#10: HealthyNYC - New York City's New Mission to Increase Life Expectancy
New Yorkers want their health back—this time for longer.
If zip codes still determine health outcomes, think twice before moving to New York City.
30k NYC residents died from chronic conditions alone in 2021, with a third of those deaths due to cancer. What’s more, health inequities dramatically harm New York’s Black and Latino communities, who suffer higher rates of death related to heart disease, diabetes, cancer, COVID-19, and pregnancy-associated complications.
From 2019 to 2020, life expectancy in New York City decreased by 4.5 years, mirroring a nationwide decline. Exacerbated by the pandemic, more Americans are dying before the age of 65 than people of similar nations. And communities of low-income and color are experiencing the worst of it, dying at a premature death rate two times greater than Whites.
New York City’s health needs a rebound. So as COVID-19 recovery goes on, public health officials are now shifting their focus to reversing worsening life expectancy trends.
Dr. Ashwin Vasan, NYC’s Commissioner of Health, alongside Mayor Eric Adams recently announced HealthyNYC, a new public health initiative seeking to raise the city’s average lifespan to 83 years by 2030. The plan will address major drivers of death and health disparities, targeting 6 public health challenges currently affecting New Yorkers: Chronic and Diet-Related Diseases, Screenable Cancers, Mental Health, COVID-19, Homicide, and Maternal Mortality.
Chronic and Diet-Related Diseases:
Chronic and diet-related diseases remain the leading cause of death in NYC regardless of race or ethnicity. Still, significant racial inequities exist—driven by inadequate access to nutritious foods, physical activity, and appropriate healthcare services.
HealthyNYC sets a goal of reducing cardiovascular disease and diabetes-related deaths by 5%. To reach this goal, the initiative will increase preventive care by expanding access to healthier foods while reducing processed food and tobacco consumption.
Screenable Cancers
Full-body MRIs have made their mark in 2023, with companies like Prenuvo, Ezra, and Neko Health gaining popularity through high-profile celebrity endorsements. But even as Kim Kardashian shares how full-body imaging has saved her friends’ lives, it’s hard to imagine a world where everyone can afford a $2500 scan.
What’s more, the American College of Radiology said there is “no documented evidence that total body screening is cost-efficient or effective in prolonging life”.
While early diagnosis certainly improves cancer outcomes, a recent meta-analysis claims that on average, most cancer screenings don’t increase lifespan. NYC public health experts will therefore take a more comprehensive approach beyond just screening to reduce screenable cancer deaths by 20%
Mental Health
With the pandemic came a whole slew of risk factors for poor mental health including job insecurity, trauma, and isolation & loneliness. Still reeling, NYC now has a mental health crisis which is directly contributing to lower life expectancy.
Drug overdoses in NYC have increased by over 75% since 2019 and suicidal ideation rates among teenagers are skyrocketing. Public health officials will improve access to naloxone and recovery centers and reduce fentanyl in drug supply, while also addressing social isolation. Healthy NYC aims to reduce overdose deaths and suicides by 25% and 10% respectively.
Dr. Vasan believes social media to be a major culprit for rising adolescent suicide ideation. Social media is difficult to regulate, so for the time being, Dr. Vasan has been bolstering youth mental health resources instead.
Last month he announced “TeenSpace”, a partnership with virtual therapy platform Talkspace, making digital mental health services available at no cost to NYC teens ages 13 to 17.
Covid-19
Vaccine education and the availability of testing and treatment will continue to be essential in protecting high-risk individuals from COVID-19-related deaths. Those living in crowded areas such as nursing homes and shelters are still being affected by the virus.
COVID-19 death rates have decreased since the height of the pandemic. Focusing on vaccination uptake and masking efforts in addition to chronic disease prevention will help the city reach a 60% decrease in COVID-19 deaths by 2030.
Homicide
Since 2017, violence has nearly doubled in NYC. Homicide is now the leading cause of death among New Yorkers ages 15 to 24, with firearms accounting for over 70% of those deaths. Violence leaves families and communities with years of trauma, grief, and economic instability, leading to negative health outcomes.
HealthyNYC will invest in those communities most impacted by homicides and increase access to trauma support. The initiative wants to reduce homicide deaths by 30% but even if that is achieved, homicide deaths will still be higher than pre-pandemic numbers.
Maternal Mortality
Black women are 4 times more likely to die of pregnancy-related complications than White women. HealthyNYC calls for more culturally competent sexual and reproductive care and will do so by increasing access to high-quality services required throughout the entire maternal continuum, from pregnancy to childbirth through postnatal care.
More than just health
But improving health isn’t just about increasing access to healthcare. People of color suffer negative health outcomes due to systemic inequities in everything from income to education to housing.
Climate change also plays an outsized role in determining health outcomes. Air quality and heat-related deaths have been steadily increasing within the past decade.
That is why HealthyNYC is going beyond healthcare delivery, working to improve the city’s social infrastructure. To do so, the campaign engages leaders from the Department of Social Services, Office of Climate and Environmental Justice, Office of Food Policy, NYC Housing Authority, and the Department of Parks & Recreation.
“When we’re talking about things like transportation, or education or housing or violence, we’re really talking about health”.
~ Dr. Ashwin Vasan, 44th Commissioner of Health of the City of New York
If NYC’s public health track record is any indication, New Yorkers should be optimistic about HealthyNYC.
By the end of his 3 terms, former NYC Mayor Mike Bloomberg had a track record of public health campaigns tackling smoking rates and sugar and trans fat consumption. He imposed what was at the time the steepest cigarette tax in the U.S. and banned tobacco sales to those under the age of 21. Bloomberg even tried to ban large-size sodas and sugary drinks.
In June, Mayor Adams unveiled a comprehensive roadmap for food education that has since been implemented in the NYC public school system. In conjunction with the NYC Department of Education and Office of Food Policy, the initiative has been providing students with access to nutritious and culturally appropriate meals in schools. Community members have also become “wellness ambassadors”, helping students build knowledge of healthy eating and overall wellness.
HealthyNYC is among the few public health campaigns to use life expectancy as a proxy for overall health. The pandemic required a reactive and treatment-focused approach to healthcare. Dr. Vasan and his team are now moving on to making prevention and longevity NYC’s number one public health priority.
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