Nanny NYC Kicks Butts

(This blog was posted on Huffington Post on August 23. It attracted some amazing comments.)

Starting in his first year as mayor, 2002, Mayor Michael Bloomberg has sought to discourage smoking by New Yorkers. His efforts were opposed by many smokers, bars and cigarette vendors, and the City was derided by Human Events as “Nanny NYC”. But the Mayor’s efforts have paid off well. One-fifth of NYC smokers have quit smoking since 2002, a higher quit rate than in the nation. The Mayor crowed about this in his third annual public health report, noting that NYC had already reached its 2008 targets for lowering smoking and increasing colonoscopy screening – two years ahead of schedule. Unlike his predecessor Rudy Giuliani, who avoided drawing attention to his failures, the Mayor also admitted that he had failed to lower drug deaths and raise the number of breast-cancer screenings. The Mayor’s appetite for health activism was exceeded by the City Council when it voted earlier this year to ban metal baseball bats from schools. The Mayor vetoed the bill and the City Council overrode the veto. However, he is pressing on to help the great majority of City smokers who have tried to quit but have failed. The facts are in a new report, Who’s Still Smoking, which is based on the Community Health Survey, an ongoing telephone poll of New Yorkers. NYC is campaigning for better health by learning more about who is trying to quit and who is succeeding. The new report identifies emotional distress and binge drinking as obstacles to quitting. More surprising, it finds that fewer than one-fifth of NYC smokers are using nicotine-replacement therapies (such as patches and gum) to help quit, despite evidence that these therapies double the probability that a smoker will quit successfully.

Many Americans are increasingly dissatisfied with the high cost of medical care – yet smokers put their health at risk while spending $2,500 a year on cigarettes if they smoke one pack per day. Studies show that the United States spends by far the highest proportion of its gross product on health care but its residents have a lower life expectancy than other large developed countries like the UK, Canada, France, Germany, Japan and Sweden. Within the United States, how much Americans spend on health care per capita seems to have little connection with their longevity. A study by Christopher Murray and others on mortality disparities among “Eight Americas” in Public Library of Science - Medicine (Sept. 12, 2006) concludes that life expectancy is explained primarily by chronic illnesses (for example, heart disease and cancer) and injuries from alcohol-related traffic accidents in the 15-59 age group – and not by the relative mortality of infants or elderly people, incomes, violence or lack of health insurance.

Despite its high spending on health care, New York State ranks a surprisingly poor 19th out of 51 with an average life expectancy of 77.7 years. Hawaii has the highest life expectancy at 80 years, whereas Washington, D.C. residents have a life expectancy of only 72 years, a gap of eight years.

The size of the gap is even larger at the county level. Asian-American women in Bergen County, N.J. live the longest with an average life expectancy of 91 years. Native Americans in several rural counties in South Dakota have a life expectancy of under 67 years, a difference of 36 years.

These and other statistics point to the cost-effectiveness of public-health spending, the Nanny NYC derision notwithstanding. To support preemptive public-health activism against chronic illnesses worsened by smoking and poor nutrition, and against traffic accidents, NYC’s Department of Health and Mental Hygiene, headed by Commissioner Thomas R. Frieden:- publishes comparative data on health status in NYC's community boards,- urges colonoscopy screenings,- has alerted residents to the 75 percent increase in diabetes since 1990, and how to prevent it, - has researched safety factors for bicyclists,- has prohibited smoking in restaurants, - in a battle for better nutrition, proposes that all restaurants cut down on use of trans fats,
- proposes that 2,000 (about 10 percent) of NYC’s restaurants with standardized menu items list nutritional information, and
- is drawing attention to the fact that one million adult NYC residents do not have health insurance, even though 700,000 of them have jobs.

NYC men smoke more than women (20 percent versus 15 percent), but men and women quit at similar rates. Black and Hispanic smokers are more likely than whites to try quitting, but are significantly less likely to succeed. More low-income smokers tried to quit in 2006 than high-income smokers (68 percent versus 60 percent), but fewer succeeded. New Yorkers without a high school education were more likely to try to quit than those who have a college degree (70 percent versus 62 percent), but fewer succeeded (14 percent versus 20 percent).

Quitting rates vary by borough. Staten Island’s smoking rate has been stuck since 2002, while the citywide rate dropped by 20 percent, whereas rates in the Bronx, Manhattan and Queens have all declined more than 20 percent. So NYC’s Health Department is declaring the public health equivalent of a war on smoking in Staten Island, giving away nicotine replacements at the Staten Island ferry's Whitehall terminal Tuesdays-Thursdays, 3-6 p.m. from August 21 through September 20.

Every New Yorker should look at NYC’s surveys and alerts and should sign up for email alerts regarding health issues and emergencies. Non-New Yorkers should look at this survey as a model for what their community might do.

