Showing posts with label Mayor Bloomberg. Show all posts
Showing posts with label Mayor Bloomberg. Show all posts

Wednesday, June 20, 2012

Bloomberg praised in The Lancet

For those of you who vaguely recognize the name, The Lancet is a world-wide renowned medical journal, somewhat like the UK counterpart to JAMA, the Journal of the American Medical Association, only older by 60 years.

To provide a little background on The Lancet , for context, it is safe to say this is not a tacky tabloid:

The Lancet
In the 2010 Journal Citation Reports, The Lancet's impact factor was ranked second among general medical journals, at 33.63, after The New England Journal of Medicine (53.48).[2] 
So it carries some weight( pun intended), intellectually speaking that The Lancet came out earlier this month in support of the various public health measures of Mayor Bloomberg in improving both the quality and quantity of life in New York City -- a very dramatic improvement in a short period of time.

Here is the article, Redefining public health in New York City.
New York City's life expectancy is rising faster than anywhere else in the USA, as its health department pioneers tactics that could transform the practice of public health. Ted Alcorn reports.
“If you want to live longer and healthier than the average American, come to New York City”, pronounced New York City's Mayor Michael Bloomberg as he released updated data on the city's life expectancy last December. The numbers gave him reason to crow: from a nadir in 1990, when life expectancy in the city trailed the US average by 3 years, it had lengthened by 8 years to 80·6 years, surpassing the country.
In the national context, the increase in New York City's life expectancy stands out (figure). The Institute for Heath Metrics and Evaluation recently estimated the life expectancy for each of the USA's 3147 independent cities and counties. Manhattan's life expectancy rose 10 years between 1987 and 2009, the largest increase of any county, and the other four counties that make up New York City were all in the top percentile.
By contrast, national life expectancy lengthened only 1·7 years per decade, and the USA—already trailing the world's longest lived countries—dropped back further. “What we see in the United States sends an alarming, alarming message”, says Ali Mokdad, who led the research. “We are not catching up with what everyone else is achieving. And in many counties in the United States, we are falling behind: our life expectancy is going backward.” In this context it is all the more urgent to understand the improvements witnessed in New York City, and the lessons that can be applied elsewhere.
For the lip-service-only fact-averse right wing patriots, the people who like to run around chanting 'we're number one! we're number one!", insisting on our exceptionalism fantasy, this should be a wake up call - a very LOUD wake up call.

We used to be number one in most if not all of the desirable categories; we haven't been number one for a very long time now.  It is time to wake up and smell the coffee, time to sit up and recognize that we cannot continue to try to promote past glories as something innate to us.  We are failing.  The first step in reversing this terrible trend  of expanding failure, in our health and health care, in our longevity and other public health issues, in our educational failings, in our wealth and income disparity and our declining ability for our citizens to succeed is to acknowledge our problems.  We need to honestly identify them, find and fix the causes for our drop from that pinnacle of success.

I don't REALLY care if we are number 1 or number 5 or number 8.  But we should be worrying about why it is we are not among the world leaders in significant categories that measure both quantity and quality of life.  We should be concerned about why it is we are declining, and we should be concerned about what we can do about it.

The answer is NOT giving more money to the wealthy under the guise of pretending they are job creators; if THAT worked, we would have more jobs than we have people, given our extreme gap in wealth and income between the top 1% and the remaining 99%.  So why does anyone, especially on the right, even try to pretend that claim makes sense any more?

The answer is NOT less regulation to be more business friendly; if that worked, we wouldn't have had the financial disaster arising from fraud and disastrous business practices that sent us into a world financial crisis.  We have had more growth and better quality and quantity of every economic metric during eras of more regulation, not less.  Less regulation simply allows big business and the wealthy to shaft the majority of us to benefit a few special interests.

What does NOT work is to reduce government spending or government efforts at public health and public education.  What does not work is to be fact averse or anti-science.  What does not work is more ideology and more right wing religion dominating the public square.

What clearly DOES work is optimum regulation, and constructive public health measures.  People experiencing addiction make very different decisions than people who are not.  Sugar, like the nicotine in tobacco, or the long term effects of alcohol, is addictive. 

