Researchers Document Social and Health Issues Affecting the 100 Largest U.S. Cities and Their Suburbs

Dennis P. Andrulis, MPH, PhD, and researchers at SUNY Downstate Medical Center in Brooklyn, N.Y., produced a series of five reports documenting the health and social progress and challenges of the nation's 100 largest cities and their suburbs between 1990 and 2000. The final report, on urban and suburban hospital trends, included data from 1996, 1999 and 2002. The reports and accompanying tables are available on the medical center's website.

Key Findings

  • The project director highlighted the following findings from the reports:

    • On average, the cities and their suburbs met, or made progress towards meeting, Healthy People 2000 goals (set by a coalition of national health agencies) for reducing infant mortality, AIDS, tuberculosis, syphilis and homicide between 1990 and 1999 or 2000. No cities and only two suburbs met goals for reducing low birth weight.
    • The most consistent, and in many cases, strongest improvements in measures of health and social status occurred among non-Hispanic African-American residents in cities and suburbs.
    • Substantial gaps in health and social status remain between whites—who are better off—and other racial and ethnic groups, including Hispanics, African Americans and Asians.
    • People in poor suburbs make up more than two-fifths of the total population of the suburbs, but use only about one-fifth of hospital care in the suburbs. These results focus attention on the extent to which residents of poor suburbs—disproportionately Hispanic and foreign born and more likely to lack health insurance relative to those in wealthy suburbs—may face major problems in availability and access to acute and specialty hospital care in their areas.
    • Findings on the overall distribution of hospital services indicate, for the most part, that people in poor cities do not appear to face the same problems around general availability of acute and specialty hospital care as do those in poor suburbs. This may reflect urban areas' longer history of providing care to diverse populations or greater concentrations of individuals within smaller geographic localities. However, the report did not address specific issues around access within these cities.