Michael Bloomberg: Big Brother or Pioneer? A "Manny" for the Middle Class Rashawn Ray 7:00 PM Mayor Michael Bloomberg is a nanny, a middle-class pioneering one. With his push for smoking bans and calorie counts, he seems to have improved the lives of New Yorkers, and Americans more broadly. But he has continued to venture into the land of policing by focusing on individual choices rather than structural causes of obesity. Bloomberg's attacks on sugary drinks never properly addressed the root causes of obesity. Bloomberg attempted to raise the smoking age, tax people for drinking sugary beverages and prevent individuals on food stamps from making certain drink purchases. Honestly, I have never understood how we prevent 18-year-olds from smoking or drinking when they can join the military and go to war to defend our freedoms. Additionally, research shows that soda consumption is actually down and eating habits are linked to the food options people have in their neighborhoods. For example, public health research shows that students who attend schools within one half-mile of fast-food restaurants are more likely to be obese. Simply put, the soda tax and smoking age policies are ways for government to micromanage food service, reduce the flexibility of small businesses and raise revenue for a fractured budget. Because studies show that poverty and neighborhood resources are two of the root causes of obesity, Bloomberg's policies have two major flaws that do not properly address these causes. First, his policies specifically affect the lifestyle of middle-class Americans. As a result, he leaves out the demographic most in need: the working poor. Bloomberg mentions that his soda tax policy will reduce consumption at places like sporting events and movie theaters. What family of four dealing with underemployment or unemployment can afford to attend a sporting event, much less to eat and drink there? Second, these policies treat the symptoms rather than the cause. Consequently, blame is placed on individual choice rather than the unequal distribution of neighborhood resources. This approach is like blaming lighter fluid for the charcoal catching fire. Sure, the flame is what we see, especially when throwing lighter fluid on it. But lighter fluid without fire does very little. We need to stop blaming the lighter fluid (individual choice) and address the burning charcoal (neighborhoods with a lack of healthy food options and not enough safe, green spaces for physical activity). By not addressing structural conditions, Bloomberg's policies may create larger health disparities between the middle class and the working poor. His Policies Were Components of a Comprehensive Plan Lance Freeman 7:00 PM Mayor Bloomberg proposed a number of public health initiatives that were designed to improve New Yorkers" health and quality of life. Whether these initiatives should be viewed as innovative public health policies or unwelcome intrusions of the nanny state is a subjective call that depends on one's values toward individual liberty and public health outcomes. Only time will tell whether Bloomberg's initiatives will come to be accepted the way other public health intrusions have been -- measures like buckling one's seat belt or wearing a helmet while riding a motorcycle. Maybe one day, Bloomberg's public heath initiatives will be seen as inspired intrusions like buckling one's seat belt or wearing a helmet while riding a motorcycle. But, Rashawn, in suggesting that Bloomberg failed to address the root causes of obesity in poor neighborhoods, you make at least two dubious claims. First, you chastise him for doing little to address poverty. This criticism is odd given that the mayor last month received a Public Service Award from the Children's Aid Society, an antipoverty advocacy group. This award was based on a number of initiatives that were developed by the mayor, including a more realistic measure of poverty that was subsequently adopted by the Census Bureau; the Jobs-Plus program, which connects public housing residents with jobs and training; and a program that specifically addresses the obstacles faced by young black and Latino men. Local governments can only do so much to combat poverty; it is at the federal level where the most impact can be made. Criticizing Bloomberg for failing to provide neighborhood resources that could lower obesity levels is also wide of mark. The mayor started the Fresh program to alleviate the lack of nutritious, affordable, fresh food in low-income New York City neighborhoods. This program offers tax incentives, density bonuses, grants and loans to fresh produce retailers who open or expand in underserved parts of the city. In light of all this, Mayor Bloomberg's efforts that focus on individual behavior are best seen as components of a comprehensive attempt to address the public health problem that is obesity. He Doesn't Deserve Credit for Striking Out Innovative ways to measure poverty are important. But we have a serious national problem when we publicly acknowledge the prevention of a poverty increase instead of a reduction between the wealthy and the working poor. This is like giving a player the M.V.P. for not striking out because all the other players struck out. It is interesting how much you laud Mayor Bloomberg but limit the influence of local government. This makes much of Bloomberg's accomplishments obsolete. I have a different position. Policies are often mandated federally but implemented locally. Local legislation and policy implementation are extremely important. We saw this with Social Security and the G.I. bill - two major policies that created the middle class. This is currently occurring with the implementation of the Affordable Care Act. Given the supposed awareness of poverty in New York, Bloomberg and his staff made some questionable decisions related to sales