Mayor Bloomberg, Deputy Mayor for Health and Human Services Linda I. Gibbs and Health Commissioner Dr. Thomas A. Farley today visited Montefiore Medical Center to highlight the impacts of obesity, which kills an estimated 5,800 New Yorkers per year and is one of the leading causes of preventable death in the United States, second only to smoking. As the result of obesity, one in three adult New Yorkers now has diabetes or pre-diabetes and obesity increases the risk of some cancers, heart disease, arthritis and depression. Obesity is the only major public health crisis in America that is getting worse and nearly 60 percent of New York City residents are currently overweight or obese. In addition to the toll on health, the costs to the public are steep: in New York City $4 billion is spent annually on health care costs related to obesity. The Mayor’s Task Force on Obesity has proposed initiatives – including limiting the size of sugary drinks, significant contributors to the epidemic – with the goal of reducing the percent of obese adults by 10 percent and children by 15 percent over the next five years.
Montefiore Medical Center the Bronx is at the center of obesity epidemic, where obesity and diabetes rates are the highest in the city. The Mayor was joined by Public Advocate Bill de Blasio, Manhattan Borough President Scott M. Stringer, Montefiore Medical Center President and CEO Dr. Steve Safyer, Montefiore Executive Vice President and Chief Operating Officer and Pediatrics Chair Dr. Philip Ozuah, Director of Montefiore School Health Program Dr. David Appel, Director of Montefiore B'N Fit Program Jessica Rieder, Chairman of the Montefiore Department of Family and Social Medicine and Director of Community Health and Wellness Doctor Peter Selwyn, President of the New York Health and Hospitals Corporation Alan Aviles, HealthFirst President and CEO Pat Wang, Department of Environmental Protection Commissioner Carter Strickland, Food Policy Coordinator Kim Kessler and Department of Education Deputy Chancellor for Operations Kathleen Grimm.
“In New York City nearly 60 percent of adults and nearly 40 percent of children are overweight or obese and there are real world consequences,” said Mayor Bloomberg. “People’s lives will be shorter, their quality of life is going to be dramatically reduced and obesity is going to start killing more people in this country than smoking. Obesity is the only major public health issue we have that is getting worse and New York City has the courage to stand up and do something about it.”
“The obesity epidemic is on track to reverse the enormous progress made in health and life expectancy in recent decades,” said Deputy Mayor Gibbs. “If obesity rates continue to grow, this generation of children may be the first to live shorter lives than their parents. Our initiatives are bold, targeted and aim to combat this dangerous and growing challenge. ”
“Limiting the size of sugary drinks to no more than 16 ounces at food service establishments will help us confront the obesity and diabetes epidemics, which now affect millions of New Yorkers,” said Health Commissioner Dr. Thomas Farley. “This intervention will begin to curb the thousands of empty and unnecessary calories New Yorkers consume from sugary drinks every year, and educate people about the health risks they pose.”
“As a parent, I know that every time my kids walk down the aisle at our neighborhood deli they are confronted with more bad choices than good ones,” said Public Advocate de Blasio. “It’s an uphill battle that is taking a terrible toll on families across this City – and no one will pay a higher cost than our children if we fail to act. Mayor Bloomberg understands that we are losing the fight against obesity and it is time for a new approach. I commend the Mayor for recognizing this public health crisis and taking it head-on.”
“If public health is our goal and obesity our enemy, we must be creative and aggressive to fight and win this war,” said Manhattan Borough President Stringer. “That’s why I commend Mayor Bloomberg for drawing a line in the sand and taking on the soda cartel which is driving the obesity epidemic in this country. The policy is a bold start, but much more needs to be done. We should give every New York City child the tools they need to make smart, healthy choices by focusing on nutrition in the schools, and we should give small business owners a boost by we should give small business owners a boost by increasing funding for retail access initiatives like Healthy Bodegas. Throughout my six years as Borough President, breaking the pattern of harmful environmental and health conditions in many of Manhattan’s neighborhoods has been a top priority. The Mayor’s action continues New York City’s record in leading the nation in innovative strategies to protect the health of its residents.”
“We see the often grave health impacts of the obesity epidemic every day across our public hospital system with ever increasing numbers of overweight patients presenting with diabetes, hypertension and congestive heart failure,” said HHC President Alan D. Aviles. “While there is no single action that will help all patients avoid or reduce excess weight gain, a sensible restriction on the available portion size of sugary beverages can increase the odds."
“Mayor Bloomberg’s proposed ban on the sale of large surgery drinks is an important step in the fight against obesity,” said Montefiore Medical Center President and CEO Dr. Safyer. “I’ve watched for years as sugary beverages and unhealthy foods have been marketed to our children, while the obesity epidemic exploded. What we need now are far-reaching measures to protect our children from the risks of diabetes, heart disease, and cancers associated with obesity.”
“The importance of Mayor Bloomberg’s initiative cannot be overstated,” said Montefiore Executive Vice President and Chief Operating Officer Dr. Ozuah. “As Physician in Chief of The Children’s Hospital at Montefiore, it’s been incredibly challenging to watch more and more children coming in each year with complications from obesity-related illnesses. With this ban, my hope is that children, as well as adults, can begin establishing healthier habits and working towards a healthier future.”
