Health Disparities in New York City, Adam Karpati, M.D., M.P.H., Bonnie Kerker, Ph.D., Farzad Mostashari, M.D., et al., The Commonwealth Fund, July 2004
New York City's Health Department has, throughout its history, paid special attention to improving the health of the City's most vulnerable residents. From the late 1800s, when the Department developed sanitation programs to improve living conditions in tenement neighborhoods, to the early 1900s, when public health physicians were dispatched door-to-door in poor areas of the City, to the 1990s, when new programs were developed to fight tuberculosis and HIV/AIDS, the Health Department has recognized that social and economic factors are inextricably linked to health.
While great gains have occurred in improving overall health and reducing health disparities, the persistence of racial, ethnic, economic, or other social inequalities in health is unacceptable. Eliminating health inequalities must involve investment on four fronts: improving access to and the quality of preventive health care, promoting healthy life choices, creating social and physical environments supportive of healthy living, and reducing the burden of poverty and other social disadvantage. Reaching these goals requires a broad and detailed understanding of which groups are most vulnerable, the patterns of illnesses and risk factors among these groups, and how disparities change over time. We hope this report is useful to all our partners in this effort.