"Health" refers to the health issues
facing the city, touching on everything from the mayor to Medicaid to managed
care to mosquitoes.
New York City is one of the biggest public health challenges in the
world. With 7 million residents--over 1 million of whom are uninsured--the city has the largest number of HIV cases and the largest number of
intravenous drug users in the U.S. Efforts to contain a tuberculosis
outbreak that threatened the city in the 1990's have been a major
success--between 1992 and 1998, the deadly
multi-drug resistant cases of TB declined by over 90 percent.
New York City has 20 public hospitals which served 1.5 million people in
1998 alone. Run by New York City's public Health and Hospitals
Corporation, the hospital system now has a surplus of $21 million,
following years of deficits and cutbacks.
Maia Szalavitz is author, with Dr. Joseph Volpicelli, of "Recovery
Options: The Complete Guide: How You and Your Loved Ones Can Understand
and Treat Alcohol and Other Drug Problems." She writes frequently on
health, science and public policy for the New York Times, New York Magazine,
the Village Voice, and other publications.
by Maia Szalavitz
Health Web Sites
New York is one of the leading centers for medical research and
of the best hospitals in the country. But even for New Yorkers, finding
information about health on the Internet can be tricky. Some sources are
unreliable; others are biased. Here are some tips for evaluating health
information on-line, followed by a list of some good, general resources
for New Yorkers who wish to research particular conditions or just live
There are two main concerns regarding health sites:
1) Who is the source? When you visit a health Web site, check to see who
sponsors it. Is it a doctor or a group of doctors with a particular
agenda? A drug company? A government agency? A non-profit?
If it is a non-profit, is it a partisan group or a genuinely independent
Any of these sources may be helpful, but be sure you know where a site is
coming from as you consider the information it contains.
You can usually discover these biases by clicking "about this site" or
"who we are" or "mission statement" and by checking their list of links
and honors and how they promote themselves.
2) Science or anecdote? Many health sites-- particularly those about
nutrition, diets and alternative or complimentary medicine-- base their
claims on anecdotes, or stories about successes from individual patients
Scientists have learned to be skeptical of such claims because they can
easily be biased. For example, a doctor may unknowingly be in contact
only with those for whom a treatment worked -- because the others went
elsewhere when it did not. Or, his patients may not be typical of people
with the condition -- and so while the treatment may work for this small
sub-group, most patients will not be helped.
This is why double-blind placebo controlled trials published in a
peer-reviewed journal are considered the "gold standard" in determining
what is effective. And, even better than one double-blind published
placebo-controlled trial is ten of them -- and even better than this is
ten of them with a large number of patients in each one. The more evidence
there is lined up on one side, the less likely it is that the results are
due to chance rather than the effectiveness of the treatment.
Anecdotes are not bad -- they may signal that something works-- but they
are not, in themselves, evidence of effective treatment.
If you keep these ideas in mind, you cannot go too far wrong in seeking
useful health information.
Here are some good places to start:
New York On-line Access to Health -
A great resource for New Yorkers seeking health information, this page is
a joint effort of the New York Academy of Medicine, the New York Public
Library, City University of New York, and the United States Department of
It includes extensive lists of links and resources on numerous health
topics from 'abdominal pain' to 'Zollinger-Ellison Syndrome.' Available
in Spanish as well as English.
NYPL Choices -
This is a service of the branch libraries of the public library
system. It includes information on how to choose the best physician and
links to on-line databases of specialized medical information.
Online Merck Manual -
Although this is aimed at physicians, people searching for an overview of
standard treatments and medications for particular conditions may want to
start here. It is searchable.
Excite Health News -
This page collects health news from AP, Reuters and other sources and is
National Library of Medicine -
Includes access to Medline (searchable database of 4,300 medical journals
-- abstracts available for most articles), Medline Plus (a more
consumer-friendly listing of health information by topic) and health news
New York Health Care Accountability Foundation -
This site provides a tool to measure whether your doctor is doing the
appropriate tests and measurements to keep you healthy as well as a report
card on the performance of various HMO's, updated annually.
Cochrane Collaboration Consumer Information -
The Cochrane Collaboration is an organization based in the United Kingdom
using the best scientific practices to determine which treatments are most
effective. They do this by reviewing the available evidence and
suggesting where more research is needed. This site provides information
for consumers about what has been learned and how to make good choices
This site is aimed at life scientists (and full disclosure, I write
regularly for them) but it has a great magazine called H.M.S. Beagle which
covers numerous health advances and their implications and it also offers
daily summaries of the latest medical and biological research from the
New York City Department of Health -
Includes health alerts (including West Nile info), information on
restaurant sanitary conditions and information on various health-promotion
New York State Department of Health -
More health data for New Yorkers including information on how to sign up
for Child Health Plus and Family Health Plus-- the insurance programs for
those who are presently not covered by other plans.
This site, aimed at doctors, allows you to search Medline, the database of
medical journals, for free. Abstracts of most journal articles are
available for free as well. Once you have some basic knowledge about a
condition you are researching, you can look here to get a sense of what is
going on in terms of study in the area. There is a companion
consumer-focused site, CBSHealthWatch, which is linked.
American Cancer Society -
Half of all Americans will face cancer at some point in their lives-- and
the New York and Washington-based American Cancer Society web site
provides a wealth of information for those dealing with the
disease. Includes links to other major cancer sites and resources.
AIDS Information -
A sort of "AIDS central" for New York city with links to major HIV/AIDS
organizations and information sites.
Debunks medical scams and inflated claims made by "alternative" medical
Citizen Action -
Healthcare is one of the primary focuses of this New York advocacy
group. Includes information on New York's health plans for low income
people lacking insurance.
An incredible research resource for cancer patients and others concerned
about this disease.
National Alliance for the Mentally Ill -
An organization of advocates for people with mental illness which includes
information on treatment and support for various disorders like
depression, bipolar disease and schizophrenia.
Insure Kids Now -
Information on New York state's insurance program for poor kids and
information on other state's policies, from the federal government and the