New Disease, Old Problems: Urban Ecologies of Health and the Roots of Pediatric AIDS in the United States

Jason Chernesky, University of Pennsylvania

The HIV-AIDS epidemic in the United States disproportionally affected children and families of color. Most of the cases of pediatric AIDS in the U.S. were relegated to specific cities, and was the result of particular environmental changes in those cities after World War II. Those changes included concentrated poverty, high rates of unemployment, social dislocation, and easy access to, and use of, drugs like heroin. These factors were inextricably linked to large, urban infrastructural changes such as new highway construction, planned shrinkage, and the building of new institutions like academic medical centers. Using the Newark-New York City Metro area as my lens, my paper explores how the shifting urban environment in the U.S. helped HIV find an ecological niche in certain urban landscapes during the late 1970s and early 1980s. Drawing on published public health studies, census data, social science research about intravenous drug use, scientific studies about the disease ecology of HIV-AIDS, and archival sources, I reveal how pediatric AIDS was a problem in some cities and not others – even when the conditions on the ground were similar across urban environments. Here, the types of social and economic inequalities that disproportionately placed some Americans at higher risk of exposure to harmful toxic waste or industrial effluence, also created the unequal exposure to HIV-AIDS.

No extended abstract or paper available

 Presented in Session 227. Childhood and the "Healthful" Environment: Disease, Morality, and Reformation