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Gotham Gazette

The Place for New York Policy and politics

Citizens Union

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Paying Attention to Cities

Gotham Gazette

The Place for New York Policy and politics

Citizens Union
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For More on Helping New York's Economy

An $825 Billion First Step By James Parrott
The stimulus package proposed by Congress is key to halting the economy's downward spiral but it will not solve all our problems. Economist James Parrott of the Fiscal Policy Institute looks at what the package would do -- and what more needs to be done.

Using the Crisis to Prevent the Next One By J. Mijin Cha
The current turmoil can help us reduce our dependence n Wall Street and create good "green collar" jobs that help fuel a resurgence of the middle class. The director of campaign research at the Urban Agenda explains how.

Infrastructure Investments that Make Sense By Carter Craft
As big as the stimulus package may be, the country has to invest the money wisely. An urban planner offers some novel ideas for New York projects -- from recycling grease to ferries for freight.

From Gas-Guzzling Cars to Clean Buses By Charles Stone
Simply lending funds to struggling auto companies won't spur economic growth. Instead, an economist suggests, the government should create a voucher program to deploy the resources of the auto companies, spur investment -- and help the environment.

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A Federal Stimulus for City Parks By Anne Schwartz
Advocates hope that President Obama and Congress will recognize that funding parks would not only improve the quality of life and the environment but also spur investment and raise real estate values.

Stimulus Money: The Downturn's Silver Lining? By Graham Beck
The stimulus package could offer more federal funds for transportation projects. The MTA is making its list, but there are sure to be lots of restrictions -- and competition.

Barack Obama's early pronouncements, from creating a White House Office of Urban Policy to promising bold new investments in infrastructure, education and alternative energy, suggest that the new president understands something that many of his recent predecessors clearly did not: what's good for cities is good for America.

New York, the nation's biggest city by population and economic activity, could greatly benefit from a president who is committed to ending years, if not decades, when the federal government all but turned its back on the needs of urban communities. Even before the current economic downturn, the city lacked the resources to adequately address mounting problems of aging public infrastructure, housing shortages, traffic congestion, environmental pollution and growing economic inequality. While these problems can't all be placed at the feet of officials in Washington, the federal government has long underfunded programs that primarily benefit city dwellers. In the last eight years, things got even worse for New York.

Federal support for mass transit stayed roughly flat since the start of the decade, even as ridership in numerous cities - including New York - surged to record levels. The Bush administration drastically reduced funding for public housing, contributing to rent hikes, service cutbacks and a nearly $6 billion backlog in capital work at the New York City Housing Authority, whose buildings are home to more than 400,000 low-income New Yorkers. The administration also underfunded the project-based Section 8 program by nearly $3 billion, dealing a profound blow to one of the nation's most critical affordable housing programs at a time when demand for low-income housing in New York far outstrips supply. And it cut funding for the nation's workforce development system by roughly $2 billion, with New York City's job training and youth employment services taking a disproportionately large hit. Perhaps most galling, New York was consistently shortchanged in homeland security funding.

Washington's disdain for the priorities of cities like New York was not limited to traditional areas of concern to urban advocates. The absence of federal leadership on issues such as immigration, health care, energy policy, scientific research and access to higher education also adversely affected the five boroughs in countless ways.

Reciprocal Relations

New York could use a helping hand from Washington, especially in these tough economic times. While the Bloomberg administration has made progress in several areas, only the federal government can provide the resources and leadership needed to help the city accomplish its housing development goals, expand the transit system or make the city more energy efficient.

But, more than ever, the country also needs New York. In today's global economy, the nation's singular international city is inextricably linked to that of the country.

Obama, himself a lifelong resident of cities, has sent some encouraging signals that he understands this dynamic and plans to free up more resources to strengthen urban areas. But just what should he do to help New York?

A Plan for the City

Last week, the Center for an Urban Future published a report that laid out 51 specific recommendations for what the Obama administration and the 111th Congress could do to help New York.

Our recommendations started with the premise that one of the most critical jobs of the federal government today is keeping New York safe. This means allocating anti-terror funds to localities based on risktheyface rather than politics, moving aggressively to prevent the spread of weapons of mass destruction, passing legislation to get illegal guns off the street and enacting bills already proposed in Congress that would pay for thousands of additional cops in New York and other cities.

