Bloomberg Speaks on Non-Communicable Diseases at UN General Assembly
By NYC.gov - SEP. 20, 2011
The following are Mayor Bloomberg's remarks as delivered this afternoon at the United Nations:
“Thank you, Mr. President. Excellencies; distinguished guests: Thank you all, good afternoon to everyone. For those of you who have come to our city for this meeting, and for the upcoming session of the United Nations General Assembly, welcome to New York. We are always delighted to be your hosts. And I am honored to have this opportunity to address you.
“Improving public health has long been one of my passions, and it’s why I’m devoted to enhancing one of the world’s preeminent schools of public health at my alma mater, the Johns Hopkins University, which is dedicated to saving lives, millions at a time.
“Public health remains an intense focus of my philanthropic work, as well as of my public service as Mayor of the City of New York. And without a doubt, the greatest public health challenges in the world today are those that you’ve identified: the dangers of chronic, non-communicable diseases.
“The increase in cardiovascular disease, cancers, diabetes, and chronic respiratory diseases has, as the World Health Organization warns, reached epidemic levels. Unless we head off this epidemic now, each year tens of millions of people across the globe – especially in low- and medium-income nations – will be subjected to crippling pain and disability caused by cardiovascular disease and cancer.
“Tens of millions more will be left speechless and immobile by debilitating strokes, or maimed and enfeebled by diabetes. And tragically, tens of millions of others will face early and painful deaths, leaving families bereft and, often, impoverished.
“We have made reducing non-communicable disease the focus of public health policy here in New York City, a city of about 8.4 million people. And I’m happy to report that we have had considerable success as a result. It’s fundamental to why for New Yorkers today, life expectancy has increased faster and remains higher than for Americans overall. Between 2001 and 2008, life expectancy in our city grew by more than a year and a half. That’s an outcome we take pride in and that we’ve worked hard to achieve. And I believe all nations worldwide can achieve similar success.
“At the outset of our Administration, we recognized that non-communicable diseases – especially heart disease and cancer – far outstripped all other causes of death in our city and that the single most effective thing that we could do to reduce them was to discourage smoking. Since then, we have implemented a range of policies to achieve precisely that goal.
“We have, for example, made New York City’s bars and restaurants, like our other workplaces, smoke-free. Recently, we extended that ban to our parks and public beaches. We’ve also mounted hard-hitting educational media campaigns that graphically depict the dire consequences of smoking. We’ve made smoking cessation programs far more widely available. And very importantly, we’ve increased the excise taxes to make cigarettes purchased in our city the most expensive in the nation at about $11 a pack.
“Here are the results of these efforts. Before 2002, the proportion of adult smokers in our city had been constant for many years; roughly 22 percent. Today, that has dropped to 14 percent – the lowest on record. There are now some 450,000 fewer adult smokers in our city than there were in 2002. That means we’ve already saved at least 1,500 lives a year. Most encouraging of all, the proportion of public high school students who smoke has been cut by more than half, from 18 percent to just 7 percent. And that will save even more lives in the years ahead.
“Such results can be – and must be – replicated worldwide. Because when it comes to preventing tobacco-related illness and death, we are in a race with time – a race we can’t afford to lose.
“Here is what is at stake: By the end of the decade, the WHO expects 7.5 million tobacco-related deaths worldwide, every year. Some 80 percent of these deaths will take place in the world’s low- and middle-income nations – nations where tobacco companies have stepped up their marketing briskly.
“As The Economist has put it: ‘The tobacco industry is getting the world’s poor hooked before governments can respond.’ Unless we do respond, the results will be one billion pre-mature deaths worldwide during the 21st century.
“That would be a calamity of the first magnitude – and that’s why I’ve also made tobacco control a major priority of Bloomberg Philanthropies. Since 2006, we’ve established partnerships with governments and citizens’ groups around the world to implement public policies designed to defeat the global tobacco epidemic. These policies are familiar to many of you. They carry out the intent of the historic ‘Framework Convention on Tobacco Control,’ the world’s first public health treaty, ratified by some 170 nations – and many nations are now taking action.
