Father knows best: Michael Bloomberg’s public health obsession

Two weeks ago, New York Mayor Mike Bloomberg was consumed with anxiety: Had a right-wing loon attempted to blow up some of his New Yorkers as they waded through the sea of sweaty corpulence that is Times Square on a summery Sunday afternoon? Those Tea Partiers hate health care, after all, and for the last nine years, Bloomberg has done his best to make New York a health-conscious city.

Turns out, the answer was no. But even with New York safe from a jihadi-made car bomb, Bloomberg still has a lot to worry about. Are his people at risk of hypertension from eating in restaurants that serve salty dishes? Have any of his children developed a lump — in her breast, under his armpit, in a place where lumps cannot be detected by prodding alone — from consuming trans fats? Also, why are so many New Yorkers still not rail thin?

These concerns keep Mayor Bloomberg, America’s most successful nanny, up at night, while irritating the hell out of his critics, who believe the mayor has an unhealthy obsession with his own (thinness), and is oblivious to the failings of New York’s public health initiatives.

“Bloomberg seems to be a sort of a classic example of somebody who has the particular obsessions of the upper class when it comes to health issues,” said Paul Campos, a professor of law at the University of Colorado and author of The Diet Myth. “In particular, he seems obsessed with weight.”

While you can still eat quite well in New York, you can’t eat just anything, and you can’t eat anything any way you want. Trans fats are illegal and chain restaurants with 15 locations or more are required by law to include calorie information on their menus.

“You basically have people who have a kind of personal, neurotic relationship to their weight, who then turn this toward public health policy,” Campos said. “This business with calorie counts, and other initiatives, seems to speak to the idea that people are too fat; especially the idea that making people thinner is a reasonable goal for public health intervention. It would make no sense whatsoever if people weren’t projecting their own neuroses on the data.”

The credit for Bloomberg’s initial nannying goes to Thomas Frieden, whom Bloomberg hand-picked in 2002 to head up New York’s Orwellian-sounding Department of Health and Mental Hygiene in 2001. Frieden, an expert on contagious diseases, was behind the city’s cigarette ban and the creation of a needle exchange. When Bloomberg gave Snapple the contract to stock public schools with juice — under the impression, of course, that juice is better than soda for the city’s future mayors — Frieden complained that water would have been even better.

Three years later, Frieden instituted new regulations that mandated calorie counts for chains with at least 15 restaurants, insisting that New Yorkers wanted — nay, needed — calorie counts. “Not everyone will use it, but many people will, and when they use it, it changes what they order, and that should reduce obesity and, with it, diabetes,” he told the Times in 2007. After crafting the new regulations, Frieden’s only obstacle was gaining the city health board’s approval. Luckily, he was the board’s chair, and all of its members were appointed by Bloomberg. The regulation passed in 2008, and now New Yorkers have to think about the caloric content of what they’re eating even if they don’t want to.

Frieden left for the CDC in May 2009, laying the groundwork for a soda tax before he turned out the lights in NY. “‘It is difficult to imagine producing behavior change of this magnitude through education alone, even if government devoted massive resources to the task,” Frieden wrote in the New England Journal of Medicine. ”Only heftier taxes will significantly reduce consumption.” Perhaps hoping that New Yorkers could actually be cajoled into agreeing, Frieden added that a soda tax in New York could possibly save all of mankind from its vices: ”Diet-related diseases also cost society in terms of decreased work productivity, increased absenteeism, poorer school performance and reduced fitness on the part of military recruits.”