Opinion: Don't let politics obscure a health victory in New York

It's easy to understand why New Yorkers are disillusioned with Mayor Eric Adams. Ethics investigations have swirled. His political instincts have at times seemed out of touch, and his alliances have left many questioning his values and integrity. As the June primary looms, with a strong challenge from my old boss, former Gov. Andrew Cuomo, and a growing progressive field, Adams is facing significant headwinds.

But beneath the headlines, something quietly transformative has happened in New York City over the past four years: the health of the city improved, and its future health trajectory was reimagined. That's a success worth acknowledging – regardless of how one feels about the mayor's reelection prospects.

As New York state's former Health Commissioner, I don't offer praise lightly, especially when it comes to urban public health in our nation's biggest city and economic engine. But during one of the most turbulent periods in New York City's modern history, the city's public health leadership under former Health Commissioner Dr. Ashwin Vasan delivered.

New York was tested not just in theory but in crisis. In early 2022, the city was still in the grip of the Omicron COVID-19 wave. City hospitals were strained, and communities  werereeling. Yet thanks to the city's public health leadership, New York didn't just survive the tail end of the pandemic – it reasserted itself as a leader. When mpox hit months later, once again New York became the epicenter, and once again the city mounted a nationally-recognized response that contained the spread and protected those most at risk. These were not just emergencies; they were crucibles. And the city passed the test.

Meanwhile, the city managed to set out a longer-term vision for healthier, longer lives for New Yorkers. At the heart of this is HealthyNYC, a bold, data-driven plan to tackle the chronic diseases and other preventable illnesses that kill the most New Yorkers, but are often treated as background noise. Think heart disease, diabetes and overdoses: conditions rooted in social and community needs as much as medical. HealthyNYC didn't just diagnose the problem; it codified a clear set of citywide goals and metrics into law. It put accountability at the center of health governance and ensured that making New Yorkers healthier will be a permanent north star of its planning and policy. Life expectancy has increased on this watch, not only due to COVID's retreat.

And it moved from talk to action. The city introduced plant-based meals in hospitals and schools and made community health workers a permanent feature for chronic illness prevention and maternal health. It prioritized prevention over treatment and nutrition and support over tests and pills. These aren't just feel-good policies – they reflect a seismic shift in how cities can improve population health. And other jurisdictions are taking note. In the era of “Make America Healthy Again,” New York quietly implemented a model with nonpartisan, American appeal.

Mental health, long a political third rail, also saw meaningful investment. Were there stumbles? Of course. Mental health policy has been neglected for so long that it's no surprise that turning the lights back on comes with bumps. But consider this: more than 22,000 teens accessed free telehealth services in the first year of NYC Teenspace, with 70% reporting improvements, most from historically underserved neighborhoods. Sixteen new school-based mental health centers were opened. The city invested in clubhouses – community-based recovery programs – that offer support to people with severe mental illness, without stigma and without coercion. And despite recent federal cuts, 988 and crisis services were expanded using local resources.

More broadly, New York made visible progress on street homelessness and mental illness, especially when compared to peer cities like San Francisco, Los Angeles and Chicago. Yes, the work is far from done, especially when it comes to getting these New Yorkers stably housed, and the city has only laid modest groundwork for the proven Housing First model to be scaled up. But it's not nothing and was done seriously.

Then there's the overdose crisis. Fentanyl continues to devastate communities across the city, state and nation, and a New Yorker dies every three hours on average from an overdose. Yet in 2023, New York City saw its first decrease in overdose deaths in nearly a decade – a modest 1% decrease, but a shift nonetheless, the green shoots of progress. This was no accident. It came on the back of expanded naloxone access, public health outreach, overdose prevention centers and a general willingness to treat addiction as a public health issue, not just a criminal one.

On health care affordability, New York City again broke new ground. It launched a $2 billion effort to cancel medical debt – an anchor weighing on families that too often goes unnoticed in public health debates – and over the next three years, 500,000 working-class New Yorkers will sleep easier at night. It created the city's first Office of Healthcare Accountability, finally shining a light on opaque pricing and providing transparency for patients and employers and unions alike.

The administration also invested in the future of health – not just through services, but through systems. Under Dr. Vasan, New York made long-overdue upgrades to its health data infrastructure, launching the Center for Population Health Data Science, a first-of-its-kind effort to modernize and integrate public health data, and began responsibly harnessing the power of artificial intelligence to identify disease patterns and improve health outcomes. In an era where data drives decision-making, this is the kind of unglamorous but foundational work that can make or break a city's resilience to the next pandemic or crisis.

Dr. Vasan's public health legacy reminds us that effective governance transcends political turbulence. Even as public trust in government wavers and budget cuts threaten progress, cities remain our laboratories for health innovation – and New York City has once again proven itself a pioneer. The measurable improvements in New Yorkers' health outcomes weren't achieved through headline-grabbing pronouncements but through methodical, evidence-based interventions and community partnerships.

As we navigate increasingly polarized debates about the role of government in health care, New York City's recent public health achievements offer a compelling case study: when leadership prioritizes prevention, public health and data-driven decision-making, communities thrive. The city's residents today lead longer, healthier lives than they did four years ago – perhaps the most meaningful metric by which we can evaluate any administration. That transformation didn't happen by accident. It happened through vision, investment and the quiet excellence of public health governance working as it should.