How To Live Longer
Observers of city government have learned about a wide variety of local issues in recent years. Today a new question is before us.
We have written about education, housing, planning and development, health care, crime and punishment, air and water quality, rent control, housing and planning, waste disposal, public sector unions, race and intergroup relations, as well as political topics such as districting, elections, campaign finance and term limits.
This year recurring scandals involving legislators have provided an ominous background for the solons’ deliberations. It is hard to pay close attention to the intricacies of local laws when your colleagues are in the dock.
So we welcome a new issue which arose this summer, as a result of an initiative by Mayor Bloomberg. This one had not been on the radar screen of policy wonks, but it has become the subject of debate. On May 31, 2012, Mayor Bloomberg proposed a Health Department regulation which would restrict the sale of sugary soda drinks to containers of sixteen fluid ounces or less. This would apply to any establishment inspected by the Health Department, which would enforce the rule.
Mayor Bloomberg’s proposal surprised the public and experts in the food business. Authorities on nutrition and dieticians were asked for their opinions on the legality and wisdom of an issue they had not previously considered. If an ingredient in food products is found by scientists to have detrimental effects on the body, what, if anything, should the government do about it? How toxic must a substance be to warrant official action? Are there any less drastic measures which would protect the public other than prohibiting the use of the challenged ingredient?
In any case, where does the city or the state get the authority to decide the size of a soda cup, which is neither a food nor a drug? Or any other containers for food or drink? Currently the Food and Drug Administration (FDA), a federal agency, sets standards for the labeling of food products. For example, whole milk must contain 3.25% fat. Skim milk, once an outcast in the dairy cooler, has been rebranded as fat-free milk, and now attracts younger purchasers.
Mayor Bloomberg has an intense interest in the field of public health. Over the years, he has contributed $107 million to Johns Hopkins School of Public Health, which was established in Baltimore to teach the subject. Public health is a relatively new academic discipline; the school was established in 1916 as an initiative of the Rockefeller Institute. It was, at the time, the first graduate level university dedicated to public health, combining social work, hygiene, and sanitary engineering. In 2001 the school was co-named for Michel R. Bloomberg, a Hopkins alumnus who went on to study at Harvard Business School.
Over the last ten years, the Mayor has proposed and secured the passage of various bills to improve public health. His national campaign against firearms has the vital purpose of making it more difficult and less convenient for people to kill each other and any strangers who may be in the way of their bullets.
Although violent crime in the United States has decreased significantly since 1970, a disproportionate number of young people and minority group members are victims and perpetrators in these murders, which often arise out of trivial misunderstandings. Among the most tragic victims are youngsters who are innocent bystanders when street gangs battle.
Recently a new practice has emerged: a mass homicide by a deranged shooter. In Norway in July 2 011, an admirer of Nazism, killed 77 young people. The authorities have agreed that he will serve 21 years in prison, which comes out to less than three months for each person he killed. There have also been mass shootings in schools, stores, movie theaters, job sites and other public places.
Some of these killings are considered “suicide by police”, which is aggravated by the death of innocents and the misery suffered by their families.
The beverage lobby is fighting the serving-size restriction tooth and nail. They believe that if it stands, there will be other legislation in the future regulating the serving size of food products. They feel the hot breath of government on their industry. Some of their advertisements relate the issue to the Second Amendment, which gives people the right to bear arms. They appeal to the libertarian streak in the American psyche.
We expect that the new regulation will be challenged in court, as happens frequently with regard to local laws and land-use decisions. New Yorkers appear to be particularly litigious, or interested in enforcing their Constitutional rights, depending on which side you are on. And there are certainly enough lawyers in the city to see that every case will be brought as long as the litigants can pa y counsel.
The new regulation does not prohibit people from drinking as much soda as they like or buying as many 16 oz containers as they wish. The purpose is to encourage moderation and help with a choice that for many is an unconscious one. When eating on the go, the serving size of our beverage is usually chosen for us. People generally get the medium-sized beverage for fountain drinks or whatever bottle is in a cooler and want to consume all that they have taken, even if they are satisfied before the servings is finished . If people who regularly drink sugary beverages consume smaller portions every day, over the long term they will be spared, or delayed in developing, myriad health problems.
The industry does have a point though. They see the opening wedge in the city’s drive to control its citizens eating habits for their own good. They have already done so with the ban of trans fats in 2006. The city’s anti-smoking campaign aims at reducing demand, mainly by health warnings and graphic imagery.
I remember from my childhood the cigarette ads of the 1940s with their emphasis on drawings of doctors wearing white coats. One slogan at the time was “4 out of 5 doctors prefer Chesterfields.” Lucky Strike cigarettes advertised “not a cough in a carload.”
The idea of promoting cigarettes as good for your health today seems ludicrous. But a half century ago, many people believed the advertising. 50 years ago, prior to the Surgeon General report released in 1964 that smoking is bad for your health, many believed that smoking was harmless or, like global warming, that nothing could be definitively proven on the subject. Those people were tragically misled. The tobacco companies continued to profit from the sale of their toxic product, fighting regulation, disclosure of contents or warnings of any sort.
Cigarette manufacturers targeted their ads to young people. I recall that as managing editor of my college newspaper, the largest ads we received were from an agency that represented tobacco companies. At the time, we did not realize that we were being used to sell a dangerous product to college students.
Obesity, which shortens the lives of millions of people, is rampant in the United States. Its cost, in medical expenses, lost earnings, and a shortened life span, along with increased burdens in providing services, runs into billions of dollars. Obesity rates vary throughout the states. At 34.9%, Mississippi has the largest portion of its population as obese and Colorado, the narrowest at 20.7%. New York State ranks relatively well on the scale, with 24.5% obese (ranked 42nd).
Many regulations, initially unpopular, came to be accepted after they were adopted. Among them are seat belts for automobiles and bicycle helmets. It took years to develop widespread compliance, but now there is general acceptance of the rule, and thousands of lives have been saved over the years.
Although the New York Times poll from this August showed 62% of the people opposed to the regulation, the comments received by the Health Department were largely in favor.
We believe that public health is one of Mayor Bloomberg’s strongest areas, based on his lifelong interest in the field, and his concern for people’s physical well being.
He appointed two excellent commissioners, Dr. Thomas R. Frieden in 2002, who is now the director of The Center for Disease Control and Prevention, and Dr. Thomas Farley in 2009. Both hold the degrees of M.D. and M.P.H. We hope the next mayor will appoint people of that caliber to this important position.
Many people do not think of health as a core function of local government. That is in part because health issues come to public attention primarily in emergencies (e.g. West Nile virus). New Yorkers have enjoyed generally good health in recent years, as reflected by increased life expectancy.
What people do not generally recognize is that decisions made by the City Health Department can have an impact on their lives. Getting the public to follow rules for good health is a difficult task, and there is a very limited budget for such initiatives. On the other side, New Yorkers are people with generally good judgment, and they are likely to be receptive to sensible messages.
The city also benefits from the substantial presence of hospitals and medical schools. Although costs are high, the service they provide is well regarded.
In the early part of the 20th century, New York State earned a reputation as leader in social progress. It would be a proud achievement if New York regained that reputation for initiative.
Governor Cuomo has the opportunity to make public health a prime goal of his administration, as Mayor Bloomberg has done in the city. We hope he takes special interest in this issue, which for many people is a matter of life and death.