What do we know about sugar and addiction, and when did we know it?  The research has been accumulating for the past 25 years.  You no more override addiction by simply exercising your individual liberty, given the changes to your brain activity and chemistry, than you can just decide to not be drunk after consuming alcohol or decide not to be unconscious while under general anesthesia.  That is not how our bodily organs work, no matter how much bumper sticker thinking you repeat about your individual ability at independent decision making.
Sugar addiction 
A 1987 study showed sugar acted as an analgesic drug whose effects could be blocked by a morphine blocker.[2] In her 1998 book, author Kathleen DesMaisons outlined the concept of sugar addiction as a measurable physiological state caused by activation of opioid receptors in the brain and hypothesized that dependence on sugar followed the same track outlined in the DSM IV for other drugs of abuse.[3]
2002 research at Princeton began showing the neurochemical effects of sugar, noting that sugar might serve as a gateway drug for other drugs.[4] The research group fed chow to the rats as well as a 25% sugar solution similar to the sugar concentration of soft drinks. After one month the rats became "dependent" on the sugar solution, ate less chow and increased their intake of the sugary drink to 200%.[5] The sugar industry asserts that similar effects have been reported for rats given solutions that tasted sweet, but contained no calories.[citation needed] However, some scientists say that caloric value may not be the issue. Researchers say that sugar and the taste of sweet is said to stimulate the brain by activating beta endorphin receptor sites, the same chemicals activated in the brain by the ingestion of heroin and morphine. [6]
In 2003, a report commissioned by two U.N. agencies at the World Health Organization and the Food and Agriculture Organization was compiled by a panel of 30 international experts. It recommended that sugar not account for more than 10% of a person's diet.[2] However, the US Sugar Association asserted that other evidence indicates that a quarter of our food and drink intake can safely consist of sugar.
A 2008 study noted that sugar affects opioids and dopamine in the brain, and thus might be expected to have addictive potential. It referenced bingeing, withdrawal, craving and cross-sensitization, and gave each of them operational definitions in order to demonstrate behaviorally that sugar bingeing is a reinforcer. These behaviors were said to be related to neurochemical changes in the brain that also occur during addiction to drugs. Neural adaptations included changes in dopamine and opioid receptor binding, enkephalin mRNA expression and dopamine and acetylcholine release in the nucleus accumbens.[4]
Part of the problem in people making intelligent decisions is that they are unaware of how much sugar is added.  You expect sugar in candy bars or other sweets; you are less aware of it in ketchup, or crackers and peanut butter, or salad dressing, items labeled health foods like dried fruit, etc.  Your intention is to eat something else, not selecting for sugar.

The blog Chemistry on Your Table, about the intersection of science and food noted:
The average American consumes approximately 22 teaspoons of added sugar every day, which adds more than 320 calories to our daily diet. On average, 16% of Americans’ daily caloric intake comes from added sugar.
Added sugars in processed foods may be listed (or disguised) in the ingredients under a range of names such as:



The increase in sugar consumption is not an accident; it is big business, complete with Big Agri-business subsidies and lobbying.


 is the term for the relationship between sugar and various aspects of food addiction including: bingeing, withdrawal, craving and cross-sensitization. Some scientists assert that consumption of sweets or sugar could have an addiction like effect.[1]
is a weekly peer-reviewed general medical journal. It is one of the world's best known, oldest, and most respected general medical journals.[1] The Lancet was founded in 1823 by Thomas Wakley, an English surgeon who named it after the surgical instrument called a lancet, as well as after the term "lancet arch",[citation needed] a window with a sharp pointed arch, to indicate the "light of wisdom" or "to let in light". It publishes original research articles, review articles ("seminars" and "reviews"), editorials, book reviews, correspondence, as well as news features and case reports.

Friday, June 8, 2012

Mayor Bloomberg Isn't the ONLY Mayor Advocating Limits on Sugary Drinks!

Mayor Bloomberg has been getting a lot of bad press for his public health proposal regarding sugary drinks.  Personally, I think a certain amount of that attention is because a narrow segment of the population disagrees with him about gun control.
NRA Reality - old, white, not buff
Rambo NRA ' Gun Nut' hero Fantasy
When you consider the conservative inhabitants of the Red states, and the progunners fit the profile of old and white, flabby and crabby -- and by flabby, I mean obese not just deficient in muscle tone -- it makes sense that they would be as upset at limiting their fattening soft drinks the same way they get upset at limiting their gun fetish objects that enhance their fantasies of themselves as heroic 'Rambo' figures.  A casual perusal of peopleofwalmart.com will show you what I mean.  After checking out peopleofwalmart.com, consider that it is Wally World that is the number 1 seller of guns in the U.S.  That NRA classic profile I use probably owes the outcome to beer as much as sugary drinks, but you only get in trouble driving with beer, not sugary soda.