President Bush Wasn't Reading Out on 9/11

Michael Shaw's Huffington Post blog this morning (August 16) comments in detail on a photo of President Bush at 9:25 a.m. on September 11, 2001, after "George Bush spent 10 very long minutes reading a story to a group of second graders." But the fact is that the President was not reading to the pupils. They were reading to him (see video of these seven minutes).

The message of The Pet Goat is that a single heroic victory by the pet goat could solve the goat's basic problems. The goat ate everything, exasperating the father of the girl who owned the pet. The father said: "That goat must go!" But the next day the goat butted a wannabe car thief. All was forgiven. Mission accomplished.

A Good Idea: Proposed Reverse 911 (City Alerts Us)

In his New York Civic blog today, Henry Stern suggests that the City of New York have a system for alerting cell phone (and landline phone) users to bad weather, serious accidents and traffic delays. It's a good idea, especially if one can opt out of it should it be overused. A possible danger is that in a real emergency the City's alert would overload the phone networks at precisely the time they are most needed. If the messages are very brief that would perhaps avert the overload danger.

CityEconomist suggests a less-intrusive and less-risky Reverse 911 option that would not preclude the phone option. Why doesn't the Mayor's Office of Emergency Management send out short alerts? OEM already has an email list for sending press releases (I get some of them) and could have sent out alerts regarding the Con Ed explosion and the Brooklyn tornado, in addition to the extensive information it posts passively on its City website.

CONGESTION PRICING | Federal $ for Plan Is Good Value

The U.S. Department of Transportation did the right thing and promised (provided legislators support the Mayor's plan) a $354 million grant to New York City, out of $1.1 billion earmarked for reducing traffic and promoting mass transit. Since Manhattan is the densest and most congested place in the United States, it would have been peculiar if NYC had been left out, even if a gridlocked Albany was slow to give the plan immediate support. The grant will provide help primarily for mass transit improvements, with a small amount for installing systems to charge drivers entering congested parts within Manhattan (New York Times, August 14 and 15, 2007).

However, the Federal money does not pay for the cost of installing systems to charge vehicles for coming into Manhattan. Some of that infrastructure may already be in place through the existing EZ Pass system at bridge and tunnel entrances, but hundreds of millions of additional installations and software will be needed. Newspaper accounts suggest that the Mayor could look for corporate support to make up the difference. CityEconomist wonders if Homeland Security could chip in to ensure that every entrance to Manhattan is monitored.

Also, Transportation Secretary Mary E. Peters pointedly made the grant contingent on legislators approving the Mayor's congestion pricing plan in some form this fall. "I share the mayor's confidence that the support will be there," she said. The City Council leadership has supported the Mayor's plan but Albany has been slow to respond to it.

The Manhattan congestion pricing plan would be the first in the United States, although it is well established in London and is spreading to other UK cities. It is also in place in Singapore. Nobel Prizewinner William Vickrey proposed congestion pricing for NYC as early as 1992 in economic hearings held by the City Comptroller Liz Holtzman (see Testimony on Congestion Pricing); he felt strongly that on-street parking regulations and fees should be considered strategically at the same time.

While the mayor’s plan has extensive support among people who see congestion pricing as inevitable given the long delays caused by gridlock in Manhattan, it has been opposed on the following kinds of grounds: (1) the charge will simply make driving easier for the wealthy and will be a severe burden for small businesses or low-income drivers (but: the number of bicyclists has doubled in London since congestion pricing has been introduced), (2) it will discriminate against the other four boroughs and will add tolls where none exist now (but: it will allow easier travel in Manhattan and may encourage new economic activity in the other boroughs), and (3) deliveries will be more expensive to make (but: the existing mess is already very expensive in time and parking fees). The CityEconomist perspective is that New York City's streets are a scarce resource that must be allocated in some way or they will become useless for anyone wanting to get anywhere promptly.

Some of the details of the Mayor's plan are subject to debate. For example, parking lots on one side of 86th Street are inside the congestion zone and on the other side are outside of it. The flat fee of $8 for cars and $21 for trucks is an issue - the late Prof. Vickrey recommended toll systems that would charge a fee that reflects actual congestion. However, these details can be addressed by a planned 17-member commission, yet to be appointed. The commission will have the responsibility to propose changes to the plan – within the overall objective of reducing traffic congestion by 6 percent.

Cities and Innovation

Henry George, author of Progress and Poverty and onetime candidate for Mayor of New York City (he came in second, ahead of Theodore Roosevelt), argued that cities benefit from their density and that the increase in land values is unearned and should be the main place to look for tax revenues to support city services.

So why does city land become more valuable as it grows and becomes more dense? From a consumer perspective, cities offer cultural resources. But from the producer perspective, city density offers advantages for businesses.

Glenn Athey, Max Nathan, and Chris Webber have sought to explain these advantages as contributing to innovation. Their working paper, "Cities and Innovation," is in the tradition of Jane Jacobs's book, The Death and Life of Great American Cities (her book The Economy of Cities is cited) and focuses on how cities contribute to innovation and why cities need innovation policies and approaches.

