City infrastructure is very old, and much of it needs to be replaced. Because the city has an insufficient tax base, it can’t afford most of this work and needs to keep applying bandaid fixes because it can’t afford to deal with the root cause. It’s an unhelpful comparison to equate Baltimore city and county because of the many other differences, such as higher population density, lower median income, greater difficulty in establishing work areas due to traffic volumes, extent of paved/built area, occupational hazards like lead and asbestos being far more common in the city, etc. Sure, mismanagement plays a role, but it’s unhelpful to attribute everything to that.