"soda jerks, people of walmart.com, page 20
just a little harmless'sugary drink excess - or addiction?
I mean, it's not like anyone is drinking sugary soda pop to excess.......is it?

Yes it IS.  And as was noted in a segment of 60 Minutes earlier this year, sugar is an addictive substance, not just a food choice.  That puts it in a somewhat different category from other kinds of food, an aspect of the discussion which has been overlooked in the push back against Mayor Bloomberg.



It is NOT just Bloomberg who is promoting the idea of a little healthy portion control on sugary drinks as a public health measure!  Other mayors share the idea in different iterations.
Public health issues are a public problem; failing to address self-destructive patterns of consumption that are the root cause of public health issues require a comprehensive and broad (pardon the pun) based solution, portion control
in the form of product size limitations or taxation is just one part of that solution.  To call it the nanny state is to deny or ignore the nature of the problem, and to fail to produce a solution, just as gun nuts rejecting reasonable gun control relates directly to our high rates of death and injury.  And as with both sugary drinks and guns, the worst victims tend to be children.  Portion control solutions work.  No one is taking away your freedom to indulge, but it is making that choice a more thoughtful one that makes it easier to make the correct choice.

FOR EXAMPLE, from the Philadelphia Weekly re hizzoner, Mayor Nutter of Philadelphia:

Mayor Nutter Says Bloomberg Soda Plan ‘Worth Evaluating and Considering’

dont-buyAs we mentioned earlier today, Mayor Michael Nutter is in Washington, DC today and delivered the keynote address at the Center for Science in the Public Interest’s Inaugural National Soda Summit. His statements were recently sent out to press and note something we’ve all been thinking: He is still adamant about his soda tax idea and even believes New York City Mayor Michael Bloomberg’s ban on super-size drinks is a positive step.
“Mayors across the country and I have proposed taxes or new regulations on sugar sweetened beverages,” he said. “We need a multi-pronged approach to decrease sugary drinks consumption. Education, taxation, and increased access to healthier options have to all be a part of the discussion.”
Last summer, the Nutter Administration proposed a 2-cent per-ounce tax on soda, after a previous plan failed and property taxes were hiked instead. The city has invested its own and federal stimulus cash into an anti-soda campaign, in which posters are put up outside delis and other establishments asking consumers to think twice before purchasing their beverage of choice.

Sunday, June 3, 2012

Bloomberg takes credit for NYC better health result

The lives of New Yorkers are blooming, by which I mean that thanks to the intervention of Mayor Bloomberg, people are healthier and living longer than their national counterparts.  Hizzoner credits his moves related to smoking, and to posting calories for food as the reason.
Absent better arguments that can show other cities have taken similar measures, with a different result, it makes a certain distinct amount of sense as these claims go.  Is it the absolute or only reason for those statistical differences? Probably not.   Are we so simplistic and unrealistic that we expect all solutions to be without any difficulties? (Sadly, perhaps we are.)
I applaud Mayor Bloomberg for trying to come up with solutions for our health care cost problems and for taking on the issues of public health in the proper ways in which civil government should act in response to those health problems, those problems are more than just an individual choice issue.
I differ with the mayor on how to present this for acceptance, but I applaud a reasoned portion control approach to help solve a very real problem.
Here is the NYC.gov announcement, that I think is well worth reading by those who are critical of the mayor or his proposal.  And in case you are already thinking this is just Bloomberg's spin on his proposal, the announcement precedes it by some 5 months.

