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Citizens Union


AIDS And The African-American Community; Homeless and Health


In his column in the New York Times, Bob Herbert reports that one in every fifty black American men is infected with HIV. "That's an astounding statistic," writes Herbert and then he puts forward several more. AIDS is the leading cause of death in black men between the ages of 25 and 44. While blacks make up just 13 percent of the US population, more than half of all new HIV infections occur among blacks. Blacks are ten times more likely to be diagnosed with AIDS and ten times more likely to die from it. Black women account for 64 percent of all new infections. Herbert faults a variety of factors for the spread of the disease in black communities including: information about the threat of AIDS not being disseminated widely or effectively enough, particularly among youngsters who feel they are invulnerable; poverty contributing to a lack of access to health care information, preventive services, and even treatment; widespread denial in the black community because of the stigma attached to AIDS, homosexuality and IV drug use. Politicians and clergy are beginning to speak out but Herbert suggests that, "nothing less than a mighty chorus is needed to cope with this overwhelming tragedy, a chorus comparable in its seriousness of purpose to the civil rights movement."

Another recent article reports on a survey that found high rates of unprotected sex and HIV transmission among young New York City men. In particular, a high proportion of young men are engaging in unprotected anal sex, a major risk factor for transmission of HIV. About 50 percent of black and Hispanic men and 39 percent of white men said they had anal sex and did not use condoms. Also alarming was the fact that 16 percent of the men surveyed were found to be HIV positive, while only 3 percent said they had previously tested positive for the disease, meaning they were recently infected. The survey was conducted by the New York City Department of Health and the New York Blood Center between March 1999 and July 2000.


Although homeless men and women suffer from physical and mental illness at higher rates than many others in the population, they do not receive necessary medical care and one in three homeless people surveyed reported being unable to get drug prescriptions filled. A study released by the Journal of American Medical Association found almost half of all homeless people had at least one major illness and three-quarters were suffering from either a mental problem or abuse of alcohol or drugs. The majority do not have medical insurance, and homeless veterans often do not take advantage of military insurance benefits. One percent of Americans find themselves homeless in the course of a year.

A 1969 sanitation law intended to discourage people from abandoning cars or car parts is being used to arrest homeless people because the wording contains a prohibition against leaving any box, barrel, bale of merchandise on a city street. Anyone sleeping in a box is in violation, according to a recent ruling by a federal judge upholding the policy.

Two pieces of good news arrived recently with an announcement by former US Housing Secretary Andrew Cuomo and another by Mayor Giuliani of funds for new housing initiatives. Before leaving his job along with the Clinton administration (and prior to announcing his bid for governor) Andrew Cuomo visited the city bearing news of 84.7 million in federal funds for programs to house the homeless. Giuliani then announced a $600 million increase over four years in low cost housing. The Coalition for the Homeless has a chart that demonstrates the Mayor's housing budget only amounts to 47 percent of what was spent on housing eleven years ago, before his administration. And it is also true that his budget cuts about $700 million in other programs, mostly social service. Nevertheless, additional low-cost and subsidized housing is welcome news. According to a study last year by New York University, housing is critical to ending homelessness. Eighty percent of homeless families in the City that were provided with subsidized housing remained stable after five years and did not re-enter the shelter system, regardless of other problems. Only 18 percent had stability in the group that did not receive subsidized housing.


Forced to rely on emergency room care because the 1996 welfare reform laws deny them Medicaid preventive care, immigrants in the city are reportedly getting sicker. And continuing to enforce this policy will cost the state and federal government $132 million in emergency room treatments by the year 2005, according to a new study by the New York Immigration Coalition, "Welfare Reform and Health Care: The Wrong Prescription for Immigrants. "Ironically, this policy was established so that it would save the government money," Margie McHugh, executive director of the Coalition, told Newsday. In addition to that cost, approximately 6000 immigrants will be hospitalized for conditions that could have been prevented by access to regular coverage.

High school students with limited English are overlooked and underserved, according to a report by the Urban Institute released in January. Shortages of trained teachers, relevant curriculum, lack of individualized instruction all are contributing to extraordinarily high drop-out rates for immigrant teens. Mayor Giuliani's recent budget proposal may help in that it incorporates funding for weekend English classes for 38,600 students.


Founders of the gay rights movement, which began 52 years ago, are aging and mostly poor, according to an editorial by Dudley Clendinen in the Times last month. Harry Hay, the first to organize for gay rights back in 1948, is now 88 and ailing. Phyliss Lyon and Del Martin, founders of the first enduring organization for lesbians, are almost 80. Dr. Franklin Kameny, who first insisted that to be gay was not to be abnormal or mentally ill, who first petitioned for employment rights and legally championed for gay civil rights, is now 75. But for gay and lesbian elderly, according to Clendinen, "the twilight years can be especially daunting." Studies in New York and Los Angeles found 65 to 75 percent of elderly gay and lesbian residents live alone. When a partner dies, Social Security does not pass on survivor benefits, and many pension plans exclude same-sex partners. Attitudes also tend to be conservative in housing for the elderly, especially in subsidized low-income housing. The National Gay and Lesbian Task Force has recently focused attention on the needs of aging lesbians and gay men. There are several plans for gay retirement colonies under way, but at present, there is only one.

For-profit nursing home owners in the city are raking in millions in profits and exorbitant salaries, according to an article in the Daily News. The Clove Lakes Health Care and Rehabilitation Center in Staten Island reported $8.4 million in profits this year. Sheepshead Nursing Home in Brooklyn followed with $5.6 million, and Kings Harbor Multicare Center in the Bronx with $4 million. Nursing home executive salaries jumped, too, with five homes paying their owners $1 million or more. Many not-for-profits homes in the city run by religious organizations also reported surpluses. Critics such as the Nursing Home Community Coalition of New York, a patient advocate group, fear that profits are being gained at the expense of the residents. "The way to make a profit is to cut staff," Cynthia Rudder, director of the Coalition, told the Daily News. Last month the News reported staff shortages and neglect in city nursing homes with the state health department unable to handle all the patient abuse complaints or to adequately monitor the industry. Most nursing homes in New York are funded by Medicaid, presently at a cost of $5 billion, paid for by taxpayers.

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