Consumed in the City

As a public health field worker assigned to control tuberculosis in New York and Chicago in the 1990s, Paul Draus encountered the horrible effects of tuberculosis resurgence in urban areas, and the intersections of disease, blight, and poverty. "Consumed in the City" grows out of his experiences and offers a persuasive case for thinking about and treating tuberculosis as an inseparable component of the scourges of poverty, homelessness, AIDS, and drug abuse. It is impossible, Draus argues, to treat and eliminate tuberculosis without also treating the social ills that underlie the new epidemic. Paul Draus begins by describing his own on-the-job training as a field worker, then places the resurgence of tuberculosis into historical and sociological perspective. He vividly describes his experiences in hospital rooms, clinics, jails, housing projects, urban streets, and other social settings where tuberculosis is often encountered and treated. Using case studies, he demonstrates how social problems affect the success or failure of actual treatment. Finally, Draus suggests how a reformed public health agenda could help institute the changes required to defeat a deadly new epidemic. At once a personal account and a concrete plan for rethinking the role of public health, "Consumed in the City" marks a significant intervention in the way we think about the entangled crises of urban dislocation, poverty, and disease. Paul Draus is a research scientist at the Center for Interventions, Treatment and Addictions Research in the Department of Community Health at the Wright State University School of Medicine.