“Healthfirst applauds Mayor Michael Bloomberg’s effort to limit the portion size of sugary soft drinks at public eating establishments,” said Pat Wang, President and CEO, Healthfirst. “As a not-for-profit health plan coordinating the health care of close to 600,000 people in New York City, we see both the human and financial costs of obesity on a daily basis – the suffering of individuals with obesity-related disease, the impact on their families and the growing financial costs of treating these conditions once they have set in. The Mayor’s initiative is important because it aims to lower the incidence of obesity-related illness by lowering the rate of obesity itself.”
“I applaud Mayor Bloomberg for taking steps toward making New York City and the Bronx healthier communities,” said State Senator Gustavo Rivera. “Much of what determines one's health is one’s habits. I believe in the long-run, making sure that our youth are not developing unhealthy habits like drinking large amounts of soda instead of water or healthier beverages is an important cause. It may seem like a small change, but making our community healthier is like making an individual healthier – it is going to take a lot of little things."
“NYC Water helps you maintain a balanced weight because it has zero calories, zero sugar, and zero fat–whether you drink one ounce or 32,” said Commissioner Strickland. “Our world class drinking water is a healthy alternative to high calorie sugary drinks, and is an effective means of fighting obesity because it’s available to all New Yorkers at only a penny a gallon.”
“The Mayor has been a fearless leader in the arena of food policy throughout his tenure, and the sugary drink portion size proposal is yet another bold action that will help our City continue to progress towards our goal of making the healthy choice the easy choice for all New Yorkers,” said Food Policy Coordinator Kessler. “The City has long had a dynamic approach to the complex challenge of obesity - with programs aimed at increasing access to and awareness of healthy foods as well as reducing consumption of unhealthy ones. I am thrilled that our task force initiatives continue this holistic approach, with recommendations aimed at immediate impact as well as longer term investments like expansion of our school wellness and garden programs.”
Obesity is a rapidly growing and major public health problem. In the early 1960s it affected only 13 percent of Americans; by 2009-2010, 35.7 percent were obese. With at least 58 percent of New York City adults – 3,437,000 people – now overweight or obese, this has become the norm in New York City. It is not a norm without consequences: obesity is a leading cause of preventable premature death, second only to tobacco, and is responsible for the deaths of 5,800 New York City residents per year through diseases such as diabetes, heart disease, and stroke.
The obesity epidemic has led to massive increases in the prevalence of type 2 diabetes, which can result in blindness, kidney failure and amputations. One in three adult New Yorkers now either has diabetes or a condition known as pre-diabetes, a state where blood sugar is higher than normal but not high enough to be considered diabetes and the person is at risk for developing diabetes in the future. In NYC it is estimated that there are 2,600 annual hospitalizations for amputations related to diabetes and 1,400 new dialysis patients due to diabetes each year. In addition, applying national estimates to the NYC population, over 100,000 adults 40 years and older have diabetic retinopathy (eye disease) which if untreated, may lead to blindness. Obesity also increases the risk of some cancers, heart disease, arthritis; severe obesity leads to immobility and depression.
Obesity statistics are even more startling among New York City youth. Despite recent progress with childhood obesity, 21.3 percent of New York City children ages 6-11 years are obese, compared to 19.6 percent nationally.
The obesity epidemic strikes hardest in communities already suffering from health and economic disparities, particularly black, Latino and low-income neighborhoods; black New Yorkers are almost three times more likely, and Hispanics twice as likely, as whites to die from diabetes. The Bronx, in particular, is facing an obesity crisis. While the citywide rate of overweight and obesity is 58 percent, in the Bronx 70 percent of adults – about 630,000 people – are overweight or obese.
The price of obesity goes beyond human suffering. Nationally in 2006, direct medical costs related to obesity were $147 billion. Nationwide, higher rates of death among obese employees cost roughly $44 billion annually. Loss of productivity due to disability among active workers ($39 billion) and loss of productivity due to total disability ($65 billion) from overweight and obesity add to this toll. In NYC, obesity costs alone are roughly $4 billion annually, including private insurance and out of pocket costs. Estimates of future costs are even more concerning: according to one study, obesity-related direct expenditures are expected to account for over 21% of the nation's direct health care spending in 2018.
The Mayor’s Task Force on Obesity, co-chaired by Deputy Mayor Gibbs and Deputy Mayor for Operations Cas Holloway, has launched a set of initiatives that seek, over the next five years, to:
- Reduce the percent of NYC adults who are obese by 10 percent (23. 4 percent to 21. 1 percent).
- Reduce the percent of children (K-8th grade) who are obese by 15 percent (20. 7 percent to 17. 6 percent).
- Reduce the percent of adult New Yorkers who: consume one or more sugary drinks per day by 30 percent (30. 3 percent to 21. 2 percent); consume no servings of fruits and vegetables in the previous day by 30 percent (11. 6 percent to 8. 1 percent); and report no physical activity in the past 30 days by 15 percent (27. 3 percent to 23. 3 percent).
