AIDS, TUBERCULOSIS, VIOLENT CRIME, AND LOW-BIRTH-WEIGHT IN 8 US METROPOLITAN-AREAS - PUBLIC-POLICY, STOCHASTIC RESONANCE, AND THE REGIONAL DIFFUSION OF INNER-CITY MARKERS

In previous papers of this series we have shown how public policies of 'planned shrinkage' triggered contagious urban decay and massive dest ruction of low-income housing within poor minority communities of New York City. The resulting social disintegration exacerbated epidemics o f infectious disease, including AIDS (acquired immunodeficiency syndro me) and TB (tuberculosis), and such behavioral pathologies as substanc e abuse and violence. We extend this work on the neighborhood-level 's ynergism of plagues' to the metropolitan regional scale for eight US u rban areas containing more than 54 million people. Several have centra l cities, which, like New York, suffer from what Skogan characterized as a relentless 'hollowing out' of poor communities. We find AIDS, TB, violent crime, and low birthweight near the worst affected cities to be markers of an accelerating regional synergism of plagues, a diffusi ng system of interacting and self-reinforcing pathology fueled by, but spreading far beyond, the worst affected inner-city areas. We uncover an apparent threshold condition for regional spread of this synergism , triggered through a stochastic resonance with public policies affect ing the distribution of catastrophic events within central-city minori ty neighborhoods. Control of AIDS, violence, multiple-drug-resistant T B, and other pathologies in the United States will require regional re form and the sharing both of resources and of authority across present ly ungovernable systems of fragmented administrative units: the urban centers of the late 19th-century USA, by the late 20th, are vast, tigh tly coupled urban and/or suburban complexes producing a regional 'line ar chain' condition for both public health and public order in which t he welfare of the whole is increasingly determined by the sickness of the least strong.