.

Key Results and Findings:

  • A Plague on Your Houses: How New York Was Burned Down and Public Health Crumbled was published by Verso Publications in 1998. The book describes three interconnected phenomena:
    • The "hollowing out" of the inner city in the 1970s—in this case the South Bronx and other New York neighborhoods—due to the city's withdrawal of services and the subsequent epidemic of fires and destruction of whole neighborhoods.
    • The rapid incubation of pathologies such as AIDS, TB, drug abuse and crime within and around the destroyed core, fueled by massive physical and social disruption and powerful adaptive behaviors.
    • The spread of the same pathologies along two pathways: commuter routes to the suburbs and interstate travel from large to smaller metropolitan areas.
  • The authors conclude that:
    • The keystone populations that determine the national public health and public order are poor inner-city neighborhoods.
    • These relatively small neighborhoods communicate over long distances between cities, and pathologies such as TB, AIDS, substance abuse and violent crime incubate and spread in susceptible poor neighborhoods and diffuse out to entire metropolitan regions.
    • Three-quarters of the U.S. population lives in metro regions and thus is subject to these contagious processes.
    • Rapid air transport has created a global village wherein diseases incubate and spread between large metropolitan areas and then hopscotch over to smaller cities, in which the process begins anew.