This article explores the factors for conducting administrative reforms in the United States in the area of public health. For detailed consideration, the author selected New York City as an example the largest metropolitan area that faced aggravation of social problems due to the shortcomings in the existing public health system. Rapid increase in the number of resident in the conditions of significant growth of population density led to proliferation of the dangerous infectious diseases, for elimination of which local authorities had to take prompt actions of state regulation, including creation of the new administrative branches. Special attention is given to the treatment of tuberculosis and preventive measures thereof, namely the importance of tracking all new cases. In studying public health system of New York City, the author applied interdisciplinary approach that ensured comprehensive and objective outlook upon the problems of poorest population groups of the city. Comparative-historical method was used juxtapose the situation in New York and typologically similar US metropolises. Chronological method allowed tracing the patterns in evolution of administrative innovations, and assessing them in a single historical perspective. The main conclusion consists in the statement that private medicine appeared to be insufficient due to the drastic changes of social conditions in the densely populated metropolises, as the constantly growing population of poor immigrant neighborhoods was capable of paying for medical services. At the same time, namely the residents of such ghettos were most vulnerable category of population from the standpoint of epidemiology. Taking preventive measures by the municipal authorities, which included mass vaccination and clearing New York streets from dirt and trash, became an effective way to alleviate the situation. The administrative reforms in the city significantly improved the situation, which laid the foundation for sweeping changes in the future.
David Rosner (ed.), Hives of sickness: public health and epidemics in New York City, New Brunswick, NJ, Rutgers University Press for the Museum of the City of New York, 1995, pp. vii, 223, illus., $35.00 (0-8135-2158-0).
