The coming crisis of public health in the suburbs

A process of urban decay, coupled with forced displacement and behavioral problems, affecting an increasing number of neighborhoods in large U.S. cities. The resulting social disintegration has intensified a nexus of deviant behaviors and conditions, including substance abuse, that are related to transmission of HIV and resurgence of other contagious diseases. These diseases will diffuse, or are already diffusing, along the transportation hierarchy from larger into smaller central cities, and radially from the central cities into the surrounding areas. A widespread program of urban reform is a critical precondition for the control of contagious disease in the United States. It also is important for housing, social services, housing-related public services, and public health across urban and suburban jurisdictions.