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The impact of New York City's 1975 fiscal crisis on the tuberculosis, HIV, and homicide syndemic

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  • Freudenberg, N.
  • Fahs, M.
  • Galea, S.
  • Greenberg, A.

Abstract

In 1975, New York City experienced a fiscal crisis rooted in long-term political and economic changes in the city. Budget and policy decisions designed to alleviate this fiscal crisis contributed to the subsequent epidemics of tuberculosis, human immunodeficiency virus (HIV) infection, and homicide in New York City. Because these conditions share underlying social determinants, we consider them a syndemic, i.e., all 3 combined to create an excess disease burden on the population. Cuts in services; the dismantling of health, public safety, and social service infrastructures; and the deterioration of living conditions for vulnerable populations contributed to the amplification of these health conditions over 2 decades. We estimate that the costs incurred in controlling these epidemics exceeded $59 billion (in 2004 dollars); in contrast, the overall budgetary saving during the fiscal crisis was $10 billion. This history has implications for public health professionals who must respond to current perceptions of local fiscal crises.

Suggested Citation

  • Freudenberg, N. & Fahs, M. & Galea, S. & Greenberg, A., 2006. "The impact of New York City's 1975 fiscal crisis on the tuberculosis, HIV, and homicide syndemic," American Journal of Public Health, American Public Health Association, vol. 96(3), pages 424-434.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2005.063511_4
    DOI: 10.2105/AJPH.2005.063511
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    Cited by:

    1. Littleton, Judith & Park, Julie, 2009. "Tuberculosis and syndemics: Implications for Pacific health in New Zealand," Social Science & Medicine, Elsevier, vol. 69(11), pages 1674-1680, December.
    2. Marc Suhrcke & David Stuckler & Jonathan E Suk & Monica Desai & Michaela Senek & Martin McKee & Svetla Tsolova & Sanjay Basu & Ibrahim Abubakar & Paul Hunter & Boika Rechel & Jan C Semenza, 2011. "The Impact of Economic Crises on Communicable Disease Transmission and Control: A Systematic Review of the Evidence," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-12, June.
    3. Singer, Merrill C. & Erickson, Pamela I. & Badiane, Louise & Diaz, Rosemary & Ortiz, Dugeidy & Abraham, Traci & Nicolaysen, Anna Marie, 2006. "Syndemics, sex and the city: Understanding sexually transmitted diseases in social and cultural context," Social Science & Medicine, Elsevier, vol. 63(8), pages 2010-2021, October.
    4. Dimitrios Paraskevis & Georgios Nikolopoulos & Anastasios Fotiou & Chrissa Tsiara & Dimitra Paraskeva & Vana Sypsa & Marios Lazanas & Panagiotis Gargalianos & Mina Psichogiou & Athanasios Skoutelis & , 2013. "Economic Recession and Emergence of an HIV-1 Outbreak among Drug Injectors in Athens Metropolitan Area: A Longitudinal Study," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-10, November.
    5. Himmelgreen, David & Romero-Daza, Nancy & Heuer, Jacquelyn & Lucas, William & Salinas-Miranda, Abraham A. & Stoddard, Theresa, 2022. "Using syndemic theory to understand food insecurity and diet-related chronic diseases," Social Science & Medicine, Elsevier, vol. 295(C).
    6. Bordo, Michael D. & Duca, John V., 2023. "How the new fed municipal bond facility capped municipal-treasury yield spreads in the Covid-19 recession," Journal of the Japanese and International Economies, Elsevier, vol. 67(C).

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