       Document 0162
 DOCN  M9620162
 TI    U.S. apartheid and the spread of AIDS to the suburbs: a multi-city
       analysis of the political economy of spatial epidemic threshold.
 DT    9602
 AU    Wallace R; Wallace D; Institute for Health, Health Care Policy and Aging
       Research,; Rutgers University, New Brunswick, NJ, USA.
 SO    Soc Sci Med. 1995 Aug;41(3):333-45. Unique Identifier : AIDSLINE
       MED/96083020
 AB    We compare mechanisms of AIDS diffusion at the county level from five
       U.S. central city epicenters into their associated metropolitan regions.
       Four of the five show an expanding 'hollowed out' center of physically
       and socially devastated, politically and economically abandoned high
       density minority neighborhoods, surrounded by rings of relatively
       affluent majority suburban populations. From these centers AIDS diffuses
       into the suburbs as a single, spatially extended disease ecosystem. The
       exception, San Francisco, has not yet experienced the 'hollowing out'
       process and is, we conclude, a major AIDS epicenter markedly less
       coupled to its suburbs because of that fact. This may constitute one of
       the few empirical observations of spatial threshold in epidemiology. Our
       empirical results contradict the conclusions of a recent National
       Research Council report that AIDS will be largely confined within
       marginalized urban populations. In reality U.S. urban apartheid,
       particularly its continuing disruption of minority social structures,
       has markedly accelerated the diffusion of AIDS into suburban
       communities. A widespread program of reform, which rebuilds minority
       physical and social community structures within both city and suburb, is
       an essential, but largely unrecognized, component to any serious
       strategy for the control of AIDS in the United States.
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*TRANSMISSION
       Cross-Sectional Studies  Disease Outbreaks/*STATISTICS & NUMER DATA
       Human  Incidence  Minority Groups/*STATISTICS & NUMER DATA  *Politics
       Population Density  Poverty/STATISTICS & NUMER DATA  *Race Relations
       Risk Factors  Socioeconomic Factors  Suburban Population/*STATISTICS &
       NUMER DATA  United States/EPIDEMIOLOGY  Urban Population/*STATISTICS &
       NUMER DATA  Urban Renewal  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

