Creating a Prevention Agenda: The New York City Experience
Prevention is a key focus of many presentations at the APHA Annual Meeting. Today Thomas Farley, MD, commissioner of health and mental hygiene in New York City, presented the city’s comprehensive program “Take Care New York: 2012: A Policy for a Healthier New York City."
Farley calls Take Care New York the City's comprehensive health policy to help all New Yorkers live longer and healthier lives. First launched in 2004, Take Care New York identified 10 steps New Yorkers could take to improve their health—such as stopping smoking and increasing physical activity--and set ambitious goals for 2008 in each of ten priority areas. Since 2002, the city has reported progress for each of the measures and the program reached or surpassed goals for 2008 in four areas.
The latest version, Take Care New York 2012, was launched in 2009 and set action plans for individuals and families, health care providers, community organizers, businesses, and government. New to the 2012 edition:
- Implementing public policies to improve health to complement what can be done by individuals and medical providers.
- Improving neighborhood conditions that impact health, such as safe homes and access to healthy, affordable foods.
- A focus on children's health given children's unique and important health needs and our opportunity to promote life-long healthy behaviors.
- Reducing health disparities among New Yorkers of different races, ethnicities and income levels.
NewPublicHealth spoke with Dr. Farley about the newest version of Take Care New York.
NewPublicHealth: How does Take Care New York 2012 differ from the version before it?
Dr. Farley: The two programs are directed to somewhat different audiences, not completely but somewhat. The original Take Care New York was directed more towards individuals and healthcare providers and what you can do to be healthy and what you as healthcare providers can with your patients to help them be healthy. Take Care New York 2012 has more of a community and policy focus, what we can all do as a society for everyone to be healthy, but there’s a lot of overlap between those two.
NPH: Does the newer program establish partnerships to help achieve the goals?
Dr. Farley: Take Care New York 2012 certainly lays out broad goals and to reach those goals we definitely need actions of other agencies and other organizations. There are ten focus areas with specific indicators for each of those ten areas, and then strategies to reach those indicators. The strategies include what healthcare providers can do, what we can do as far as community based promotion.
NPH: Did you take any lessons from other communities in developing Take Care New York?
Dr. Farley: You know, we really developed Take Care New York pretty much on our own and so no, we didn’t really try to copy other health departments. I’ve had inquiries from other places to see ours, but I don’t know how many people have developed an agenda that’s similar to ours. We’re certainly going to share what we’ve done, and we hope that other communities will find value in that. I think it’s extremely valuable to articulate what are the most important things we could do to promote our health, and there are some principles about how to do but I think each community is somewhat different. Even if the health problems are similar, the opportunities to solve them may be different. There are different entities out there and there are different political realities, and a prevention plan has to take all this into account. But there are principles here which we found useful and we hope to offer them as examples which other people may want to take and apply their own way in other jurisdictions.
NPH: Would Take Care New York be of value regardless of where another community was in addressing health priorities?
Dr. Farley: Take Care New York has ten areas, and some of them are likely to be in most prevention plans. For example, Be Tobacco Free. There’s a specific item on smoking because it’s such an important predictor of our health. Now there are ways in which we approach smoking prevention in New York City, which are going to be different from what other jurisdictions are going to do. You know, we already have very high cigarette taxes and strong smoke free air laws, and so we were looking for other things we could do on top of that. Other jurisdictions may need to have a smoke free air law, they may need to raise taxes, so they’re starting from a different place.
We have a policy called Make All Neighborhoods Healthy Places that recognizes that neighborhoods have a big influence on health and there are things that we can do at the neighborhood level to its physical structure and the way that it’s maintained that have an impact on health. You might not find that concept in many other strategic plans and other jurisdictions may look at that to decide whether or not it work or whether they might need some variation. Being a starting point for some communities is a strong way for us to help them work on their prevention efforts.