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Health Department Releases Strategy to Address Chronic Disease

Chronic Diseases such as Heart Disease, Diabetes and Cancer are the Top Killers of New Yorkers

This Roadmap Supports Citywide Effort Aims to Reduce Deaths From Chronic Diseases by 2030

Strategy Outlines Proposals That Tackle Conditions and Inequities Harming New Yorkers’ Health and Shrinking Life Expectancy

January 28, 2024 — Today, the New York City Health Department released Addressing Unacceptable Inequities: A Chronic Disease Strategy for New York City — a multiagency strategy that addresses the root causes of chronic diseases such as heart disease, diabetes, and screenable cancers and outlines interventions that support longer, healthier lives for New Yorkers. Chronic diseases are a leading cause of death in NYC, taking an especially high toll on Black New Yorkers and New Yorkers in communities experiencing disinvestment.

“I’ve seen firsthand how chronic disease hijacks your life and what it can do to a family. That’s why we are taking action right now to improve New Yorkers’ health and increase life expectancy,” said New York City Mayor Eric Adams. “Our administration launched HealthyNYC to address the key drivers of death and develop a comprehensive vision for improving life expectancy across New York City. With this report, we are creating a clear roadmap for the city’s multiagency efforts to tackle the biggest diseases that are killing New Yorkers, as well as address the structural and environmental conditions that impact their health and shorten lifespans.”

“We all know the feeling hearing about a family member, friend, loved one, or news about ourselves saying we have a chronic disease. What it all might mean to live with heart-disease, type 2 diabetes, or hypertension,” said Deputy Mayor for Health and Human Services Anne Williams-Isom. “In the report we are putting out today, we focus on how these conditions affect our communities, how we view those effects through an equity lens, and what we as a city can do from a systems and structures perspective to bring greater support to the social determinants of health. This report gives us a path forward to tackle chronic disease in a way that shifts our systems to make every New Yorker healthier through highlighting our park spaces for physical activity to food access and everything in between.”

“This report shines a much-needed light on the devastating impact chronic disease – in all of its forms – is having across this City, touching each and every community and family. Unfortunately, the analysis shows us that the situation has worsened in recent years, as we see average life expectancy dropping and disproportionally impacting our black and brown communities,” said Deputy Mayor for Strategic Initiatives Ana J. Almanzar. “The silver lining is that the solutions to turn the tide are known and are within our grasp, as this report makes clear through its comprehensive and holistic set of strategies. The promotion of food access and the role of nutrition – which have been key pillars of this administration – are central to any large-scale effort to empower communities and individuals to improve overall health and wellness.”

“A person’s diet is incredibly influential in determining their overall health, both contributing to and being a powerful solution to prevent chronic disease,” said Mayor's Office of Food Policy Executive Director Kate MacKenzie. “By integrating efforts to expand food access and nutrition security, strengthening SNAP enrollment, and curbing harmful marketing, we’re taking a comprehensive approach to creating a healthier and more equitable New York City. We’re looking forward to seeing this cross-agency collaboration reduce chronic disease and improve wellbeing through transformative changes to our food system.”

“As a physician, I see the majority of my patients battling cardiovascular disease, diabetes, and cancer — all health issues that the City has a moral imperative and the power to address,” said Health Department Acting Commissioner Dr. Michelle Morse. “With New York City’s long history as a leader in public health, this chronic disease strategy provides a comprehensive road map for the City to ensure New Yorkers live healthier and longer lives.”

Life expectancy in NYC has dropped dramatically and inequitably since the start of the COVID-19 pandemic, from 82.6 years in 2019 to 78 years in 2020, rising to 81.5 years in 2022. Between 2019 and 2020, the largest decreases were observed among Black and Latino New Yorkers, among whom life expectancy fell by 5.5 and 6 years, respectively. Similar inequities by race, ethnicity, and income also exist for rates of premature death (death before age 65).

In response, the Health Department launched HealthyNYC, a comprehensive vision for improving life expectancy and creating a healthier city for all. With an overall goal of increasing life expectancy to exceed 83 years by 2030, HealthyNYC sets ambitious goals, which will require specific gains among Black New Yorkers, to address key drivers of death including chronic disease, suicide, maternal mortality, violence, drug overdose, and COVID-19. The chronic and diet-related disease goals established by HealthyNYC include reducing deaths due to heart- and diabetes-related diseases by 5% by 2030 and deaths due to screenable cancers by 20% by 2030, as these are leading causes of death among all racial and ethnic groups in NYC.

“Addressing Unacceptable Inequities: A Chronic Disease Strategy for New York City” is intended to set a foundation for action in the coming years and to foster sustained partnerships across private, public, and nonprofit sectors, as well as meaningful engagement with communities across the city. It outlines a broader call to action to change the structural and environmental conditions that impact health and to alter the trajectory of life expectancy, ensuring that all New Yorkers have the opportunity to live a healthier, longer life.

From connecting patients in the NYC Health + Hospitals system with public benefits to addressing harmful marketing practices to revitalizing streets and parks, this strategy provides a comprehensive approach to prevention, treatment, and support in addressing the leading causes of death in our city. The strategy focuses on three key upstream approaches:

Meeting the material needs of New Yorkers by improving access to resources such as food and government benefits.