tax and other provisions. The creation of new policies often gives the illusion of real change until we see that funding is shifted away from jobs in health-related fields. Over the past five years, New York City health agencies have seen roughly 500 staff members cut and park services have seen nearly 30 percent of its work force eliminated. In many ways, it seems that funding for public health initiatives is simply being repackaged and sold as something better. Given the supposed awareness of poverty in the city, Bloomberg and his staff made some questionable decisions related to sales tax and other provisions. These decisions debunk one of the most innovative parts of the new poverty measure - the ability to assess families" everyday expenditures related to local goods and taxes. This new measure had to show that the working poor would be severely crippled by these changes. Although New York City houses more billionaires than most places in the world, over 20 percent of New Yorkers live below the poverty line and about 25 percent live right above it. People don't just need jobs. They need jobs that pay a living wage. I am sure that Bloomberg is assuming that some of these billionaires will be the ones to make investments to build grocery stores and revitalize local communities. The problem is that other cities such as Philadelphia and Washington have seen the working poor shifted out of the areas they called home as wealthier residents purchased cheaper property with government subsidies. This is gentrification at its finest and the groups on each side of this arrangement often vary by skin color and life outcomes. His Record Was Uneven, but His Initiatives Were Innovative With regard to anti-poverty policy you make some valid criticisms of Mayor Bloomberg's tenure. To be sure, his record has been uneven. Laudatory in some respects, while disappointing in others. But the debate over his antipoverty record is veering away from the original question: Is Bloomberg a public health innovator or a "nanny state" scold? This uneven record speaks to an innovative mindset - a willingness to risk failure in pursuit of public health. On net, his public health initiatives have been innovative. As our urban health problems have evolved from communicable diseases such as cholera to chronic ones like obesity, new ways of thinking about public health are necessary. Few would argue against 19th and 20th century local government's intrusions to address concerns like cholera. Efforts that may seem intrusive will likely be necessary to address illnesses like diabetes that plague our cities in the 21st century. Bloomberg has been creative in pushing levers at his discretion when addressing the problem of obesity in low-income communities including incentivizing land use regulations and attempting to use local taxes to discourage some unhealthy habits. Moreover, while I do not agree with all of Mayor Bloomberg's public health initiatives, he has been willing to experiment with different approaches. Some of these seem promising and others wrong-headed. But this uneven record speaks to an innovative mindset - a willingness to risk failure in pursuit of public health. A Living Wage Would Have Improved the Mayor's Efforts Bloomberg gets credit for pushing the boundaries. In an ideal world, investments will be made to provide people with affordable, nutritious food and places to be more physically active in their communities. However, this is not the current reality of most New Yorkers, and history tells us it might not ever be. Although the calorie count initiative is innovative and promising, it might not reach its full potential without a living wage for the working poor. While some of us can go to Trader Joe's or Wegman's on a regular basis, the working poor are choosing between a corner store and a McDonald's. Although calorie counts might work among the middle class, the working poor are making a very rational cost-benefit analysis about how far the two dollars in their pocket can go. Granted, Bloomberg is aiming to address this issue with the grocery store initiative, but we need to think more consciously about how to create affordable, nutritious options. Even better, people need living wage jobs where they can make an informed decision about food. It seems that the regulation policies like the soda tax and food stamp restrictions are mainly important to pay for the job losses in the public sector. Bloomberg said the money would be used for health services and teachers. While these re-additions are important, what about health education beyond scare ads? What about more green spaces to increase physical activity, or using soda tax revenue to create school gardens to enhance healthy eating and nutritional knowledge in poor neighborhoods? School gardens are found to increase test scores and may contribute to closing the obesity and achievement gaps across racial/ethnic and social class lines. While I do believe that Bloomberg wants to save lives, I question the political trade-offs he used to pass these public health policies. A Living Wage Is Something We Can Agree On I wholeheartedly endorse your call for a living wage. A guaranteed income of some sort is a prerequisite for social justice. But it will take more than a living wage to address chronic public health problems. Consider that among men obesity rates tend to rise with higher incomes. In many nations, such as China, obesity rates rise as the nation becomes more affluent. The causes of public health problems like diabetes, obesity and hypertension are complex and not completely understood. To address these multifaceted problems we must be willing to use a variegated approach and to experiment. For this reason the novel approaches put forth by Mayor Bloomberg are worthwhile. Join Room for Debate on Facebook and follow updates on twitter.com/roomfordebate.