New study examines rising disparities in AIDS deaths in NYC

Between 2005 and 2012, the percentage of city AIDS deaths in the Bronx and Brooklyn climbed significantly while deaths of people with AIDS in Manhattan significantly decreased, according to a new study released today by Health People: Community Preventive Health Institute.

"Growing Disparities in AIDS Deaths in New York City" examines AIDS deaths in the years since the Bloomberg Administration defunded some 60 local AIDS support and outreach programs in the Bronx and Brooklyn while "re-allocating" 59 percent of the city's federal funds for various outreach and support services to Manhattan-based agencies.

In 2005, before the funding shift that favored Manhattan, deaths of people with AIDS in the Bronx, Brooklyn and Manhattan were all virtually equal to each borough's percentage of HIV/AIDS cases; but, by 2012, the last year for which city statistics are available, deaths of people with AIDS in both the Bronx and Brooklyn were 30% higher than their percentage of city HIV/AIDS cases, while Manhattan's percentage of HIV/AIDS deaths had decreased to the point that its share of city deaths was 23% less than its share of city HIV/AIDS cases.

"We can't show cause and effect," said Chris Norwood, the study author and executive director of Health People. "But, death shifts like this are unusual and certainly should be examined."

The study also examines the city's contracting procedures for its some $110 million a year in federal AIDS funds commonly known as "Ryan White" funding. The city Department of Health contracts with Public Health Solutions, which is one of New York's largest, private non-profits, to actually issue the Request for Proposals for these funds and grade the applications then received from the hundreds of organizations and providers that apply to the city for "Ryan White" funding. The study notes that Public Health Solutions appears to have no public guidelines for choosing the reviewers who "grade" the applications. Further, information obtained by Health People through Freedom of Information Law (FOIL) requests shows that Public Health Solutions has used a "Coordinating Panel" entirely composed only of Manhattan-based organizations and government representatives to make its final funding recommendations to the New York City Department of Health.

"This procedure appears to violate the City Charter," said Ms. Norwood. "The Charter specifically requires 'an inclusive citywide process' for decisions about funding for services provided to populations with mental health and substance abuse problems, which includes a large portion of the clients for these AIDS services."

"Moreover, since these federal AIDS funds are allocated to New York City based on its overall caseload, the Bronx and Brooklyn - which have almost half the city's HIV/AIDS cases - did not actually even receive the federal money that the city was given based on their HIV/AIDS cases," she added.

Socrates Caba, an organizer of the 718 AIDS---and More---Coalition, underscored the Health People study's findings and is seeking three reforms in the Ryan White contracting process:
● a funding priority for local organizations actually located in the neighborhoods where services are being provided;
● fair funding by borough reflecting borough HIV/AIDS caseloads; and,
● for the city to require that Public Health Solutions establish an open grading process for funding applications which includes reviewers from all boroughs and equal borough representation on any "Panel" that makes funding recommendations to the New York City Department of Health.