Like the changing seasons, our nation is undergoing bitter-sweet political change.
Though difficult to believe, Michael Bloomberg is left with 3 months before leaving his 12 year appointment as New York City mayor. Meanwhile, the City of Los Angeles celebrates 3 months since the election of their first Jewish mayor, Eric Garcetti, and 70 million uninsured Americans await the opening of the Health Insurance Exchange in less than 10 days.
To lessen the blow of rapid transition, public health figures from NYC to Los Angeles met on Friday, September 20th, to discuss public health during a time of political change.
The conference, hosted by the New York Academy of Medicine and New York University Global Institute of Public Health, comes at a time when 6% of local health departments serve 49% of the U.S. population. Robert Pestronk, Executive Director of the National Association of County and City Health Officials (NACCHO), sees this as an opportunity, “To take care of the American people,” he says, “we need to look at cities.”
In this series, we will take a look at public health across 3 settings: 1) New York City, 2) the City of Los Angeles and 3) federal and national organizations. In Part 1, we will focus on NYC.
Part 1: New York City Races to Make Last-Minute Policies
In 2007, a New Yorker would have laughed at the mention of Smoke-Free Housing, “They used to think we were crazy,” said Sheelah Feinberg, Executive Director of NYC Coalition for a Smoke-Free City. However, fast-forward to 2013, and 59% of New Yorkers support the idea. This comes as no surprise, given than today, 86% of New Yorkers don’t smoke.
Andrew Rein, Associate Director for Policy at the Centers for Disease Control and Prevention, explained it best, “Culture eats strategy for lunch.”
Lesson learned, the NYC Department of Health and Mental Hygiene seeks to use the notion of culture change to shift the opinions of New Yorkers in favor of more radical anti-obesity initiatives. Although previously unsuccessful in limiting the consumption of sugary drinks, such as by removing their SNAP subsidy or placing a 16 oz. serving size cap, Tom Farley, Commissioner for the NYC DOHMH, admits that these efforts were not without reason, but closely followed the principles of “risk management.”
“We understand that important things are risky,” he stated, “And we will be sued for most of the important things that we do.” Farley feels that it’s important to take on big ideas, even if they’re controversial. Susan Kasangra, Deputy Commissioner for Health Promotion and Disease Prevention, further elaborated on the important behind NYC’s anti-obesity efforts, “With all the education in the world, you can not change the individual whose choice is predicted by the environment.”
Feinberg, on the other hand, remains concerned with the City’s inability to pass tobacco legislation. She is especially worried about the growing misconception that the tobacco problem has been resolved, which may open doors for alternative tobacco products. The Coalition is moving forward with bold ideas, and quickly, including the proposal to raise the minimum sale age of cigarettes to 21. Feinberg is hoping to “keep the drumbeat of public health” alive, well after the potential change in administration.
Equally concerned is Veronica White, Commissioner for the NYC Department of Parks and Recreation, a City agency often left out of the conversation, despite a $5 billion budget that doubled under Mayor Bloomberg. A potential reduction in their budget may result in a mass reduction of public programs and park services, such as Walk NYC and park renovations.
What will happen to NYC agencies with the coming mayor remains to be seen. New York State recently released the The Prevention Agenda 2013-2013, a blueprint for state and local action to improve the lives of residents across five priority areas. Each area includes a unique framework for public health intervention, adopted from former NYC Health Commissioner and current Director of the U.S. CDC, Tom Frieden. The framework may be one of the few linking documents between the Bloomberg administration and the next NYC mayor.
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