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Largest cities exceed national average in cutting violent crime, report says Health study also cites high reductions in infant mortality, spread of AIDS

WASHINGTON — WASHINGTON -- Violent crime, infant mortality and the spread of AIDS and other urban problems have begun to recede in some of the nation's largest cities, even though they are increasing in smaller cities, a new report by a public health research organization said on yesterday.

The report, issued by the nonprofit National Public Health and Hospital Institute, was based on census information, federal crime statistics and health care surveys from the 100 largest cities in the country. It found, among other things, that from 1980 to 1990, the number of children living in poverty increased nationally by 12 percent, while in the 25 largest cities, the ranks of poor children increased by 9.4 percent.

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The study also found that violent crime over the same time increased nationally by 46 percent, while the rise was 36.4 percent in the largest cities.

Referring to programs that have lowered the incidence of disease, the report said that since 1980, "the largest 25 cities are doing better" than the United States generally.

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Dennis P. Andrulis, the institute's president, said the group's report should be taken into consideration by federal lawmakers in drafting legislation that would turn programs like Medicaid into block grants administered by states.

The Republicans' plan to balance the budget would establish block grants for welfare, child care and Medicaid, and, in some cases, food stamps. Mr. Andrulis said that he was concerned that block grants would not take into consideration specific needs of individual cities, adding, "Proposed block grants, with their fixed-funding formulas, may not be well-suited to what cities need."

President Clinton has said he will veto the budget bill, but he has not specifically objected to the idea of using block grants for cash assistance to poor people, though he has objected to the Medicaid block grants.

Mr. Andrulis said that many of the largest cities were finding some solutions to intractable problems simply out of desperation and that their approaches should be studied by smaller cities with similar problems.

For example, the report found that local health officials in Cleveland, the country's 23d largest city, had made significant strides in fighting the incidence of tuberculosis, gonorrhea and AIDS.

"Cleveland may serve as a model of disease control for other U.S. cities," Mr. Andrulis said.

As the country's most populous city, New York is a prime example, the report said, of a large city having rates of violent crime, infant mortality, teen-age pregnancies, high school graduation and households headed by women among others that were better than the national averages.

By comparison, the report found that in Mobile, Ala., the 79th most-populous city, the increase of violent crime was almost triple the average of the 100 cities; the decline in the rate of infant mortality was a third of the national average; the decline of teen-age pregnancies was less than half the national average, and the increase of high school graduations lagged behind the national average by about a fifth.

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The number of households led by women in Mobile increased by almost 26 percent, a rate two-thirds above the national average.

"The overall perception of large cities is that they are dens of iniquity while smaller cities have more of a main street ideal with a veneer of respectability," said Sara Rosenbaum, director of the George Washington University Center for Health Policy Research and an adviser to the report. "But if you put aside the assumptions, underneath, the problems are often far worse in smaller cities."

Officials from cities with smaller populations than the 100 examined by the report say urban problems are finding their way into suburban towns and villages. John DeStefano, the mayor of New Haven, said in an interview that communities around Connecticut's largest cities, Bridgeport, Hartford and New Haven, have begun encountering the same problems found in New York and Los Angeles.

And just as necessity has forced big-city mayors to devise solutions to these problems, officials in the smaller towns have also been pressed to find creative programs.

"We do much better with crime and violent crime than towns around us," Mr. DeStefano said. "We had to."



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