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3:27 pm
Mon December 30, 2013

New York City's Bloomberg Leaves Mixed Results On Health

Originally published on Tue December 31, 2013 10:40 am

On the November day in 2001 when Michael Bloomberg was elected mayor, two things were prominent in New York City's air: fumes from the World Trade Center's smoldering remains, and tobacco smoke in the city's bars, restaurants and other public spaces.

Now they're both gone.

Bloomberg helped the city rebuild after the attack on Sept. 11, 2001. And he led the charge against smoking.

As a philanthropist, Bloomberg had been interested in public health for a decade. But as mayor, he was in a position to take the advice of experts and turn it into law, affecting how millions of people live their lives.

Dr. Alfred Sommer, from Johns Hopkins University, led Mayor-elect Bloomberg's search for a health commissioner. Sommer interviewed Dr. Thomas Frieden for the job. Unlike other candidates, Frieden didn't want to talk about bioterrorism. Sommer recalls the conversation: "'Tobacco. Tobacco's the big thing,' And I said, 'Ummm, Tom, have you heard about 9/11?' And he said, 'Oh, yeah, sure, and that's an issue we have to deal with, but I guarantee that tobacco use is going to kill far more New Yorkers than bioterrorism ever will.' "

Bloomberg bought it, beginning a push that made the city an incubator for often controversial public health experiments. He hired Frieden to crusade against tobacco, raise the stature of the Health Department, and focus on chronic health problems, like diabetes, obesity and heart disease.

The department became a hotbed of research and ambitiously gathered data on the health of New Yorkers.

Meanwhile, Bloomberg swung into municipal action, raising taxes on cigarettes and proposing a widespread ban on public smoking indoors. At a hearing in late 2002, Bloomberg spoke in front of the City Council:

"The question before us is straightforward: Does your desire to smoke anywhere at any time trump the right of others to breathe clean air in the workplace?"

There were some protests, but the smoking ban passed by an overwhelming margin in the City Council.

Resentment festered, though. Take 60-year-old Elizabeth Lane of Harlem. "That Bloomberg. I was so angry at him," she says. "If he was in the same room as me, I could have choked him! I thought he was a dictator. I said, 'Is this right? Can he really tell people what to do and how to do it?' "

Lane had smoked for 40 years and couldn't quit. But the high tobacco taxes got to her, and she found herself dropping hundreds of dollars a month on cigarettes.

Lane says family pressure and a lot of prayer moved her to put on a nicotine patch. It worked. She quit, which has helped her indefinitely postpone surgery to open her blood vessels and reduced her risk of cancer, stroke and heart disease. It has also potentially saved taxpayers tens, if not hundreds of thousands of dollars. And quitting smoking changed Lane's mind about Bloomberg.

"He knew what he was doing. He did the right thing. And I'm thankful to him now," she says.

Curtailing smoking has been Bloomberg's signature public health achievement. Other cities around the world followed New York's lead, including London and Paris.

But the dramatic success with smoking has been difficult to replicate.

Take his campaign to reduce obesity. Over the past eight years, the Bloomberg administration has banned trans fats, required food establishments to post calorie counts, encouraged green markets and produce carts and started the country's first large-scale registry of people with diabetes.

There's been some improvement among schoolchildren. "Overall, obesity rates in K-through-8, children ages 5 to 14, has declined 5.5 percent over the past 5 years," Bloomberg reported in 2011.

But among adults, rates of diabetes and obesity have increased.

The initiative that garnered the most attention by far was attempting to limit the size of sodas and other sugary beverages served in restaurants, cafes, movie theaters and sports venues.

"Compared to smoking, this is an easy battle to win, and nobody's going to stop this, is my impression," Bloomberg announced the day before his soda ban hearing started in the City Council.

Bloomberg and his aides argued that people could buy as much soda as they wanted, that the new rule would just reset the default portion size from 24 or 36 ounces back down to 16 — forcing people to think a little bit before gulping down hundreds of calories from a single cup.

But opponents quickly got the label "soda ban" to stick. And they got help lobbying against the measure from the food industry.

Six in 10 New Yorkers oppose Bloomberg's sugary beverage initiative, according to a New York Times survey. Two state courts so far have rejected the rule, and another court appeal is pending. Bloomberg biographer Joyce Purnick says the backlash might have had as much to do with Bloomberg fatigue as anything.

"It was the third term, and here he was doing it again," she says. "So, beyond the opposition of the beverage industry, I also think that it was, 'Enough already. You've done this too many times. I'm getting sick of you. I'm getting sick of your policies. Leave me alone.' "

Bloomberg's successor, Mayor-elect Bill de Blasio, has said he supports the sugary beverage initiative, though he hasn't said much about other efforts. Public health experts aren't sure what to expect, but they doubt that anytime soon they'll have another ally like Bloomberg, an activist policy wonk with a fat checkbook and a willingness to take unpopular political risks.

This story is part of a reporting partnership with NPR, WNYC and Kaiser Health News.

Copyright 2013 WNYC Radio. To see more, visit http://www.wnyc.org/.

Transcript

ROBERT SIEGEL, HOST:

The 12-year tenure of New York City Mayor Michael Bloomberg ends on the New Year's Day. And we have a look back now at one aspect of his long run.

Fred Mogul, of member station WNYC, reports that Bloomberg made New York an incubator for often controversial public health experiments.

