York City Health Research Articles

Commentary

Click to increase image sizeClick to decrease image size Additional informationNotes on contributorsWilliam SweetWilliam Sweet is a staff writer with Editorial Research Reports, Congressional Quarterly.Katherine D. SeelmanKatherine D. Seelman, a Ph.D. candidate in political science at New York University, is an energy resource consultant for the National Council of Churches. She is a former fellow of Resources for the Future and the National Wildlife Federation.Leonard R. SolonLeonard R. Solon, a health physicist, is Director of the New York City Health Department's Bureau for Radiation Control, and adjunct associate professor in the Department of Environmental Medicine at New York University Medical Center.

ASSOCIATION BETWEEN HEPATOBILIARY CANCER AND TYPHOID CARRIER STATE

A case-control study of deceased typhoid carriers registered by the New York City Health Department between 1922 and 1975 was carried out to test for an association between the typhoid-carrier state and death due to hepatobiliary cancer. 471 carriers were matched with 942 controls for sex, age at death, year of death, borough in which the carrier died, and where they were born. The results show that chronic typhoid carriers die of hepatobiliary cancer six times more often than the matched controls and that this difference is significant (P<0·001) by simple χ 2 test and by the Mantel-Haenszel method of χ 2 for matched triples. Possible mechanisms for this association are discussed.

Should Premarital Syphilis Serologies Continue to be Mandated by Law?

ONE OF the screening tests that has been used to measure the extent of communicable syphilis in a population is the premarital syphilis serology that is mandated by law in most states. Approximately 4 million serologies are performed annually in the United States for this purpose. 1 In New York City, according to the Office of the City Clerk, 57,994 marriage licenses were issued in 1976. Therefore, about 116,000 premarital syphilis tests were performed. For some time, the Bureau of Venereal Disease Control of the New York City Health Department has been exploring whether this screening test has a meaningful impact on syphilis control. For a screening program to be considered cost-effective, the disease screened should be of serious or catastrophic consequence and easily preventable or treatable, and the cost of the screening test itself should be negligible. Screening for hypertension and glaucoma fulfills these requirements well. On the other

Age patterns of childbearing: a canonical analysis.

A cross-sectional study of maternal age-specific birthrates was conducted in an attempt to gain insight into age patterns of childbearing. The age specific fertility rates were considered as the dependent variable set. These 6 variables consisted of 1970 live births to women in the age groups 15-19, 20-24, 25-29, 30-34, 35-39, and 40-44. The age-specific fertility rates were calculated for each of the 338 New York City health areas that are the sampling units. The canonical analysis used is a multivariate method of exploring these patterns which provides a means for dealing with some of the difficult analytical problems encountered. The relationships of fertility patterns with sets of variables reflecting housing, income and occupation, education and labor force participation, marital patterns, and ethnicity are explored for New York City neighborhoods. 3 dimensions of childbearing emerged with high consistency across the variable sets - roughly describable as early, middle and late fertility. The 1st pattern - high early fertility and particularly teen-age childbearing - is identified with the poorest areas of the city. The income, occupation, education and unemployment figures in these areas are consistent with a minimal preceived penalty for early childbearing. The 2nd dimension - birthrates of women ages 25-34 - identifies another distinctive group of areas. Many low income women at this age continue to bear children at moderate rates; middle income women bear the children they postponed having in the earlier years. The late childbearing group seems best understood as attributable to religious and ethnically related differences among areas. The 1st dimension is the most important for the perspective of the impact on population growth.

Should Premarital Syphilis Serologies Continue To Be Mandated by Law?

ONE OF the screening tests that has been used to measure the extent of communicable syphilis in a population is the premarital syphilis serology that is mandated by law in most states. Approximately 4 million serologies are performed annually in the United States for this purpose.¹In New York City, according to the Office of the City Clerk, 57,994 marriage licenses were issued in 1976. Therefore, about 116,000 premarital syphilis tests were performed. For some time, the Bureau of Venereal Disease Control of the New York City Health Department has been exploring whether this screening test has a meaningful impact on syphilis control. For a screening program to be considered cost-effective, the disease screened should be of serious or catastrophic consequence and easily preventable or treatable, and the cost of the screening test itself should be negligible. Screening for hypertension and glaucoma fulfills these requirements well. On the other

Barriers to the Delivery of Mental Health Services: The New York City Experience

The author discusses some of the barriers encountered in attempting to transform New York City's fragmented mental health services into a comprehensive, nondiscriminatory, and accessible system. Among the barriers he identifies are the belief that more money alone will solve the problem; the uneven distribution of funds among the boroughs of the city and the resistance of existing agencies to redistribution; and the way in which reimbursement patterns shape the kinds of services provided. He believes the single most effective stimulus to the development of an integrated system of care would be a requirement that eligibility for reimbursement under Medicaid be based on a facility's participation in a comprehensive system of care. He emphasizes the need to remove social, rehabilitation, and other services from under the mental health umbrella and to obtain other sources of funding for them; the need for local governance of services; and the need to provide work opportunities for the more seriously disabled.

