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AJPH First Look, published online ahead of print Jan 31, 2006
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The Impact of New York City’s 1975 Fiscal Crisis on the Tuberculosis, HIV, and Homicide Syndemic

Nicholas Freudenberg, DrPH, Marianne Fahs, PhD, Sandro Galea, MD, DrPH and Andrew Greenberg, MS

Nicholas Freudenberg and Marianne Fahs are with the Program in Urban Public Health, Hunter College, City University of New York, New York, NY. At the time of writing, Sandro Galea was with the Center for Urban Epidemiological Studies, New York Academy of Medicine, New York, NY. Andrew Greenberg is with the PhD Program in Sociology, City University of New York Graduate Center, New York, NY.


Figure 1
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  		FIGURE 1— Incidence of tuberculosis (TB), AIDS, and homicide in New York City (NYC) from 1970 to 2002, and relative timing of the New York City’s financial crisis and federal budget cuts (box).

Note. Data for TB obtained from NYC Department of Health and Mental Hygiene, Bureau of Tuberculosis Control.33 Data for AIDS obtained from HIV Epidemiology Program, New York City Department of Health and Mental Hygiene.34 Data for homicide obtained from Langan and Durose.35

Data for TB, AIDS, and homicide were scaled by 1985 (median year of interval of interest) incidence rate for ease of comparison. Therefore, the y-axis represents the incidence rate for a given year compared with the 1985 incidence rate; a y-axis measure of more than 1 suggests incidence higher than 1985, and a measure of less than 1 suggests lower incidence than 1985.

 

Figure 2
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  		John L. Holloman Jr, MD, president of New York City Health and Hospitals Corporation from 1974 to 1976. In 1976, Holloman said, "I’m going to stay and fight this out. They’re trying to balance the budget on the backs of the poor." A few months later he was fired.

Reprinted with permission from the New York Times, October 21, 1976.

 

Figure 3
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  		Workers at Bellevue Hospital, a New York City public hospital, protesting budget cuts in 1976. They averted one round of cuts by forgoing cost-of-living increases for 2 years, a giveback worth $10 million.

Reprinted with permission from the Bellevue Hospital Archives.

 




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