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Health crusader helps NYC kick butts

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in Leaders & Managers

For decades, New York City’s health department focused on fighting communicable diseases. But when Thomas Frieden took over as health commissioner, he discovered that more than 70 percent of deaths in the city came from other causes.

So, the doctor’s brash admonitions focus on heart disease, lung cancer and diabetes as well as HIV/AIDS, tuberculosis and hepatitis. Smoking can kill you just as dead as unprotected sex, he warns.

It’s all part of Frieden’s ambitious plan to improve the city’s health.

Here are some of Frieden’s operating methods:
  1. He insists on the boss’s support. Before Frieden accepted the job in 2002, he wanted to know what mayor-elect Michael Bloomberg would think of a health commissioner who’d go tough on tobacco. If the mayor wasn’t willing, Frieden wasn’t coming.

    Bloomberg said “Yes,” so Frieden unleashed an anti-smoking plan featuring a steep new tax on cigarettes, smoke-free workplace rules and help for people to quit smoking.

  2. He takes a practical approach. In a TV interview about West Nile virus, Frieden avoided talking about bird and mosquito biology, focusing instead on which insect repellents work best.

  3. He drives change. Public health workers always run up against people’s self-destructive behavior. That doesn’t faze Frieden.

    “The sweet spot in public health is not exhorting people to change,” he says. “It’s changing the context in which people behave.”

    Instead of telling people they shouldn’t smoke at work, you ban smoking on the job. Instead of telling people to cut back on butts, you jack up the price.

    So far, it’s working: The number of smokers in the city has dropped by 200,000 since Frieden took over.
—Adapted from “Data-Driven Doc,” Jonathan Walters, Governing.

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