Administrative Incongruence and Authority Conflict in Four Abortion Clinics

Warren M. Hem is a physician who is Director of the Boulder Abortion Clinic in Boulder, Colorado. Marlene Gold and AnnuGail Oakes are the Director of Counseling and Head Nurse, respectively, a t Boulder Abortion Clinic. w HEN THE REFORM New York abortion law was passed and came into effect in July, 1970, one of the most extraordinary upheavals in medical practice occurred in U.S. history. An operation which had been illegal, stigmatized, and clandestinely performed under the most sordid circumstances suddenly became legal and accessible, at least in New York City. Most traditional medical practitioners and hospitals in the state of New York were unprepared to cope with the enormous demand for services. The New York City Health Department made strenuous efforts to prepare hospitals in that metropolis, but officials had no way of knowing the impact of the new law. Thousands of women streamed into New York City from throughout the United States and Western Hemisphere. One of the results was the emergence of the free-standing abortion clinic devoted entirely to the performance of this procedure. As laws in Washington, D.C. and California changed, more clinics sprang up in these areas. The 1973 decision of the U.S. Supreme Court resulted in the establishment of clinics in most of the major cities (Hausknecht 1973 :985; Burnhill 1975:431).

A Wind in Africa: A Story of Modern Medicine in Mali

A Wind in Africa has become a controversial book. Is its author egoistic, racist, and anti-African? By describing America's humanitarian measles control and smallpox eradication program, is the book intended as a counterweight to our unsavory involvement in Viet Nam? Well, from the viewpoint of a physician who spent two years in West Africa (the locale of this book), the answer to all these questions is a qualified no. Dr Imperato, then head of the Agency for International Development measles and smallpox program, now with the New York City Health Department, has written a harsh but accurate and entertaining view of the life and times of an American physician in Mali. His descriptions of American embassy wives and expatriots of all nationalities and of providing bush medical care, bargaining for art work, traveling the roads, and dealing with African servants have the unmistakable ring of authenticity. Dr Imperato describes the

Writing Public Health History: The Need for a Social Scaffolding

John Duffy's two-volume compendium of public health events in the nation's largest city and Stuart Galishoff's account of turn-of-the-century Newark, New Jersey, offer examples of some of the work now appearing in the field of American public health history. Both concentrate on the problems of a single city. Both also focus primarily on departments of public health and their efforts at identifying and solving health problems rather than on efforts of the private sector. They record changes over time in local governments' perceptions of what constituted health problems, in how governments took responsibility for alleviating health problems, and in what solutions were offered. The books differ considerably on the time period covered and on the amount of detail provided, if for no other reason than as a function of their length. Duffy offers us a study of encyclopedic proportions. Certainly the most comprehensive and detailed history of public health in any American city now available, or likely ever to be available, the two volumes represent an enormous amount of time and effort. Beginning with the Dutch settlement and following through to the 1960s, these books present a chronicle of New York City's health conditions and the city's efforts to control them. Responding to one disaster after another, New York coped with its health-related problems. Duffy tells us of them all and of the city's attempts at solving them, dividing his story in the year 1866, when a

REIMBURSEMENT AS TAXATION

1Director, Hospital Administrative Services New York City Health and Hospitals Corp. (10010) 2Assistant Director of Finance Methodist Hospital, St Louis Park, Minn. 55426

Letter: Home care for the aged.

Comments and Correction1 July 1975Home Care for the AgedDAVID MUMFORD, M.D., IRENE BOGDAN, R.N., ELIZABETH HOYT, M.D., ROSA RODRIGUEZ, M.D.DAVID MUMFORD, M.D.Search for more papers by this author, IRENE BOGDAN, R.N.Search for more papers by this author, ELIZABETH HOYT, M.D.Search for more papers by this author, ROSA RODRIGUEZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-83-1-125 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Doctor Brickner and his team deserve congratulations for organizing the program described in the January 1975 issue of the Annals. He is incorrect, however, in his statement on page 5 that other "programs either lack a full range of professional health services, limit their patients to those with particular health problems, or have other restrictions." In addition, on page 6, he claims to be unaware of programs designed to seek out and deliver a full range of professional health services to homebound, socially isolated older people hidden in the community.For the benefit of Dr. Brickner and...Reference1. SOMERSBRYANT AN: Home care: much needed, much neglected. Ann Intern Med 82:111-112, 1975 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: DAVID MUMFORD, M.D.; IRENE BOGDAN, R.N.; ELIZABETH HOYT, M.D.; ROSA RODRIGUEZ, M.D.Affiliations: Organization of Home Health Agencies New York City Health and Hospitals Corporation Coney Island Hospital Brooklyn, New York 11235 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1975Volume 83, Issue 1Page: 125-126KeywordsMedical services ePublished: 1 December 2008 Issue Published: 1 July 1975 PDF downloadLoading ...