“For example, two years ago, the Brazilian State of Sao Paulo mandated comprehensive smoking-free public places. Since then, six more Brazilian States have followed. Turkey has adopted similar policies nationwide, and also mandated graphic cigarette pack warnings and raised tobacco taxes. And so far this year, Nepal, Lebanon, Argentina, and Ecuador and other nations have enacted comprehensive tobacco control laws.
“The progress we’re seeing on tobacco is encouraging action on other fronts as well. To attack diabetes and heart attacks, for example, in New York, we have also taken the lead in promoting healthier eating. In 2008, we became the first jurisdiction in the United States to require restaurant chains to post calorie information on menus and menu boards. Surveys now tell us that customers who observe these postings buy food with fewer calories.
“In 2009, we enacted the first restriction on cholesterol-raising artificial trans fat in the city’s food service establishments. Our licensing of street ‘Green Cart’ produce vendors has greatly increased the availability of fresh fruits and vegetables in neighborhoods with high rates of diet-related diseases.
“We’ve led a national salt reduction initiative and engaged 28 food manufacturers, supermarkets, and restaurant chains to voluntarily commit to reducing excessive levels of sodium in their products. And we’ve mounted a public education campaign highlighting how consuming sugar-sweetened drinks contributes directly to the obesity epidemic that plagues far too many New Yorkers, especially our children.
“Bloomberg Philanthropies has also begun to address another major and non-contagious cause of death and disability in the world, with another vital change in the fabric of our daily life: Improving road safety, especially in rapidly motorizing nations.
“We’ve identified ten low- and middle-income countries that account for nearly half of all road deaths globally. And in partnership with governments and non-governmental organizations, we’ve begun to improve life-saving policies. That includes, for example, passing and enforcing seat belt laws, and laws requiring motorcyclists to wear helmets.
“We’ve also focused on traffic engineering that improves road safety; and on upgrading urban transport that not only unclogs crowded roads and streets but that also enhances air quality and quality of life. The problems of modern life are deeply inter-related. And so, thankfully, are their solutions.
“As the chair of the C40 Cities Climate Leadership Group, I can tell you that improving transit, and other steps cities around the world are taking to shrink their carbon footprints, have the immediate, additional benefit of also improving air quality and public health.
“In fact, one of the key lessons we’ve learned is that making our environment healthier often creates such multiple benefits. And before leaving you, let me touch on four other lessons as well.
“First, we’ve learned that changing the social and physical environment is far more effective than changing individual behavior alone. Making workplaces and places of entertainment smoke-free; reconfiguring city streets to make them safer; creating ways for consumers to find healthy food. Such social and physical changes that make the healthiest route are also the ones easiest to follow.
“Second, and very importantly in today’s world, healthy solutions are not necessarily costly solutions. Far from it. New York’s smoke-free air act, our restrictions on trans fats, and our requirements concerning calorie posting in restaurants cost virtually nothing in public funds to implement. And raising cigarette taxes raises public revenues.
“Third, collaboration with the private sector – as in the national salt reduction initiative – and with non-government organizations – as in traffic safety efforts worldwide – are very important. Collaboration across borders, among national and local governments and agencies, is also critical. The challenges before us are too vast and complex for individual governments to overcome alone.
“But fourth and finally, while government action is not sufficient alone, it is nevertheless absolutely essential. There are powers only governments can exercise, policies only governments can mandate and enforce, and results only governments can achieve. To halt the worldwide epidemic of non-communicable diseases, governments at all levels must make healthy solutions the default social option.
“That is, ultimately, government’s highest duty. And one of the spiritual founders of the United Nations – America’s Franklin Delano Roosevelt – once put it: ‘The state’s paramount concern should be the health of its people.’ So why don’t we all resolve to renew our efforts now to address the worldwide crisis of non-communicable disease, and bring better health, and greater hope, to all the people of our good Earth.
“Thank you, and enjoy your stay in New York.”
An international leader on public health. Mike works to create better, longer lives for the greatest number of people.
IN MIKE'S WORDS
The science is clear: employ data-driven approaches to large public health problems and death and illness rates fall.
Data-driven solutions can help to save lives from preventable causes.
With better research and interventions, we can prevent deaths and injuries from preventable public health risks.