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Using an epidemiological approach, this text charts the changes wrought by misguided social policy on the American landscape since the 1970s. It begins with the decision of Nixon's urban advisor, Daniel Patrick Moynihan, acting on the advice of New York City and the Rand Institute, to operate "benign neglect" and "planned shrinkage" on the fire companies of New York. These policies caused massive closure of fire companies, particularly in the poor minority communities with overcrowded, aged housing, such as the South Bronx, Harlem, Brownsville and Bedford-Stuyvesant. An epidemic of fires broke out, landlords abandoned properties and the middle class left the city in droves. Communities were shattered both physically and socially. Public health deteriorated and violent crime spiralled upwards. A tubercolosis epidemic took hold, with new case rates similar to those of South Africa. Drug abuse became widespread which led, in turn, to a large AIDS outbreak. Infant mortality soared. Soon the problems afflicting the communities of the city were spreading throughout the metro region and springing up across the country.