A decade of health policies and health-promotion messages in New York City aimed at preventing cardiovascular disease have pushed heart-disease rates downward faster than they have elsewhere in the US, according to the city’s health commissioner. “Making healthy choices easy ought to be our goal at the population level,” Dr Thomas Farley said during the opening ceremonies of the Canadian Cardiovascular Congress 2013.
Since 2002, when Mayor Michael Bloomberg took office and began implementing policies to battle smoking and obesity, the life expectancy of New Yorkers has risen by 36 months vs an average increase of 21.6 months in the rest of the country, Farley noted. Half of this increase was from decreased heart disease—probably the result of the ban on smoking in public places.
Encouraging Smoking Cessation
The city used a multipronged strategy to get its citizens to stop smoking. In 2002, it banned smoking in public places. Currently, it has the highest taxes on cigarettes in the country. When focus groups revealed that smokers were afraid of suffering but not of dying, they implemented a hard-hitting ad campaign that shows a patient with lung cancer “suffering every minute.”
The prevalence of smoking dropped from 21% in 2002 to 15.5% in 2012, “which represents about 300 000 fewer smokers . . . and saves an estimated 1500 lives a year,” Farley said.
Focusing on Diet, Calories, and Physical Fitness
Close to 60% of adults in New York City are overweight or obese—”a problem of normal people in an abnormal environment,” according to Farley.
To turn this around, the public-health department focused on increasing consumption of fruits and vegetables and making people aware of calories, sugary drinks, trans fat, and sodium.
The city established standards for food and beverage vending machines that deliver millions of meals and snacks to New York City government employees. It is also working with retailers to increase the prominence of healthy foods and set up a system of street vendors who sell only fruits and vegetables, in targeted neighborhoods.
In 2006, the New York Board of Health voted to restrict artificial transfat in 24000 restaurants, one of the first major cities to take this step. That initiative appears to have paid off. Then, in 2008, the city implemented a policy requiring that fast-food restaurants post the calorie content of foods. This resulted in a small but meaningful effect: 15% of consumers read the calorie content, and these individuals then eat 100 fewer calories.
The city has also led a successful campaign to lower the sodium content in food. Last year, 21 companies met voluntary sodium-reduction targets for such products as Heinz ketchup (15% lower) and Kraft singles American cheese (18% lower).
Public Policies to Prevent CVD
Speaking with heartwire after Farley’s presentation, CCC scientific program committee chair Dr Andrew Krahn (University of British Columbia, Vancouver) noted that the public-policy approaches undertaken in New York will be key to combating CVD.