Dr. Thomas Frieden
Commissioner, New York City Department of Health and Mental Hygiene
If you’re searching for a powerful public official driven by unbridled activist zealotry, look no further than the Big Apple’s health czar Thomas R. Frieden. In January 2002, Frieden took the helm of New York City’s Department of Health and Mental Hygiene (DOH), which has an annual budget of over $1.6 billion and more than 6,000 staff. In the intervening years he’s taken previously inconceivable steps towards tracking and controlling what New Yorkers — and, by extension, all Americans — get to do with their bodies. (The absurdly Orwellian undertones of the term “Mental Hygiene” haven’t been lost on us; we eagerly await city-sponsored distributions of mind floss and “Thought Purity” kits.)
Frieden doesn’t simply blur the line between public and private health; he barely recognizes its existence. He famously told the Financial Times that “when anyone dies at an early age from a preventable cause in New York City, it’s my fault.” What constitutes a “preventable cause” for Frieden? Essentially any behavior that he personally disapproves of, including: eating fatty foods, smoking (anywhere), “insufficient” breast-feeding, and using birth control that isn’t city-approved.
Traditionally, public health has been confined to the containment and eradication of communicable diseases. But Frieden has publicly and perhaps permanently expanded that purview to cover any potentially risky behavior, even when an individual choice has no effect on the well-being of others. That has led to, as the New York Post puts it, “a nanny state on steroids.”
Frieden spearheaded the creation of an intrusive surveillance program for the city’s 530,000 diabetics. The results from routine medical examinations for all diabetics are now automatically forwarded to the DOH, and, along with name, date of birth and address, permanently recorded in a registry open to city bureaucrats. For diabetics who are found to have “elevated” glucose levels, the DOH floods their homes with (unwanted) medical materials and warning letters, and notifies their physicians of their test results.
In early 2007, Frieden launched a campaign to encourage people to drink tap water; city employees were disbursed throughout the city to hand out empty water bottles. (The fact that residents need to be assured of the safety of basic public works is, in and of itself, probably an indicator of more pertinent problems.)
Frieden seems to take a salacious delight in pushing public policy into people’s bedrooms. The reception room of his office sports a bowl of free condoms — unique among the city’s health officials. He’s commissioned — with taxpayer dollars — New York-themed prophylaxes that, per his suggestion, feature a map of the Manhattan subway system. And, under his tenure, the DOH has spent over $2 million dollars to harangue new moms into breast-feeding their children for at least 6 months — a city-established “health limit” that essentially ignores the unique needs of individual women and their children.
Frieden spawned a publicity bonanza in January 2007 when he announced that DOH scientists had uncovered a HIV “supervirus” — a drug-resistant strain of the deadly disease that can lead to full-blown AIDS in less than three months. But Frieden’s proclamation — and the ensuring media hysteria — turned out to be premature. Upon further testing, the strain did respond to treatments and was confined to a single person.
In December 2006, the DOH approved a requirement that restaurants print calorie-counts on menus and menu boards. In a cruel twist of irony, though, the law only covers restaurants that already provide the information in another format; so, in effect, it punishes the very behavior it’s aimed at encouraging. Unsurprisingly, a number of restaurants have stopped offering calorie information entirely since the requisite menu notifications are too expensive or cumbersome.
Of course, the piece-de-resistance of Frieden’s reign is his successful campaign to ban the use of trans fat — an artificial food ingredient found mostly in margarine, pastries, and fried foods — in all of the city’s restaurants. In the months leading up to the ban’s December 2006 approval by the city council, Frieden took every opportunity to brand trans fats as a “dangerous” and “unnecessary” part of the city’s food supply.
Unsurprisingly, the reality of the situation is a bit more complex. Some businesses — especially smaller outfits — have struggled to find a replacement that’s just as cheap as trans fat without sacrificing food quality. Case in point: O’Neil Whyte, a baker in Harlem, told The New York Times in December 2006 that “things without trans fat are harder to get and more expensive.”
What’s more, a widely-touted justification for the ban — fighting obesity — is specious at best. Trans fat bears almost no relationship with rising obesity rates, and isn’t acutely dangerous like, say, arsenic or lead. Plus, trans fat’s natural substitutes aren’t any healthier, according to not only the National Academy of Sciences, but also the federal Department of Health and Human Services and the Food and Drug Administration. The American Heart Association has warned that the trans fat ban has the “potential for unintended and adverse consequences, such as restaurants returning to the use of oils high in saturated or animal-based fat if healthier oils are in short supply.”
Unfortunately, health activists nationwide took inspiration from Frieden’s trans fat crusade. As of August 2007, over two dozen state and city legislatures are considering copycat bans of their own.
Considering the national embarrassment brought on New York City in early 2007 by a widely publicized video of rats scurrying around fast food restaurants just a few days after a city health inspection, you’d think that Frieden might have more pressing priorities than themed condoms and culinary witch hunts. But he goes where the headlines are, and more often that not that means shirking sound science for the sake of a news hook.