On my journey to discover public health and the responsibility it carries, I found myself captivated by Dr. Tom Frieden and his relentless pursuit of what is right, regardless of bureaucratic procedures.
I learned the most about his legacy in "Saving Gotham," written by Tom Farley, which delves into Dr. Tom Frieden's and Dr. Tom Farley's experiences in public health and their efforts to improve the health of New York City as health commissioners. As a reader, I resonated with the sensation that processes serve little purpose when patient lives are at stake.
For those that have not read the book, it covers their work in reducing smoking rates, improving nutrition, and combating infectious diseases across NYC in early 2000's. It also explores their strategies for addressing public health challenges and the impact of their initiatives on the city's residents. Much of their work was considered controversial within the political realm and had significant impacts on economies at large.
What fascinated me was that "health," the ability to truly save lives and stop disease, even had to go through political conversations. "What do you mean raising cigarette tax?" "What do you mean stop selling soda pop in schools?" "What do you mean I have to change what oils I cook with?". As a graduate school student, I couldn't fathom how such important things that cause chronic disease and cancer could even be debated. Shouldn't everyone want their family, friends, and communities to live longer, happier, healthier lives free of disability and suffering? How is this even a dilemma? But as any curious college student, I began to understand the multidimensional aspects of health policy.
For example, critics have argued that some of the initiatives, such as restrictions on sugary drinks and trans fats, represent government overreach and infringe upon personal choice. Another example is the potential socioeconomic impact of certain public health policies, particularly on small businesses and low-income communities. For instance, restrictions on certain food products may disproportionately affect businesses and consumers in underserved neighborhoods.
Of course, there is always ample resistance from the "Industry", such as the tobacco industry, fast food chains, and beverage companies pushing back against regulations that impact their products and profits, leading to contentious debates and legal challenges.
Yet, through very detailed statistics, data trends, and studies, the book emphasizes the importance of evidence-based interventions and the use of data to drive decision-making in public health. That is my biggest takeaway.
For me, the book underscored the idea that small changes in policy and environment can lead to significant improvements in population health. These controversies are still alive today and reflect the ongoing debates surrounding public health policies, individual freedoms, industry interests, and the balance between regulation and personal responsibility.
Just as with anything else, it's important to consider differing viewpoints and the complexities of public health decision-making. Regardless, Dr. Tom Frieden was able to leave a footprint that saved millions of lives, some examples:
His efforts reduced the number of smokers by 350,000 and cut teen smoking in half.
Advocated for a tax on sugar-sweetened beverages, the single leading driver of increased calorie consumption in the United States, of at least 1 cent per ounce.
In September 2006, the city proposed to restrict trans fat served in New York restaurants. New York City's trans fat ban followed mandatory labeling of trans fat by the FDA, was credited with saving lives, and preceded by more than a decade the FDA's action to ban trans fat from food throughout the United States.
"I loved clinical practice, but in public health, you can impact more than one person at a time. The whole society is your patient." --Tom Frieden
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