New York’s big-soda ban gets canned

Modern Healthcare - - NEWS - By Steven Ross John­son

New York City’s plan to limit the size of so­das and other sug­ary drinks was shot down June 26 by a state ap­peals court. The rul­ing high­lights the po­ten­tial chal­lenges lo­cal pub­lic health de­part­ments face in at­tempt­ing to ad­dress con­cerns linked to the ris­ing preva­lence of chronic dis­ease.

“The na­ture of chronic dis­eases re­quires cross-dis­ci­plinary ap­proaches in which so­cio-eco­nomic be­hav­ioral fac­tors are con­sid­ered,” said Sara Mark, ex­ec­u­tive di­rec­tor of the Cen­ter for Con­sti­tu­tional Gov­er­nance at Columbia Law School. Mark re­cently co-au­thored an opin­ion piece for the Huff­in­g­ton Post where she ar­gued that the court’s rul­ing limited the city health depart­ment’s abil- ity to ef­fec­tively ad­dress new types of pub­lic health threats.

“If the court is say­ing to the agency that the agency can’t con­sider these sorts of fac­tors, then agencies and govern­ment are go­ing to be left re­ally ille­quipped to deal with these cur­rent crises,” she said.

Tra­di­tion­ally, lo­cal pub­lic health de­part­ments have ad­dressed pop­u­la­tion health risks through food in­spec­tions, vac­ci­na­tion pro­grams and med­i­cal-ed­u­ca­tion ser­vices, as ex­am­ples.

But in­creas­ingly, they have also sought to curb health-risk be­hav­iors such as smok­ing, over­con­sump­tion of un­healthy foods and bev­er­ages and seden­tary life­styles. Such con­di­tions ac­counted for 84% of all health­care spend­ing in 2006, ac­cord­ing to the Cen­ters for Dis­ease Con­trol and Preven­tion, and half of all Amer­i­cans re­ported hav­ing one or more chronic dis­eases.

Be­cause pub­lic health threats have changed, ad­vo­cates say the abil­ity of health de­part­ments to deal with those new chal­lenges also must change.

Some fear that the court’s rul­ing may lead other lo­cal health de­part­ments to re­con­sider ef­forts to im­ple­ment sim­i­lar reg­u­la­tory ini­tia­tives, out of worry that they may face sim­i­lar le­gal bar­ri­ers.

Dr. Terry Ma­son, chief op­er­at­ing of­fi­cer for the Cook County (Ill.) Depart­ment of Pub­lic Health, which over­sees ap­prox­i­mately 2.5 mil­lion res­i­dents for 129 mu­nic­i­pal­i­ties sur­round­ing Chicago, said his depart­ment is not cur­rently seek­ing to im­pose a sim­i­lar ban, but it might in the fu­ture, with enough pub­lic sup­port.

“While we’re not talk­ing about leg­is­la­tion or or­di­nances to ban cer­tain things just yet, I think that those types of things are go­ing to come,” Ma­son said. “When people be­gin to re­ally un­der­stand the re­la­tion­ship be­tween over­con­sump­tion of un­healthy foods and bev­er­ages and chronic dis­ease, they’re go­ing to be more sup­port­ive, and that kind of sup­port is go­ing to help us get this done.”

But some crit­ics of such health-risk be­hav­ior reg­u­la­tions ar­gue they’re too sim­plis­tic to ef­fec­tively ad­dress the com­plex­i­ties of an in­di­vid­ual’s di­etary habits.

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