Taking credit where credit isn t due

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A new report finds that life expectancy in New York City is rising faster than anywhere else in the US, prompting health experts to consider whether the city might serve as an object lesson to public health departments around the country.

According to the Institute of Health Metrics and Evaluation at the University of Washington, Manhattan's life expectancy increased by 10 years between 1987 and 2007, with the other four counties that comprise New York City showing comparable gains. At an average life expectancy of 80.6 years, New York surpasses the national average by about two years. And while the city's mayor, Michael Bloomberg, is happily accepting some of the credit for the renewed health of his city, we here at ACSH are skeptical as to just how much of that credit he deserves.

Inarguably, the gains in New York City's life expectancy since the 1990s have more to do with attention to AIDS and crime than to trans fat bans and calorie counts. As the report notes, AIDS-related mortality and a notorious homicide rate were sinking the city's life expectancy rate in the early '90s. However, as the murder rate plummeted and new treatments for HIV became available, the city population's life expectation rebounded. Now, though, with 87 percent of deaths in New York City attributable to non-communicable diseases. and mortality data that shows this number beginning to fall, health experts are wondering whether Mayor Bloomberg's public health policies deserve credit.

"Not so fast," says ACSH' Dr. Gilbert Ross. "The report finds that over 60 percent of the increase in life expectancy since 2000 is due to reductions in heart disease, cancer, diabetes, and stroke yes. But these reductions are a nationwide phenomenon: Heart disease rates have been falling in the US since the decline in smoking rates began over 40 years ago, statins became widely prescribed, and improved detection and treatment of high blood pressure." And while Dr. Ross gives credit to the Bloomberg administration for the anti-smoking initiative that has reduced disease, as well as the city-wide addition of bike lanes that encourage physical activity, he can't fathom how other, more questionable efforts have improved anyone's health. "The trans fat ban of two years ago was scientifically unfounded," he says, "but even if it weren't, we wouldn't be seeing its effects yet. Posting caloric content on menu items doesn't seem to have had a discernible effect, on consumer preferences in particular, either."

ACSH s Dr. Josh Bloom believes that the report is ridiculously slanted. There is a single sentence about antiretroviral drugs and AIDS, he notes, yet plenty on dietary issues like encouraging low-fat meals. To try to equate these factors is sheer nonsense. The life span in New York rose by ten years primarily because HIV/AIDS became treatable during this time. This had no more to do with the New York City Health department than I did with bringing down the Berlin Wall. Credit belongs to the drug companies that came up with the new therapies, not any politician.

Also important, the report identifies low-income areas in the city where residents' life expectancy is significantly lower than that of more affluent areas. Within the past decade, the Bronx District Public Health Office (one of three offices established in 2002 to reduce health inequities in high-poverty areas) has begun to work on programs aimed toward making healthful choices more possible. These pilot programs include efforts to attract produce vendors to the area, improving asthma management through the school system, and providing information and services to reduce teen pregnancy. Dr. Ross, for his part, was glad to hear it. "These are good programs indeed," he says. "They're likely to have significant health benefits as opposed to something like a trans fat ban."