Another critical priority is helping New York and other cities maintain and upgrade their existing transportation infrastructure. Specifically, the Obama administration should dramatically increase the share of federal transportation funding that goes to mass transit, fund Amtrak at a level that enables vast improvement to intercity rail service, accelerate plans to develop and implement a more technologically advanced air traffic control system that would reduce flight delays and include more ferry projects in federal transportation infrastructure packages.

On economic development, Obama could help New York by increasing federal investment in microlending programs as a way to support the smallest entrepreneurs. A renewed federal commitment to scientific research would also go a long way given that New York is home to one of the world's largest concentrations of academic research institutions.

On housing, the president should restore funding for public housing, meet federal commitments to the project-based Section 8 program and help spur the creation of new supportive housing for the mentally ill.

There are many other things the new president could do, from taking immediate steps to ensure that the 2010 Census does not undercount New York and creating a large-scale nationwide effort to retrofit buildings to be more energy efficient, to expanding the federal Earned Income Tax Credit and streamlining the visa process to make it easier for artists to enter the country.

Others will undoubtedly have different ideas. The important thing is for New Yorkers to realize that having a friendlier audience in Washington is only the first step. Rather than simply waiting for Obama-or Adolfo Carrion, the Bronx borough president, who will reportedly head the new Office of Urban Policy-to set an agenda, New York's policymakers and champions should be helping to frame the national debate about what a more enlightened urban policy should look like and crafting a set of policy recommendations that federal officials could run with from the get-go.

Jonathan Bowles is director of the Center for an Urban Future



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Gotham Gazette

The Place for New York Policy and politics

Gotham Gazette is published by Citizens Union Foundation and is made possible by support from the Robert Sterling Clark Foundation, the John S. and James L. Knight Foundation, the Altman Foundation,the Fund for the City of New York and donors to Citizens Union Foundation. Please consider supporting Citizens Union Foundation's public education programs. Critical early support to Gotham Gazette was provided by the Charles H. Revson Foundation, Rockefeller Brothers Fund and the Alfred P. Sloan Foundation.

The Real Danger Of Anthrax

By Maia Szalavitz

As the number of anthrax exposures continues to increase, and with disruptions at major news organizations in New York, Governor Pataki's New York City office and the United States Congress, fear of the disease is spreading much faster than the spores.

The only antidotes for this terror are information and then appropriate action.

REASONS NOT TO PANIC

First, all forms of anthrax -- the inhaled form (pulmonary), the swallowed form (gastro-intestinal) and the skin type (cutaneous)-- are readily treatable. The anthrax which is currently being sent through the mail is susceptible to numerous types of antibiotics (including the very first antibiotic, penicillin), not just high-tech Ciprofloxacin. The disease is not contagious from person-to-person. If you believe you may have been exposed and want to know what the potential symptoms are, go to the Centers for Disease Control web site. Exposure does not mean infection, however. Most people who have tested positive for exposure will not develop disease even without treatment. Those known or suspected to have been exposed are given treatment just to be sure.

Secondly, the bleak data on survival rates from the most lethal form-- pulmonary anthrax -- was collected either before antibiotics or other modern supportive technology like respirators and IV fluids were readily available or from places like the former Soviet Union where access to appropriate treatment was uncertain and often delayed. Death rates are likely to be far lower than the reported 90 percent with antibiotics, quick discovery and modern supportive care.

The man in Florida who had the second reported U.S. case of pulmonary anthrax is recovering, and he is 73 years old. Elderly and very young people are usually at greater risk of dying from most infections, but the seven month old infected with the cutaneous form is also doing well. Cutaneous anthrax is fatal in only 20 percent of cases if untreated. With treatment, it is even less likely to be deadly. Gastro-intestinal anthrax has not been reported here, but it has a 25 percent to 75 percent fatality rate.

The odds that any particular person will get affected are also extremely low. "The post office handles 680 million pieces of mail per day," says Hillel Cohen, a doctor of public health and Assistant Professor of Epidemiology and Social Medicine at the Albert Einstein College of Medicine, "There have been half a dozen letters over three weeks. The odds of one coming across your desk-- [and coming across in a way likely to produce disease]-- are very low."

THE BAD NEWS

Even with the small number of cases reported so far, our public health system is having difficulty coping. A much greater risk than anthrax may be panicking over bioterror and trying "quick fix" solutions that won't ultimately protect people from either terrorists or natural diseases.

