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Former NYC Commissioner Makes Case for Expansive Role in Public Health

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The Bloomberg administration may have lost the soda ban battle in 2012, but according to Thomas A. Farley MD, MPH, advocates who are highlighting the dangers of sugary drinks are winning the war.

“That was a failure of the policies, but in the end, we won. Consumption of sugary drinks during that time period has fallen dramatically in New York City,” he said at Fordham’s Lincoln Center campus on Sept. 29.

Farley, the New York City Health Commissioner from 2009 to 2014, noted that annual surveys have found that the amount of sugary drinks that people say they drink daily has dropped by a third. The nation of Mexico and the city of Berkeley, California, have also instituted soda taxes similar to the one that was defeated in New York in 2012.

Farley’s appearance, with moderator William Baker, PhD, journalist-in-residence and Claudio Acquaviva Chair at the Graduate School of Education, marked the third in a series of Fordham’s Oral Archive on Governance in New York City: The Bloomberg Years.

In a lengthy Q&A with Baker and audience members, Farley lamented that too much attention is lavished on ways we can protect ourselves individually, even though we benefit more from group efforts.

“I saw a headline the other day, ‘What you can do to protect yourself from getting an antibiotic-resistant infection.’ And the answer is really, nothing. There’s almost nothing you can do individually,” he said.

“But there’s a lot we can do as a society to prevent that.”

Reminiscing about his time in office, Farley praised the former mayor for making decisions based on data and not asking him what the political ramifications might be. That isn’t to say that Bloomberg gave the thumbs up to every idea Farley and his team proposed: Farley said he shot down an idea to ban the sale of cigarettes at pharmacies—which he noted have a “halo of health” around them that conflicts with cigarettes—and to ban their sale within a certain distance of schools.

“He listened and gave it a fair hearing, but at the end he said no. Because while he’s a public health guy, he’s also a businessman who kind of chastens at the idea of government interfering with business,” he said.

Farley said he was most proud to have put the issue of sugary drinks on the map, and to have extended the smoking ban to parks and beaches. He said his only regret was not paying closer attention to politics to get a better idea of what opponents were doing.

He detailed many of the stories of New Yorkers whose lives were saved in his book, Saving Gotham: A Billionaire Mayor, Activist Doctors, and the Fight for Eight Million Lives (W. W. Norton & Co., 2015)

Ultimately, public health should go beyond fighting pandemics, inspecting restaurants, and controlling pests, he said. It should tackle bigger problems like obesity, smoking, or designer drugs, which he said are the real challenges of the future.

“Public health needs to be in the service of dealing with modern-day stress. To do that, it needs to reinvent itself, and it needs an entirely different set of skills: communication skills, people skills, politics skills, things that are more relevant,” he said.

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