The centerpiece of the initiative is the City’s proposal to limit the size of sugary drinks sold in food service establishments to 16 ounces or less. This would apply to restaurants, mobile food carts, delis, concessions at movie theaters, stadiums and arenas. Sugary drinks are ubiquitous, high in calories, cheap, served in large sizes, and aggressively promoted. They provide no nutritional value and don’t create a sensation of fullness, meaning people typically don’t cut back on other calories when they consume extra calories through sugary drinks.
The long term weight gain and increased risk of heart disease and diabetes associated with sugary drinks have been documented in the literature and, in 2010, experts from Harvard and three other leading nutrition research institutions in the US and Canada concluded that because sugary drinks are important contributors to obesity, diabetes, heart disease, their consumption “should be limited and replaced by healthy alternatives such as water.”
New York City public hospitals have been working on making important changes to the meals and snacks they serve, as well as their beverage vending. Montefiore Medical Center has voluntarily undertaken many of the same changes and has made great strides by eliminating regular sodas and reducing the availability of high calorie beverages in their cafeterias and vending machines.
As part of its ongoing comprehensive public education effort, the City will also continue its leadership in developing hard-hitting campaigns that communicate the risks of supersize portions and excessive consumption of sugary drinks. These straightforward messages address the downsides of excess sugar and calorie consumption and build new norms around healthy eating.
About the Obesity Task Force
In December 2011, Mayor Bloomberg charged Deputy Mayor Gibbs and Deputy Mayor of Operations Holloway with significantly strengthening the City’s anti-obesity efforts by convening a multi-agency task force that would recommend innovative, aggressive solutions to address the obesity crisis in New York City. The Obesity Task Force was convened in January 2012 and conducted its work over the following several months.
Chaired by Deputy Mayors Gibbs and Holloway, Commissioners from eleven City agencies and representatives from the Mayor’s Office participated including: Alan Aviles, President, Health and Hospitals Corporation; Adrian Benepe, Commissioner, Department of Parks and Recreation; David Bragdon, Director, Office of Long Term Planning and Sustainability; Amanda Burden, Commissioner, Department of City Planning; David Burney, FAIA, Commissioner, Department of Design and Construction; Robert Doar, Commissioner, Human Resources Administration; Dr. Thomas Farley, Commissioner, Department of Health and Mental Hygiene; Kim Kessler, Food Policy Coordinator; Robert LiMandri, Commissioner, Department of Buildings; John Rhea, Chairman, NYC Housing Authority; Janette Sadik-Khan, Commissioner, Department of Transportation; Carter Strickland, Commissioner, Department of Environmental Protection; and Dennis Walcott, Chancellor, Department of Education.
About Overweight and Obesity
Obesity is defined as a body mass index (BMI) of 30 or more and overweight is a BMI of 25 or more. BMI is a metric that measures excess weight in relation to height. More information about how to calculate BMI for children is available on the CDC website (www.cdc.gov). Many serious health conditions are related to being overweight or obese, such as depression, diabetes, high blood pressure, respiratory problems and heart disease.
Current and Ongoing New York City Initiatives
- Menu Labeling: NYC requires chain restaurants that hold Health Department permits to prominently post calorie information on menu boards and menus.
- Meal and Vending Standards: NYC established nutritional standards for every City agency that purchases or serves meals to clients to improve the health of the 1. 1 million students that attend City schools; patients in City hospitals and nursing homes; clients served by homeless shelters, day cares and senior centers; and inmates in City jails. The City also established standards for City vending machines, reducing the availability of high calorie snacks and sugar sweetened beverages in City facilities.
- Green Carts: NYC has issued more than 500 green carts permits to sell raw fruits and vegetables in areas that have reduced access to fresh produce. This initiative, with the support of the Laurie M. Tisch Illumination Fund, funds micro-loans and technical assistance for Green Cart operators, as well as branding, marketing, and outreach to encourage residents of the Green Cart areas to purchase fresh produce from the carts.
- Health Bucks: Health Bucks, worth $2 each can be used to purchase fresh fruits & vegetables at all farmers markets in NYC. Farmers' markets that accept food stamps (Electronic Benefit Transfer/EBT) will give one Health Buck coupon to each customer for every $5 of food stamps spent on fruits and vegetables.
- Move-to-Improve: Offered through the New York City Departments of Health and Education, this is a comprehensive and engaging program to help teachers integrate physical activity into all areas of classroom academics.
- Active Design Guidelines: Developed by a partnership of the NYC Departments of Design and Construction, Health and Mental Hygiene, Transportation, City Planning and Office of Management and Budget, this initiative provides architects and urban designers with a manual of strategies for creating healthier buildings, streets and urban spaces, based on the latest academic research and best practices in the field.
- Urban Cycling: NYC has re-imagined the urban streetscape to promote safe bicycling for recreation and commuting. In just three years, the Department of Transportation has completed the City's ambitious goal of building 250 bike-lane miles in all five boroughs.