A Plague on Your Houses: How New York was Burned Down and National Public Health Crumbled

Journal of Public Health Policy,  2002  by Rosner, David

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Deborah Wallace and Rodrick Wallace. A Plague on Your Houses: How New York was Burned Down and National Public Health Crumbled. New York: Verso Press, 1998, xviii+2.2.2, pp. $30.00 cloth.

The hypothesis of this book is simple but extremely important: that the health status of populations is a direct measure of the physical world that surrounds them and that the cohesiveness of that world affects virtually every health measure available. By undermining the integrity of communities of poor people, not only are the health outcomes of the poor affected but that of the communities and regions surrounding them are undermined as well. In a subtle and profound sense, this book speaks to the common bond that unites all communities and the relationship of differing groups within the population to each other. This is a seriously argued book that integrates both a technical quantitative analysis with a profound social analysis of the ways that the urban market for land, the capitalist use of space, and the social relations of class all conspire to undermine the health of the rich and the poor alike.

Using Manhattan and surrounding communities in the 1980s and 1990s as their testing ground, Rodrick and Deborah Wallace have looked at the ways that the destruction of the urban infrastructure in Harlem undercut the social and economic integrity of that community and continued to destroy the health of the region. The book begins with a seemingly self-evident description of the reasons that buildings burn and the mechanisms by which fires spread. Building designs, concentrations of flammable material, materials that are used in construction, and, ultimately, the integrity of the fire fighting system-from firemen to fire pumps-are discussed as a precursor to the analysis of land use, concentration of populations, and ultimately the planned destruction of communities through the removal of firefighting services, funding, and support for poor communities.

Central to the argument are the ways that New York land values have been shaped by the social relations of land use in the city. In short, the Wallaces argue that "real estate is to New York what oil is to Texas," meaning that the economics of the city revolve around the use of land and the exploitation of that natural resource. Landlords will charge what they can get away with while investing as little as possible in maintenance or services, thereby tending to undermine the integrity of housing for those that cannot afford high rents. Politicians will see land as a commodity, not as an urban resource necessary for the healthfulness of the people who live on it. The book adds a modern resonance to some of the historical analyses that have been developed earlier by Elizabeth Blackmar, a professor of history at Columbia who wrote Manhattan for Rent: 1785-1850 (Cornell University Press, 1989), an important book on land usage in 19th century New York. In it she illustrates that the history of the rental housing (and slum dwellings) in New York was a product of the creation of capitalist social relations in the predominantly mercantile city. Here, the Wallaces show that the impact of modern capitalist social relations is no less damaging now than they were a century before. "The history of New York often seems like a series of battles over land" (p. 31), the Wallaces point out. It is in the political economy of those battles that the data they develop takes on meaning.

The modern history of abandonment of poor communities begins with Robert Moses and continues through the 1960s when Daniel Patrick Moynihan promoted his program of "benign neglect" of the urban poor as a social welfare principle. The Wallaces, in fact, argue that Moynihan "burned down poor neighborhoods [through his rhetoric] as surely as if he had doused them in kerosene" (p. 21). In general, the book analyzes the social processes underlying the abandonment of the communities, the destruction of the fire fighting services, and the concomitant destruction of the community as precursors to a broader analysis of the impact on health status and health care. At times, the book veers off into more conspiratorial elements of this abandonment, seeming to argue that political actors and consulting groups such as the Rand Corporation or even Health and Human Services administrators actively planned for destruction through policies of "planned shrinkage." The data and qualitative materials the Wallaces have gathered makes it unnecessary to editorialize on the destructive impact of these actors, and their historical analysis is certainly powerful enough for any serious reader to see the ways that the continual battle over land and the impact of racism on debates about poverty and powerlessness conspired to undermine communities.

One of the powerful elements of the book is to envisage the destruction of communities by fire as a type of epidemic. In one chapter, "A Plague on Houses: Contagious Fires," the Wallaces make the argument that we can begin to understand the fires that swept through the South Bronx and parts of Harlem in the 1970s much as we might understand an epidemic of measles: the familiar spiked outbreak that quickly gathers strength as it spreads over time. The period from 1974 through 1977 was the "epidemic" of fires, concentrated in "susceptible" areas and clustered in place and time. As in epidemics, the aftermath of the fires was equally damaging in that the damage can be measured not only in deaths or even morbidity, but also in the slow destruction of the communities which suffered from the epidemic. Migration out, loss of housing and homelessness, were but some of the most obvious manifestations of the fires that spread through communities in the mid-1970s. But the physical destruction of the communities was followed by the disintegration of the social fabric as well. Divorce, family abandonment, and the disappearance of institutions essential to the social life of the community were essential results of the epidemic. Yet, despite the obvious effects of the transformation of the city's life, few in public office voiced any outrage or even acknowledgment.