Addressing the commercial determinants of health by working to reduce exposures to and consumption of unhealthy products such as ultra-processed foods, tobacco, and alcohol.

Promoting opportunities for healthy living by investing in policies and programs that promote nutritious foods, physical activity, and social connection in communities.

A task force of leaders from multiple NYC government sectors — including Deputy Mayor Anne Williams-Isom (Health and Human Services), Deputy Mayor Ana Almanzar (Strategic Initiatives), Executive Director Kate MacKenzie (Mayor’s Office of Food Policy), and Acting Commissioner Michelle Morse, MD, MPH (NYC Health Department) — was launched in fall 2023 to develop a slate of proposals to address systemic factors that impact chronic disease rates. The task force proposed 19 initiatives, both new and existing, that leverage the unique capabilities and resources of City agencies to address the upstream factors that influence chronic disease outcomes.

Most of the proposals elevate multiagency collaborations and are planned for a variety of settings, from public schools and parks to hospitals across all five boroughs. The proposals aim to secure the future of health equity infrastructure and emergency response readiness and to help solidify NYC’s role as a leader and standard setter for governmental public health practice. The proposals presented in this strategy range from work underway and planned to launch within the City’s fiscal year to longer-term aims that will require planning, assessment, and identification of resources.

“HealthyNYC envisions a city where all New Yorkers - both today and for generations to come - live longer, healthier lives. Under the NYC Health Department's strategic leadership, this initiative brings together government agencies and community partners to create lasting, citywide change,” said former NYC Health Commissioner Dr. Ashwin Vasan. “This plan demonstrates the City's progress by establishing a roadmap to save lives and reduce preventable deaths from chronic diseases, many of which are diet-related. The Chronic Disease blueprint represents years of work and leadership by the City Health Department and its amazing staff to put forth a clear vision for how to do this by improving access to care, meeting basic needs, promoting healthy living, and combatting the damaging commercial influences that can worsen our health. I applaud Acting Commissioner Morse and the entire team for working to realize the vision of HealthyNYC and make New York the healthiest big city in the world.”

“With the right support and resources, New Yorkers can lower their risk of preventable disease and premature death,” said CUNY SPH Dean Ayman El-Mohandes. “We look forward to working with the Health Department by training the next generation of public health leaders to use community-centered, equity-focused approaches to prevent disease, promote health, and work using evidence-based approaches.”

“New York City has long been in the forefront of innovation when it comes to better health,” said Director of Food is Medicine Institute Dr. Dariush Mozaffarian. “This new plan recognizes the unacceptable toll of unhealthy food, inactivity, and mental stress on the physical and mental well-being of New Yorkers—and brings together wide-ranging and sensible programs to begin to turn the tide.”

“All of us wish for as many healthy birthdays as possible for our loved ones — but too often our health is hindered by heart disease, diabetes, cancer, and other chronic illnesses. Although some communities are much more affected by these illnesses, it's in our power to change this," said former NYC Health Commissioner Dr. Dave A. Chokshi, who chairs the Common Health Coalition. “I applaud the City's pioneering chronic disease strategy, particularly its emphasis on equity, partnerships, and accountability, which will help create healthier futures for all New Yorkers.”

"Chronic disease is one of the drivers of premature death in New York City,” said Council Member Lynn Schulman, Chair of the Health Committee. “The Health Department's bold initiative to tackle chronic diseases head-on is vitally important and needed. These conditions affect everyone but disproportionately impact communities of color and those facing systemic disinvestment. This strategy not only addresses health outcomes but also the root causes driving health inequities and paves the way for all New Yorkers to live longer, healthier lives. Together, we can build a healthy and more robust city.”

“With this Chronic Disease Strategy, New York City moves beyond simply urging people to eat healthier food, exercise more, or adopt other healthy habits, said former NYC Health Commissioner Dr. Mary T. Bassett. “It commits to addressing the broader barriers that make it difficult for many to follow through on this advice. This intersectoral, whole-of-government approach is both welcome and necessary to ensure we're helping all New Yorkers.”

“Addressing inequities in chronic diseases is critical for the health of our city’s residents,” said NYC Health + Hospitals Vice President and Chief Population Health Officer Nichola Davis, MD, MS. “The NYC Health Department’s approach is comprehensive, with multi-agency involvement, and builds on previous programs and work in the city. It recognizes the importance that social factors play in chronic disease and focuses on improving upstream factors such as access to healthy foods, addressing food insecurity, and decreasing marketing of unhealthy products. I look forward to the implementation of the outlined initiatives and the positive impact this will have on the health of New Yorkers.”

"Excited to see the health department continuing to build on its legacy of leadership in innovation by focusing citywide multi-sector efforts on reducing the burden of chronic diseases in NYC,” said President and CEO of United Hospital Fund Dr. Oxiris Barbot. “I look forward to opportunities for partnership in these important endeavors."

“Chronic diseases are the leading causes of death worldwide, and they are as preventable as infectious diseases.,” said former NYC Health Commissioner Dr. Thomas Farley. “With this strategy, New York City continues its tradition of leadership in combatting these health problems and using the resources of many city agencies to do so.”

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