THE DISTRICT government is woefully unprepared to meet the need for more extensive drug abuse and alcoholism treatment, according to a report by researchers at the University of the District of Columbia. Unfortunately, the more troubling news is that the D.C. government is confronting an explosion of social ills at a time when its budgetary problems are becoming most acute. Even though the city's population has declined steadily over the past decade, the number of people dependent on its social service safety net has soared.
Admissions to the city's alcoholism and drug treatment system, for example, have increased by 49.7 percent and 52.8 percent respectively in just four years. Another aspect of the city's drug problem, which contributed to a 166 percent increase in syphilis cases between 1985 and 1989, is the trend of trading sex for drugs. More new AIDS cases are being found among heterosexual drug users here than among any other affected group.
By any standard, the health status of D.C. residents is appalling. Pregnancy among city teens aged 15 to 17 has risen 23.5 percent in the past four years. In 1989 there were more births to single women, more infant deaths, and a higher percentage of low-birthweight babies than at any other time in the 1980s. Nationally, the death rate from heart disease has declined steadily since 1985. In Washington, it has risen steadily since 1985. The national death rate from chronic liver disease and cirrhosis has dropped since at least 1984. In the District, it climbed 60.8 percent and is now four times greater than the national rate. While all this was occurring, use of the city's public health clinics was on the decline.
The D.C. government is also taxed in other areas: city-subsidized day care slots, up 13.3 percent; city ambulance transports, up 22.9 percent; individuals requiring mental health services, up 25.5 percent; senior citizens served by the D.C. Office on Aging, up 47 percent; investigations of child neglect, up 60.9 percent; homeless shelter nights paid for by the D.C. government, up 284.4 percent -- all within the past four years.
There is a limit to how much a local government can be expected to accomplish on behalf of its most disadvantaged residents, and there are limits on what it can afford to do. Many painful choices lie ahead, and the city's stewards may find that they have to abandon some efforts entirely in order to meet more pressing needs. One of the most difficult tasks for the new mayor and the new leadership on the D.C. Council will be to persuasively define those limits, and to form and monitor an administration which makes far more efficient use of the resources at hand.