Cost analysis of regionalized versus decentralized abortion programs.

A detailed cost analysis has examined the fiscal benefits from regionalizing abortion services. Benefits were found to be virtually insignificant and not to outweigh problems of program visibility and patient accessibility incurred in such regionalization. The study covered 14 hospitals' abortion programs providing both first trimester and second trimester abortions and analyzed each program's total cost and six component costs for first trimester and second trimester procedures separately. The results of this study were employed for program planning by the New York City Health and Hospitals Corporation in its operation of abortion services.

The Administration of Chiropractic in the New York City Medicaid Program

The New York State Health Department required the New York City Health Department to include chiropractic in its Medicaid program. Seventeen additional states have also passed legislation to incorporate chiropractic in Medicaid. This report is a descriptive analysis of administrative controls governing the pattern and utilization of chiropractic services in the New York City Medicaid program. These controls include prior authorization of chiropractic treatment plans, post-treatment evaluation through pre-audit of invoices, spot checking of patients, and visitations to offices of chiropractic providers. Court decisions are cited which upheld the City Health Department in its modification of State regulations for chiropractic. By December 1970, 33 per cent of New York City's chiropractors were participating in the program whose vendor expenditure totaled $1,082,712 for 1970. Statistical tables are presented from Medical Participation Schedules.

Hospital Cost and Use Control via New York City Health Department

Hospital Cost and Use Control via New York City Health Department

The Poverty of the State

State and local governments entered the 1970s in a state of deep crisis. All states made or considered welfare cuts in 1971. At least 20 state welfare departments began 1971 with deficits. Twenty-four state Medicaid programs were in the red, and many are denying health services to the poor. San Francisco county welfare recipients were cut back to $88 per month. Twenty-six city recreation halls in Cleveland were closed, and 85 percent of recreation department employees were removed from the payroll. Mayor Lindsay laid off thousands of New York City employees, crippling welfare, health, lead-poisoning, and rat-control programs. In California, Connecticut, and other states, freezes went into effect on state hiring. In California, state employees were denied cost-of-living wage increases.This article can also be found at the Monthly Review website, where most recent articles are published in full.Click here to purchase a PDF version of this article at the Monthly Review website.

Medicaid practitioner abuses and excuses vs. counterstrategy of the New York City Health Department.

Medicaid practitioner abuses and excuses vs. counterstrategy of the New York City Health Department.

Publicly funded podiatry: the New York City Medicaid experience.

The New York City Podiatry program is discussed, with a brief review of the podiatry program of the New York City Department of Welfare prior to the inception of Medicaid. Emphasis is given to the functions of the New York City Health Department in setting standards of care, monitoring, and enforcement of high quality podiatric care. Notwithstanding the complexities and difficulties built into the Medicaid programs through legislation for efficient and effective administration, podiatry through the Medicaid program has made a significant contribution to the well-being of thousands of persons for whom podiatric care previously was inaccessible. Furthermore, the standard setting and audit responsibilities and functions of the Health Department Medicaid administration portends a relevant impact on improving podiatric care services in New York City for all patients.

Continuance of family planning in a health department clinic

Low income recipients of family planning services from a New York City Health Department Clinic were found to have high rates of clinic discontinuance. Using a life table technique, 23 per cent were found to have discontinued clinic attendance in 3 months, 35 per cent in 6 months and 42 per cent in one year. Users of oral contraceptives had much better records of clinic continuance than users of foam and diaphragm. The high mobility of the poor, side effects of the pill, factors relating to the clinic's convenience and accessibility, and factors relating to the individual patient are discussed as causes of clinic discontinuance.

New York City's health corporation.

New York City's health corporation.

The biochemistry of B 12-mediated reactions in man

From the New York University School of Medicine. 550 First Avenue, New York. New York 10016. This work was suooorted by a U. S. Public Health Service Train& Grant-No. AM 5262 and Research Grant No. CA 06657. Requests for reprints should be addressed to Dr. R. Silber. t Career Investigator of the New York City Health Research Council. $ U. S. Public Health Service Postdoctoral Fellow. The report by Minot and Murphy [l], in 1926, that pernicious anemia could be controlled by the ingestion of large quantities of liver stimulated many studies aimed at identification of the factor or factors responsible for this therapeutic effect. These investigations led in 1948 to the crystallization of vitamin B,, (cyanocobalamin) from liver [2,3]. This substance in microgram amounts produced hematologic responses in patients with pernicious anemia. The very low concentration of vitamin BIz-active derivatives in liver may explain why twenty-two years elapsed until this compound was isolated, and another two decades were required to establish the present, still incomplete, concepts of its function. We will attempt to summarize current knowledge of the biochemistry of vitamin B,,, with special emphasis on the reactions described in man. Several detailed reviews on the chemistry and biochemistry of vitamin B,, have recently appeared [4-71.