The paper was sponsored by the Centre for Cities of the British National Endowment for Science, Technology and the Arts (NESTA). This organization describes itself as "the largest single endowment devoted exclusively to supporting talent, innovation and creativity in the UK."

The authors of the paper argue that cities provide three factors that contribute to innovation: proximity, density and variety. These factors help workers share knowledge. They depend on investment in communication and transportation.

Looking closely at UK cities of various sizes, the authors argue that cities obtain values through being hubs or providing links. A hub city like New York City or London has a strong infrastructure that enables markets and business networks to form. A link-oriented city - for example, a smaller university city like Cambridge, Mass. or Cambridge, England - is important because of its strong position in knowledge networks and institutional alliances.

The authors argue that intelligent city policies to encourage innovation can pay off and that local economic-development policies have an advantage over national policies in that they can be tailored to the strengths of the region.

Turkey's Elections: We Have a Dog in the Fight

This appeared earlier today on Huffington Post

John Tepper Marlin
Turkey's Elections on Sunday: We Have a Dog in the Fight
Posted July 17, 2007 11:24 AM (EST)

When the Bush family and Texas friends wish to convey that they don't care much about something, they have been known to say: "I don't have a dog in that fight." There's a fight happening next Sunday in Turkey that we do have a dog in and have heard precious little about in the U.S. media. Do we need reminding that the U.S. position in Iraq and Afghanistan has been unraveling and that Turkey is a crucial Islamic ally?

Comment HuffIt

I was in Istanbul twice this year, first in a cool, gray week in February, then in a warm week in May, when on the 19th everyone was celebrating the anniversary of Mustafa Kemal Ataturk's blueprint for the Turkish Republic. Huge pictures of the great Ataturk abounded, along with the country's red flags with crescent and star. While 99 percent of the 70 million Turks say they are Islamic, Ataturk's secular state is a strongly held value for many Turks and survives thanks in part to the Turkish army's taking action when the constitution has been threatened, and (far more impressively) relinquishing power when constitutional order was restored.

America's dog in the fight is Turkey's remaining a secular and democratic ally. As centrist-conservative Prime Minister Recep Tayyip Erdogan stumps for his party in advance of the parliamentary elections this Sunday, July 22, the war in Iraq is an issue. Erdogan was elected in November 2002 and in March 2003 requested Turkey's unicameral Parliament to accede to a U.S. request to transport troops through Turkey to Iraq. The Parliament voted no, even though Erdogan's Justice and Development Party (AKP) won 363 of 550 votes in the previous election.

Our State Department says this vote was a "low point" for us in U.S.-Turkish relations. But for many Turks the low point was later that year, on July 4, when U.S. forces dissed the Turkish army by leading away in hoods captured Turkish soldiers and civilians for interrogation. Turkey protested, the soldiers were freed and a U.S.-Turkish commission expressed regret. But nationalist rancor lingers in Turkey as evidenced by the huge success of the anti-American movie, based on a TV series, "Valley of the Wolves Iraq." Erdogan continues providing a U.S. base for trans-shipment of three-fourths of U.S. air cargo to Iraq, has given advance clearance for military overflights, and has purged some of his own 2003 rebels. But the Nationalist Movement Party (MHP) has picked up support from this as well as from fears engendered by the activities of the Kurdish separatists (PKK).

Secularists, including the army, are on guard because of Erdogan's Islamist origins. But Erdogan has been pushing his party toward the center. His investment in infrastructure and his Europe-friendly policies have helped his country grow about 7.5 percent a year since he came to office, a pace that the State Department calls "one of the highest sustained rates of growth in the world." Foreign investment in Turkey is strong and so are exports. Erdogan's reforms have put him in a good position relative to mainstream Turks. The current worry is possible growth of the threat from the right.

The secularists on the left are relatively quiet because of Turkey's economic strength. One powerhouse is Turkey's textiles and apparel industry, which accounts for about 10 percent of GDP and more than one-third of Turkey's exports, generating upwards of $14 billion a year. Its two largest markets for textile exports are the EU (roughly 60 percent of total Turkish textile and apparel exports) and the United States. Turkish clothing manufacturers are organized as TCMA (a member of the International Apparel Federation) and a variety of textile and garment exporters are under the umbrella of ITKIB. Members of both organizations seek to maintain sales to Europe and America in the face of competition from Asia.

Western apparel buyers have spooked some developing countries with their search for evidence that the factories are sweatshop-free. Others respond with a positive attitude, viewing good working conditions as a competitive advantage. Turkish factories have been responding with claims that their work conditions are better than those in poorer countries like Egypt and China, and a small but significant number of them have implemented world-class working conditions, leading to their becoming certified according to the labor standard SA8000.

During my two visits to Istanbul this year, I listened to many labor and management representatives talk about these challenges. I will follow this blog with another on these interviews.