In 2007, I was fortunate to join Mayor Michael Bloomberg's Administration as the commissioner for New York City's Human Resources Administration. I was happy to serve in an administration with a national reputation for fresh, innovative thought and a track record for taking on challenging problems. By the time I joined, the city had already taken on a host of public health issues, including smoking, trans fat, and obesity. Obesity had been identified as a significant and growing problem in New York City, as in the rest of the country Then-Health Commissioner Dr. Thomas Fricden termed obesity "the only health problem in NYC that is getting worse." Diabetes and other obesity-related illnesses were on the rise and under the leadership of Deputy Mayor Linda Gibbs and Dr. Frieden the Bloomberg Administration was searching for ways to address the problem.
Within a year, staff from my agency and the Department of Health began collaborating to address our shared concern about obesity. My concern stemmed from being responsible for the city's Food Stamp Program, as well as the recognition that obesity and diabetes disproportionately affect the poor--the primary beneficiaries of my agency's programs. The irony that federal Supplemental Nutrition Assistance Program (SNAP) benefits could be used to purchase items with no nutritional value, such as soda, was becoming very clear. There was an inherent contradiction in the federal government's approach - in the name of nutrition assistance they were subsidizing the purchase of items that had devastating effects on health. It seemed obvious to us that the government should not be subsidizing obesity. In that spirit, we decided to explore ways to leverage SNAP in New York City.
Given his past, it was no surprise that Mayor Bloomberg was supportive and directed us to move forward. Because SNAP is administered through New York State, we had to gain support from state health and social service officials who would then have to submit a formal request to the U.S. Department of Agriculture (USDA), the federal agency that oversees the program. State officials quickly signed on to the concept and we were encouraged, even though we knew that making our case to USDA would be difficult.
The next two years brought a sea of leadership change at the city, state, and federal levels. Dr. Frieden left the city Department of Health to join the Obama Administration as the director of the Centers for Disease Control and Prevention and the New York State governorship turned over, as did the leadership in many state agencies and at USDA. But by 2010, we felt that the right people were in place and it was the right time to move forward. …