NEW-YORK-CITY TUBERCULOSIS-CONTROL EFFORTS - THE HISTORICAL LIMITATIONS OF THE WAR ON CONSUMPTION

New York City began America's first campaign to control tuberculosis i n 1893, and the disease declined until the 1970s. Throughout the 20th century, New York relied on three control strategies: screening, super vised therapy, and detention of noncompliant persons. Officials consis tently identified the persistent foci of tuberculosis to be minorities and the poor, and they concentrated efforts among these populations. Recently, however, in the setting of rising human immunodeficiency vir us infection and homelessness, tuberculosis-including multidrug-resist ant strains-has returned to New York with a vengeance. Tuberculosis co ntrol in the city has been limited by two problems that hamper many pu blic health programs: (1) antituberculosis measures, while appropriate ly targeting the poor, have been inconsistently funded and poorly coor dinated; and (2) efforts have emphasized detection and treatment of in dividual cases rather than improvement of underlying social conditions . Renewed efforts by New York and other cities must address these limi tations.