With the new year, New York City bid farewell to Mayor Mike Bloomberg after a twelve-year term. Love him or hate him, his achievements in public health were stunning. While others only talked, he managed to act on smoking, obesity, and hypertensionâ€”and he placed the burden of fixing them on the industries that profited at the cost of the publicâ€™s health.
The Mayor showed that public health is a priority for local government, not just for the federal government to create health policies from on high. Bloomberg used New York City as a laboratory for public health innovation, spotlighting issues and testing solutions on a relatively small scale.
Here’s a reminder of Mayor Bloomberg’s most significant public health campaigns:
Mayor Bloomberg’s efforts to combat smoking will go down in history as his greatest public health achievement. He successfully enacted a ban on smoking in all indoor public places including the workplace, bars, restaurants, parks, the beachâ€”basically everywhere but your own home. In addition, he raised the legal age to buy cigarettes to 21 and the minimum price for a pack of cigarettes to $10.50. New York City’s smoke-free law helped inspire a movement that to spread across the nation and the world. The Mayor showed that smoke-free laws are easily implemented and achieve almost universal compliance to protect health without hurting business.
Trans fat is created when vegetable oil goes through a process called â€śhydrogenation,â€ť which makes the oil less likely to spoil but also raises harmful cholesterol levels. In 2008, New York CityÂ barred restaurants from using trans fat in cooking, and thirteen major cities quickly followed suit. (Apparently, the ban is working!) Last November, the Food and Drug Administration announced that synthetic trans fat is no longer GRAS (“generally recognized as safe”) and food companies cannot continue to use the artery-clogging ingredient in the United States.
Eating too much sodium (salt is sodium chloride) has been linked to high blood pressure, heart disease, stroke, and premature death. Americans consume about two times the recommended limit. In 2010, Mayor Bloomberg called on the food industry to voluntarily reduce the amount of sodium in packaged and restaurant foods by 25% over five years. Thirty companies signed on to the partnership called National Salt Reduction Initiative (NSRI), and by February 2013, 21 companies met one or more of their commitments. The NSRI received extensive support from philanthropists, donors, and the federal government. He also launched a local campaign urging residents to eat less of the stuff.
Calories on the Menu
New Yorkers get a third or more of their calories away from home, and so a law was made to help them make informed food choices. Since 2008, New York City has required food service establishments to post calorie information prominently on menu boards and menus. Real-world studies show that the intervention led to only a modest reduction in calorie intake, yet the posting of calories on the menu in restaurants is part of the Affordable Care Act and so has spread across the nation.
In 2010, Mayor Bloomberg proposed a penny-per-ounce tax on soda in New York State. Proponents said the tax would raise needed revenue and would deter children and teenagers from developing a lifelong soda habit. Anti-tax forces argued that the soda tax would cut into the income of poor New Yorkers while doing nothing to improve their access to exercise and healthy food. In the end, the idea was dropped after heavy opposition from the beverage industry. According to public records in 2010, the American Beverage Association spent $9.4 million to oppose New Yorkâ€™s soda tax.
When the soda tax was shot down, Mayor Bloomberg retaliated with the soda ban, an attempt to ban the sale of any cup or bottle of sweetened drink larger than 16 ounces at restaurants, food carts, movie theaters, and concession stands at sports arenas in New York City. Opponents said that soda was unfairly singled-out as the cause of obesity. In the end, the soda ban was deemed illegal by a state judge and an appellate court, although the New York State Supreme Court has agreed to hear a final appeal regarding the matter in the near future.
Other Bloomberg initiatives include building bike lanes and “play streets” to make it safer engage in physical activity all around New York City, a hugely popular bike share program, free fitness programs in parks, business incentives for grocery stores to locate to food deserts, and several other innovative health-minded programs. Every community needs a public health champion like Mayor Bloomberg. This New Yorker will sadly miss the ex-mayor.
January 8th, 2014