FRED MOGUL, BYLINE: On the November day in 2001 that Michael Bloomberg was elected, two things were in the New York City air literally and figuratively: The World Trade Center still smoldered and wouldn't be fully extinguished for another month; and tobacco smoke still swirled around the city's bars, restaurants and other public spaces.

Those two fumes came together as Dr. Alfred Sommer, from Johns Hopkins University, led Mayor-elect Bloomberg's search for a health commissioner. Sommer interviewed Dr. Thomas Frieden for the job. And unlike other candidates, Frieden didn't want to talk about bioterrorism. He told Sommer...

DR. ALFRED SOMMER: Tobacco, tobacco's the big thing. I said, Tom, have you heard about 9/11?

(LAUGHTER)

SOMMER: And he said, Oh yeah, sure, and that's an issue we have to deal with, but I guarantee that tobacco use is going to kill far more New Yorkers than bioterrorism ever will.

MOGUL: Bloomberg bought it. He hired Frieden to crusade against tobacco, raise the stature of the Health Department, and focus on chronic health problems, like diabetes, obesity and heart disease. The agency became a hotbed of research and ambitiously gathered data on the health of all New Yorkers. Meanwhile, Bloomberg swung into legislative action, raising taxes on cigarettes and proposing a widespread ban on public smoking indoors. At a hearing in late 2002, Bloomberg told the City Council...

MAYOR MICHAEL BLOOMBERG: The question before us is straightforward: Does your desire to smoke anywhere at any time trump the right of others to breathe clean air in the workplace?

MOGUL: There were some protests, but the smoking ban passed by an overwhelming margin in the City Council. Resentment festered.

ELIZABETH LANE: That Bloomberg - I was so angry at him, I could have choked him.

MOGUL: Take 60-year-old Elizabeth Lane of Harlem.

LANE: I thought he was a dictator. I said is this right? Can he really tell people what to do and how to do it?

MOGUL: Lane had smoked for 40 years and she couldn't quit. But Bloomberg high tobacco taxes got to her, and she found herself dropping hundreds of dollars a month on cigarettes.

LANE: Which I couldn't afford - I had to beg, borrow and steal to get money to buy cigarettes.

MOGUL: Finally, Lane says family pressure and a lot of prayer moved her to put on a nicotine patch. It worked. She quit.

LANE: I don't when I'm walking. That's improved. I can walk up stairs - that's improved. And I don't cough - that's improved.

MOGUL: For Lane, quitting smoking has indefinitely postponed surgery to open her blood vessels and reduced her risk of cancer, stroke and heart disease; potentially saving taxpayers tens, if not hundreds of thousands of dollars. And quitting smoking has also changed Lane's mind about Mayor Bloomberg

LANE: He knew what he was doing. He did the right thing. And I'm thankful to him now.

MOGUL: Curtailing smoking has been Bloomberg's signature public health achievement. Other areas around the world have followed New York's lead, including London and Paris. But the dramatic success on smoking has been difficult to replicate. On more widespread and complicated problems, progress has been more incremental - when there's been progress at all.

Consider Bloomberg's most extensive and sustained campaign.

BLOOMBERG: Obesity is a very bad thing.

MOGUL: Over the past eight years, the Bloomberg administration has banned trans fats, required food establishments to post calorie counts, encouraged green markets and produce carts, and started the country's first large-scale registry of people with diabetes. There's been some improvement among school children.

BLOOMBERG: Overall, obesity rates in K-through-8, children ages five to 14, declined by 5.5 percent over the past five years.

MOGUL: But among adults, diabetes and obesity have increased. The initiative that garnered the most attention by far was attempting to limit the size of sodas and other sugary beverages served in restaurants, cafes, movie theaters, and sports venues.

BLOOMBERG: Compared to smoking, this is an easy battle to win and nobody is going to stop this, is my impression.

MOGUL: Not exactly, Bloomberg clearly touched a nerve. The mayor on stage tried to argue that people could buy as much soda as they wanted, that the new rule would just reset the default portion size from 24 or 36 ounces back down to 16 - forcing people to think just a little bit, before gulping down hundreds of calories from a single cup. But opponents called the move a soda ban and they also got help from the food industry.

UNIDENTIFIED MAN: So are we going to let the mayor tell us what size beverage to buy? If we let them get away with this, where will it end?

MOGUL: Six out of ten New Yorkers opposed Bloomberg's sugar beverage initiative, according to a New York Time's survey. So far, two state courts have rejected the rule and another appeal is pending. Bloomberg biographer Joyce Purnick says the backlash might have had as much to do with Bloomberg fatigue as anything.

JOYCE PURNICK: It was the third term, and here he was doing it again. So, beyond the opposition of the beverage industry, and the concept of don't you tell me what to do with my body, I also think that it was, enough already. You've done this too many times. I'm getting sick of you. I'm getting sick of your policies. Leave me alone.

MOGUL: Bloomberg's successor, Mayor-elect Bill de Blasio, has said he supports soda size limits, though he hasn't said much about other efforts. Public health experts aren't sure what to expect, but they doubt any time soon they'll have another ally like Bloomberg, an activist policy wonk with a fat checkbook and a willingness to take politically unpopular risks. For NPR News, I'm Fred Mogul in New York.

SIEGEL: And that story is part of a reporting partnership of NPR, WNYC and Kaiser health news. Transcript provided by NPR, Copyright NPR.