Reports

The Social and Health Landscape of Urban and Suburban America: 1990-2000 Report Series profiles the health of the nation’s 100 largest cities and their suburbs. Sponsored by the Robert Wood Johnson Foundation, the report series focuses on the relationships between growing commonality of cities and suburbs. The studies examine the relationship of key population, socioeconomic and quality of life factors with disease and health outcomes in urban and suburban communities.

• Report 1: Healthy Cities, Healthy Suburbs: Progress in Meeting Healthy People Goals for the Nation’s 100 Largest Cities and Their Suburbs, August 2002
  

• Highlights*
• On average, the cities and their suburbs met or made progress towards meeting Healthy People 2000 goals for lowering infant mortality, AIDS, tuberculosis, syphilis and homicide between 1990 and 1999 or 2000.
• By 1999, none of the 100 largest cities and only two of their suburbs had met the Healthy People 2000 goal of 5 percent of live births that are low birthweight. Rather, there were increases in low-birth-weight rates that extended to cities and suburbs in all regions with suburban communities leading the way.

• Report 2: Dynamics of Race, Culture and Key Indicators of Health in the Nation’s 100 Largest Cities and Their Suburbs, February 2003

• Highlights*
  

• The most consistent, and in many cases, strongest improvements in measures of health and social status occurred among non-Hispanic African-American residents in cities and suburbs.
• Hispanics experienced more modest gains in health and social status than non-Hispanic African Americans, and, on some indicators, made negligible progress.
• Changes among Asian populations were similar to those for non-Hispanic Caucasians, who overall made modest improvements during the 1990s.
• Substantial gaps in health and social status remain between Caucasians and other racial and ethnic groups, with the other groups continuing to fare worse than Caucasians.
• One notable exception was low birthweight: city and suburban Caucasians led the way in rates of increase in low birthweight. Andrulis commented that these higher rates of low birth weight among Caucasians might indicate their better access to assisted reproductive technologies, which can lead to more multiple births.

• Report 3: Before and After Welfare Reform: Progress and Remaining Challenges for Poor Families and Children in the Nation’s 100 Largest Cities and Their Suburbs, July 2003

• Highlights*
• Cities and suburbs made considerable progress in reducing households on public assistance during the 1990s. They made more modest reductions in poverty among children and single-mother families.
• The cities and suburbs with the largest declines in public assistance rates between 1990 and 2000 did not show similar declines in child poverty or well-being.

• Report 4: Quality of Life in the Nation’s 100 Largest Cities and Their Suburbs: New and Continuing Challenges for Improving Health and Well-Being, June 2004

• Highlights*
• Between 1990 and 2000, rates of extreme poverty and concentrated poverty dropped substantially in many urban and suburban areas across the United States.
• Violent crime rates declined more dramatically in the cities (32 percent) than in the suburbs (26 percent) over the 1990s. But despite this decline, by 2000, rates of urban violent crime remained three times greater than suburban rates.
• The study results suggested that many suburban areas may be facing new challenges related to the growing racial and ethnic diversity of their residents. Andrulis indicated that because cities have long dealt with diverse populations, there are more advocates and more political support for ensuring adequate programs and facilities for such residents; such advocacy and support is not yet available in most suburban areas.

• Report 5: Hospital Care in the Nation's 100 Largest Cities and Suburbs, 1996-2002: Implications for the Future of the Hospital Safety Net in Metropolitan America, August 2005

• Highlights*
• For-profit and nonprofit hospitals are playing an increasing role in the care of Medicaid patients in urban areas, while the role for public hospitals is shrinking.
• People in poor suburbs make up more than two-fifths of the total population of the suburbs, but use only about one-fifth of hospital care in the suburbs. Andrulis noted that these results focus attention on the extent to which residents of poor suburbs- disproportionately Hispanic and foreign-born and lacking health insurance relative to those in wealthy suburbs — are facing financial, transportation and other barriers to needed hospital care.

• People in poor cities do not appear to have the same barriers to availability of hospital care as do those in poor suburbs. This may reflect urban areas' longer history of providing care to diverse populations or greater concentrations of individuals within smaller geographic localities. However, the report did not address specific issues around access within these cities.