Could Mayor Michael R. Bloomberg’s antismoking crusade have already saved hundreds of lives? It has, city health officials said yesterday.
Smoking-related deaths in New York City fell by more than 800 a year from 2000 to 2005, a drop of more than 10 percent, according to the city’s annual Summary of Vital Statistics report, released yesterday. Asked how much of that can be credited to the mayor’s measures, Dr. Thomas R. Frieden, the city health commissioner, said, “I think most of it.”
In another piece of good news, New Yorkers are living longer than ever, after an unusually big one-year rise in longevity. In 2004 (this statistic lags the others by a year) average life expectancy in the city reached 78.6 years, almost five months more than in 2003.
After trailing for six decades, New York City overtook the national average for longevity in 2000, and by 2004, the city led the nation by almost 10 months. Health officials say it is fairly clear why the city would have improved faster than the nation over the last decade, starting with the much reduced tolls of murder and AIDS, but they are not sure why the advantage continues to grow.
Infant mortality dropped slightly in 2005, to the lowest level ever recorded, 6 deaths among every 1,000 babies. But after decades of steep decline, progress has slowed nearly to a stop, and the infant mortality rate has changed little in the past five years.
The birth rate continued to drop, to 15.1 per 1,000 people. In more than a century of keeping track, the city has been less fecund in only two periods: the mid-to-late 1970s, and the Great Depression.
Even so, New Yorkers entering the world outnumbered those departing by more than 2 to 1, as the death rate fell very slightly, to a record low of 7 per thousand. The Bayside section of Queens had the city’s lowest death rate, while Brownsville, Brooklyn, had the highest, almost three times as high.
The leading cause of death, heart disease, continued to decline steadily as a killer, as it has for several years, possibly helped by the development of cholesterol-lowering drugs.
Dr. Frieden said he was frustrated by some areas that could be improved with education and better care, but show little or no change, including H.I.V.-related deaths and the racial disparity in infant mortality.
Black infants were twice as likely to die before their first birthdays as white or Hispanic babies. “Black women go into pregnancy and go through pregnancy in much worse health status, and that translates into higher infant mortality,” Dr. Frieden said.
H.I.V. deaths in the city peaked in the mid-1990s at more than 7,000 annually, then fell sharply with the introduction of new drug treatments, but progress slowed in recent years. The death count fell last year to 1,419, the lowest in more than two decades, but only 32 fewer than the year before.
After taking office in 2001, Mr. Bloomberg sharply increased the city’s cigarette taxes, and the state later imposed another steep increase. Then the mayor closed loopholes in the ban on smoking in restaurants and extended the ban to bars. The city also gave away nicotine patch kits to tens of thousands of people.
Despite fierce opposition at the time, the tax and the smoking ban were widely accepted. Since then, surveys have shown significant drops in the number of New Yorkers who smoke, which antismoking activists attribute largely to the city’s actions.
Using formulas developed by the federal Centers for Disease Control, the city calculated the number of smoking-related deaths at 8,096 in 2005, down from an average of 8,960 between 1999 and 2001.
Most of that decline was in death from cardiovascular disease. Death from the cancers associated with smoking also dropped, but Dr. Frieden said that was a continuation of a long-term trend, not a result of Bloomberg policies.
“Cancer takes 10 or 12 years to go down after people quit,” he said. “Cardiovascular disease goes down right away. For an individual smoker, within a year after quitting smoking, your risk of a heart attack is about half what it was before.”