"The entire infrastructure is flawed and aching in budgetary pain," says Laurie Garrett, author of "Betrayal of Trust: The Collapse of Global Public Health, "The system is stretched to the max."

The run on Cipro, for example, could have been stemmed by giving the public better information. "As far as we can tell, this is garden variety anthrax which can be treated with penicillin," says Garrett, and asks why the more-expensive Ciprofloxacin is being promoted as the key treatment.

Ciprofloxacin was until recently the only FDA-approved drug for pulmonary anthrax -- though doxycycline and penicillin have just been approved by the government to try to stem the Cipro panic. The choice to use Cipro as a first treatment was made with the assumption that "weaponized anthrax" would almost by definition be designed to be resistant to most antibiotics. Since inhaled anthrax can kill so quickly, experts reasoned that when the first shot at a cure is likely to be the only shot, the drug used should be the one most likely to kill resistant bacteria.

With exposure or infections resulting from bacteria known to be penicillin-susceptible, the rationale behind the use of Cipro fails. And, with a rush on pharmacies and the Internet by the "worried well" for the antibiotic, there is a real danger that bacteria other than anthrax may develop resistance when people use the drug inappropriately. Even worse, Cipro-resistant bacteria tend to be resistant to a whole class of drugs -- so by rushing too soon to the treatment of last resort, its effectiveness can be decreased for much more common serious infections.

"No doctor should be writing Cipro prescriptions for the worried well," says Garrett. "It's irresponsible medicine."

Cohen agrees. He also points out that many of the experts on bioterror-- the government, politicians, the military, the media-- have an agenda. "People have a variety of reasons for promoting biological terrorism as an imminent danger. What's happening now is the result of groundwork to promote this or that program which goes back to the Gulf War. It is almost a type of psychological warfare against your own people-- you get them so scared that they are willing to support anything."

Cohen believes that the best way to fight biological warfare is with a beefed up public health system and with treaties against its use. "It's particularly ironic that just before September 11th, the Bush administration vetoed an extension of the Biological Weapons and Toxins Convention," he says, "which would have allowed inspection and enforcement."

Cohen cites the idea of increasing defensive research as an example of how some efforts to maximize safety could backfire. "The more places that are handling highly toxic material, the more of it there is and the more risk there is of accident or theft. A General Accounting Office report was released in August which said that we have 10,000 tons of chemical and biological weapons which we were supposed to have destroyed and we are ten years behind schedule on eliminating them," he says.

While terrorists would obviously not open their labs to inspection under treaties, the vast majority of them get their materials from legitimate researchers or government stockpiles -- so the rarer the deadly materials are, the less likely they are to be misappropriated.

Some experts argue, however, that fear of bioterror can help promote needed public health funding more generally. Cohen is skeptical of this "dual-use" argument. "The problem is, it totally distorts public health priorities. More money for general surveillance is good but if you spend millions vaccinating people against smallpox, that's money you are spending fighting [a hypothetical risk] when 20,000 people are dying of flu every year."

Cohen points out that neglecting basic public health measures like food inspection, mosquito and rodent control have already had effects. Budgets for mosquito control, for example, were cut several years before the West Nile virus outbreak. Garrett gives another example of failure involving a mosquito-borne disease from which some die by bleeding to death: 'We have a dengue fever outbreak in Hawaii right now and the health department can't diagnose cases in less than two weeks. And that's a simple organism in the middle of an epidemic." Errors in handling the suspect anthrax letters by investigators, lab problems and miscommunication between agencies illustrate how stretched the system is even with a limited number of cases.

"Public health needs to be strengthened under the control of public health people with an independent health structure for surveillance, food and water inspection and a basic reassessment of national health care." says Cohen, adding "We need a national health care system, not a national health scare system."

Maia Szalavitz is the Health Topic Page columnist for Gotham Gazette

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Read Michael Burger's article - The Environment Near Ground Zero

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Gotham Gazette the Place for Politics and Policy

Gotham Gazette is published by Citizens Union Foundation and is made possible by support from the Robert Sterling Clark Foundation, the John S. and James L. Knight Foundation, the Altman Foundation,the Fund for the City of New York and donors to Citizens Union Foundation. Please consider supporting Citizens Union Foundation's public education programs. Critical early support to Gotham Gazette was provided by the Charles H. Revson Foundation, Rockefeller Brothers Fund and the Alfred P. Sloan Foundation.

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