FOR IMMEDIATE RELEASE
PR- 453-11
December 27, 2011

MAYOR BLOOMBERG, DEPUTY MAYOR GIBBS, HEALTH COMMISSIONER FARLEY ANNOUNCE NEW YORKERS LIVING LONGER THAN EVER, OUTPACING NATIONAL TREND
City's Health Interventions Contribute to All-Time High Life Expectancy of 80.6 Years; Life Expectancy for a 40-Year-Old New Yorker Increased by 2.5 Years

Deaths From Leading Causes - HIV, Heart Disease and Cancer - Decrease as City Death Rate Falls to Historic Low


Mayor Michael R. Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs and Health Commissioner Dr. Thomas A. Farley today announced that, surpassing national figures, New Yorkers are living longer than ever before. Influenced by New York City's aggressive public health initiatives and improvements in the quality of the health care delivery system, babies born in New York City in 2009 have the record high life expectancy of 80.6 years, an increase of nearly three years since 2000 and nearly two and a half years more than the most recently reported national rate of 78.2 years. Life expectancy for 40-year-olds in New York City increased by 2.5 years (79.5 to 82) from 2000 to 2009, a substantially greater gain than the 1.2 year increase for the same age group in the U.S. as a whole. At the same time, life expectancy for 70 year-olds in New York City increased 1.5 years, compared with .7 years for the nation. Not only did the City's life expectancy rate surpass the national rate, it improved faster than any major city for both women and men. The City's health interventions - including its smoking prevention programs and expanded HIV testing and treatment - have contributed to this success, with improved outcomes in HIV infection, heart disease and cancer prevention and treatment playing the largest role in the increase in life expectancy. The gains the Mayor, Deputy Mayor Gibbs and Dr. Farley announced today come before any future improvements in medical science are taken into account. The Mayor made the announcement at the maternity ward of Lincoln Hospital, which delivered 2,574 babies during 2010, where he was joined by State Senator Jose M. Serrano, Lincoln Hospital Deputy Executive Director, William Hicks, and Medical Director, Dr. Melissa Schori.
"If you want to live longer and healthier than the average American, then come to New York City," said Mayor Bloomberg. "By investing in health care and continuing to encourage more New Yorkers to take charge of their own health, we've experienced dramatic improvements in life expectancy. This news really does make it a happy, healthy New Year."
"New York City residents are healthier than ever," said Deputy Mayor Gibbs. "Cleaner air, safer streets, healthier food - these all contribute to improved quality of our lives, and added years of life. This has come about through the creative ideas and determined implementation across many City agencies."
"Fewer New Yorkers are dying from HIV-related illness and smoking-related illnesses," said Health Commissioner Farley. "People with HIV infection are increasingly being identified through expanded HIV testing, and advances in the treatment of HIV infection are being made available to everyone with HIV sooner. Since 2002, nearly half a million New Yorkers have quit smoking and dramatically reduced their risk of heart disease and cancer that result from smoking. We will keep working to make New York City a healthier environment, which will not only lengthen life expectancy but also improve the quality of life of New Yorkers."
"As the nation's largest public healthcare system that serves one in eight New Yorkers and delivers nearly one quarter of the city's babies, HHC has played a critical role in making New York a healthier place to live," said HHC President Aviles. "Our investments in primary and preventive care, and our public health interventions that focus on helping patients manage their chronic medical conditions are making it possible for more and more New Yorkers to stay healthy and live longer."
"Mayor Bloomberg has consistently taken cancer prevention knowledge and turned it into effective policy," said Donald Distasio, CEO of the American Cancer Society of New York and New Jersey. "Programs that have prioritized access to cancer screenings, required calorie information at restaurants, made our bars and restaurants smoke-free and offered free nicotine patches all give New Yorkers the tools they need to live longer. It's certainly no surprise that the same year our city hits record lows for smoking rates, we also hit record highs life expectancy. The Mayor is to be applauded for his policies and their life-extending results."
From 2000 to 2009, New York City life expectancy rate at birth increased by nearly 3 years, far greater than the nationwide increase of nearly 1.5 years. The life expectancy of both men (78 years) and women (83 years) increased. The 2010 death rate reached an all-time low of 6.4 deaths per 1,000 New Yorkers. This marks a 13.5 percent decline from 7.4 deaths per 1,000 in 2002. In 2009, the life expectancy for a 40-year old in New York City was 82, compared with 80.1 in the United States, while the life expectancy for a 70 year old in New York City 86.9, compared to 85.1 nationwide.
The Health Department analyzed data from death certificates and determined that improvements in prevention and treatment among the following diseases and conditions contributed the most to the increase in life expectancy. Recent trends through 2010 in mortality rates for these conditions are included below, in order of significance.