Explains how political decisions and real estate interests created a housing crisis that reshaped public health in America.

Many countries suffered an obesity epidemic for decades. Many industrialized/post-industrial countries face birth rates in precipitous decline to below replacement values. New York City also suffers from these two markers of eroding public health. New York City, like many global cities, endures an ever-intensifying housing famine, especially of low-cost rental units, which led to steeply rising rents and housing code violations. This study explores whether rent affects public health patterns over the Bronx and Manhattan. Identifying local determinants of public health patterns may illuminate driving forces of the international crises. This study also reviews the history of the housing famine and the real estate industry’s role in creating famine-producing public policies adopted by compliant elected officials. Corrupt cronyism at local and national levels reduced communities to mere shreds of fragmented social networks shorn of political and economic power.

Bronx and Manhattan annual birth rates, rates of low-weight births, obesity prevalence, and mortality rates from drug overdose, cerebrovascular disease, heart disease, and diabetes were acquired from the NYC Department of Health. Annual median rent for each borough was acquired from the American Community Survey. Bivariate and multivariate regressions revealed the associations. Median rent was regressed against public health indicators by borough 2005–2021.

Both boroughs’ birth rates and obesity prevalence associated strongly with median rent, negatively for birth rate, positively for obesity prevalence. Rates of Bronx low-weight births, of Bronx and Manhattan drug deaths, and of Bronx cerebrovascular deaths declined in the early years but came to a threshold and rose. The threshold year-2021 rates associated strongly with annual median rents for those years. Rates of heart disease and diabetes mortalities showed a threshold effect, but plateaued, not rising. Median rent behaved like a toxic chemical, eliciting defined patterns of public health degradation. The mix of responses to median rent mimic public health responses to the heavy metal lead: some without and some with a threshold. Toxic chemicals are regulated. Rent should be also.