Bloomberg's Health Legacy: Urban Innovator or Meddling Nanny?

Abstract

Michael Bloomberg assumed office as the 108th mayor of New York City on January 1, 2002. As he leaves the mayoralty-having won re-election twice-his public health legacy is bitterly contested. The public health community views him as an urban innovator-a rare political and business leader willing to fight for a built environment conducive to healthier, safer lifestyles. To his detractors, Bloomberg epitomizes a meddling nanny-an elitist dictating to largely poor and working-class people about how they ought to lead their lives. His policies have sparked intense public, corporate, and political ire-critical of sweeping mayoral power to socially engineer the city and its inhabitants. Here, I seek to show how Bloomberg has fundamentally changed public health policy and discourse. He has used the engine of government to make New York City a laboratory for innovation-raising the visibility of public health, testing policy effectiveness, and probing the boundaries of state power. Even though the courts have blocked some of his boldest initiatives, he has offered a paradigm for the "new public health"-reaching beyond infectious diseases to upstream risk factors in everyday life and the human habitat. I also critically probe various arguments designed to derail his policies, along with the overarching charge of unjustified paternalism. © 2013 by The Hastings Center.