New York City officials on Wednesday announced a sweeping agenda “to achieve healthier, longer lives for all New Yorkers” and raise the city’s average life span to at least 83 years old, as public health leaders across the country grapple with declining life expectancy and seek strategies to reverse the trend.
HealthyNYC, the city’s new public health campaign, is intended to knit together disparate and ongoing initiatives focused on boosting mental health, combating opioid misuse, eating healthier meals and other efforts to improve collective health. Mayor Eric Adams and New York City officials also vowed to tackle deaths from firearms and intimate partner violence, consider the placement of public parks and grocery stores, and make life expectancy their “common cause” when pursuing policies across the city.
“When we’re talking about things like transportation, or education or housing or violence, we’re really talking about health,” said New York City Health Commissioner Ashwin Vasan, who is overseeing the initiative. He noted that average life expectancy in the city had fallen by two years, accelerated by the covid-19 pandemic.
“Getting these years back should be nothing less than our top priority,” said Vasan, who predicted that achieving all of HealthyNYC’s goals by 2030 would help avert about 7,300 premature deaths. Officials said they hope to build on the goal of raising average life expectancy to 83. “Anyone born in New York would expect to live that long — at least,” the health commissioner said.
Officials also pledged to enact a local law that will commit the city to pursuing the agenda for years to come; launch a media campaign offering strategies for residents to live healthier lives; address racial disparities contributing to gaps in outcomes; and create data dashboards that would help target future investments.
The HealthyNYC campaign will target six broad drivers of premature deaths in the city — chronic and diet-related diseases, drug overdoses, suicides, covid-19, violence and maternal mortality — and set goals to reach by 2030. For instance, officials pledged to reduce covid deaths by 60 percent, deaths linked to preventable cancers by 20 percent and pregnancy-associated mortality among Black women by 10 percent.
Under legislation that the New York City Council’s health committee chairwoman plans to introduce Thursday, health officials would be required to report on their progress every year and reestablish new goals every five years. Officials said they were unaware of other cities with similar requirements, and Vasan said the law should help ensure that the campaign persists beyond any individual mayor or health commissioner.
“Life expectancy is and should be the North Star for governments,” Vasan said. “I don’t think there’s a more important metric that offers a litmus test for how we’re doing as a society and as a democracy than how long, and how well, we live.”
New York City’s campaign arrives as declining life expectancy across the United States has received mounting attention, including a year-long Washington Post examination of why American lives are cut short. Americans are more likely to die before age 65 than residents of similar nations, despite living in a country that spends substantially more per person on health care than its peers. The same factors behind New York City’s downturn in life span have helped drive a spike in premature deaths from coast to coast.
Unlike many other parts of America, where life expectancy began to decline before the covid pandemic, New York City’s life expectancy rose to a high of 82.6 years in 2019, according to city health data, compared with the national average of 78.9 that year. Experts attribute New York’s higher rate to a range of factors, including strict local public health laws and that living in an urban environment is linked to more physical activity, improved access to grocery stores and other health benefits. They also note that urban areas attract residents with higher levels of income and education, which is associated with greater life expectancy. But New York’s life expectancy fell sharply to 78.0 years in 2020, as the city was hit hard by covid; national life expectancy dropped to 76.8 that year.
The city’s effort is “clearly necessary,” said Ashish Jha, the dean of Brown University’s public health school, who said he had been briefed on New York City’s plan. “We are experiencing the greatest decline in life expectancy in modern American history, and it is not at all clear that we’re going to have some sort of a national effort to turn this around.”
The new campaign goes beyond health-care delivery, with New York City officials vowing to increase access to employment options, combat loneliness and reckon with how access to social media affects youth mental health. Officials also set a goal of reducing city homicide deaths by 30 percent by 2030, through limiting access to illegal guns, curbing crime, greater investment in high-risk communities, additional mental health support and other tactics.
Officials acknowledged that life expectancy declines have been frequently linked to “deaths of despair” — with a local and national rise in suicides, drug overdoses and alcoholism — and pledged to reduce drug overdose deaths by 25 percent and suicides by 10 percent by 2030. But they stressed that they are seeking to tackle broader, often-overlooked causes of premature death, setting a goal of reducing deaths linked to cardiovascular disease and diabetes by 5 percent.
“Chronic disease hijacks your life,” said Adams, invoking his well-chronicled fight with diabetes as he and city leaders stood in a park by the Brooklyn Bridge to unveil the plan. “We can’t have a sick care system. We have to have a health-care system that is more proactive and not reactive.”
New York City officials are also enlisting partners across health care, social services and the private sector, many of which were already pursuing efforts to improve community health, but not in a coordinated way.
“We see this as our social responsibility,” said Karen Ignagni, chief executive of EmblemHealth, a not-for-profit health plan that serves more than 3 million people in the broader New York metro region. Ignagni said her health plan had committed to aligning its work with the Health Department, such as by using her organization’s 14 neighborhood centers to increase access to healthy food and mental health services, and sharing data to support the city’s new data dashboards. She called on other organizations across New York City to make similar commitments.
“We need hospitals to participate. We need physicians to participate. We need community-based organizations to participate,” Ignagni added. “They’re challenging everybody to step up and to participate and raise the bar here. … I look across the country, and I haven’t seen anything as big as this.”
Public health experts also pointed to New York City’s long, successful legacy of public health initiatives. Beginning in the early 2000s, Mayor Mike Bloomberg pursued an often-controversial agenda that included raising cigarette taxes, banning smoking in workplaces and attempting to limit the sale of large sugary drinks. Officials credit Bloomberg’s initiatives with helping raise the city’s life expectancy before the pandemic.
The commitment to piloting public health initiatives is “literally in the water in New York City,” said Dave A. Chokshi, a physician at Bellevue Hospital who served as New York City’s health commissioner during the covid-19 pandemic. Chokshi connected city physicians’ 19th-century efforts to pioneer sanitation reforms with modern-day health officials attempting to raise life expectancy. “I see the work that the Health Department is doing now in that broad lineage of people who are committed to saving lives and preventing suffering,” he said.
Jha, who served as White House covid coordinator before stepping down earlier this year, said that he believed tackling life expectancy “is going to have to come from local areas” — and New York City would be a model.
“When I was in the White House, I often found that when New York or another major city launched something, it would be an impetus for other cities,” Jha said. “I think what this HealthyNYC initiative will do is show very concrete areas of action, and my hope is that inspires people.”