De Blasio's post-Bloomberg health policy takes less contentious approach

From smoking to trans fats to big sodas, the bans proposed by former Mayor Michael Bloomberg cast him as a controversial national leader in public health and earned a "nanny state" epithet from critics.

Mayor Bill de Blasio has praised and sought to build on his predecessor's initiatives, but with a lower-key -- and politically safer -- approach that stresses community input instead of executive edicts.

"The health department has completely revamped the way it rolls things out," said Peter Muennig, an associate professor at Columbia University's Mailman School of Public Health. "They're much more careful about engaging the community, which means that they may have a higher success rate after the rollout, but the rollout takes much longer."

The current policies are not completely conflict-free. The agency in September mandated that chain restaurants use high-sodium warning labels, drawing the industry's ire, as Bloomberg often did. But by and large, de Blasio has avoided backlash in the public health arena -- a benefit for a mayor struggling in the polls.

"If de Blasio were to try the Bloomberg policies, he would get beat up beyond belief," said political scientist Kenneth Sherrill. "Bloomberg had different political capital. . . . he had a reservoir of goodwill on other issues."

A leader of Bloomberg's health team hinted there is merit in a softer sell.

"In taking the actions that would protect people's lives, it naturally ended up being controversial," former Health Commissioner Dr. Tom Farley said at a Fordham University forum in September.

"Sometimes that meant we would do things -- advance them faster than in a perfect world one would do it, so we wouldn't be preparing all of our partners and potential supporters in the community," said Farley, who declined to be interviewed.

Bloomberg's efforts to promote healthier habits once involved an anti-obesity ad campaign with graphic globs of fat.

De Blasio so far is better known in health for trying to reassure the public during the Ebola and Legionnaires' crises, with his "calming, comforting" Commissioner Dr. Mary T. Bassett out front, Sherrill said.

"De Blasio's health department tells us . . . not to be afraid, and Bloomberg's scares us to death," Sherrill said.

Bassett, who as a deputy in Bloomberg's health department helped engineer his lightning-rod policies, said de Blasio isn't trying to avoid criticism and wants to fight obesity, cardiovascular disease and other ills as Bloomberg did.

"These things don't change with the change in administration," she said in an interview.

The community engagement strategy, she said, "is innovative, although it may not draw the headlines."

For example, de Blasio and Bassett's five-year blueprint, Take Care New York 2020, includes opportunities for residents to vote on the health priorities of their neighborhoods.

Bloomberg banned smoking in bars, required chain eateries to post calorie counts and barred cooking oil with trans fats from restaurants. Muennig called those moves "revolutionary."

De Blasio has agreed with Bloomberg's vision, including the Big Gulp ban, which provided punchlines for TV comics and critics of government intrusion. It was overturned in court amid aggressive pushback from soda lobbyists.

De Blasio quietly explored other means of limiting sugary drink sizes last year, but he hasn't publicly addressed the issue since.

Some public health advocates groused that the de Blasio administration, under pressure from Orthodox Jewish groups, went too far in rolling back Bloomberg-era rules to fight neonatal herpes caused by a circumcision ritual known as metzitzah b'peh. Parents no longer have to sign a consent form; instead, pamphlets are left in doctors' offices in an educational campaign. The community applauded the decision.

"It shows the vision of the mayor to delve into public policy with the community as opposed to against," said Rabbi David Niederman of the United Jewish Organizations of Williamsburg.

Post-Bloomberg changes may also reflect divergent political ideologies, said Cheryl Healton, dean of global public health at NYU.

"The prior administration was accused of maybe slightly favoring the more well-off," she said. "In a sense, I think that the current work that the mayor is doing is trying to address those inequities."

Though not commonly defined as health programs, Healton and other experts cited de Blasio's universal pre-K, affordable housing and fair wage pushes as efforts to influence social factors that affect well-being. The administration is also pushing aggressive mental health initiatives.

Bassett said she is guided by de Blasio's mission to reduce income inequality -- "pursuing equity in all that we do."