Health

Conversation Starter: Mayor Bloomberg's Bid to Ban Soda Purchases with Food Stamps

Conversation Starter: Mayor Bloomberg's Bid to Ban Soda Purchases with Food Stamps

Mayor Michael Bloomberg has long made it a paramount goal to rid New York City of unhealthful foods, and he recently asked the Federal government for permission to prohibit Food Stamp recipients from using stamps to buy soda and other sugared beverages in the city.

Supporters are cheering Bloomberg’s stance, saying he’s striking a blow for better dietary habits and ultimately lower public health costs and consequences such as obesity. But critics question the move, seeing it as an example of big government, even patronizing toward the poor.

Research can be a valuable guidepost for public officials. In 2009, after Mayor Bloomberg required restaurant franchises to put calories counts on their menus, NYU Wagner professors Rogan Kersh and Brian Elbel sought to measure the impact of the calorie labeling initiative on consumer habits at fast-food restaurants in low-income neighborhoods. Their survey of 1,156 adult found little direct evidence to support the Mayor’s view that the posting of calorie counts causes fast-food patrons to buy items containing fewer calories. Elbel’s and Kersh’s widely discussed study, published in the journal Health Affairs, emphasized that follow-up studies are needed to determine the value and effectiveness of menu labeling and other obesity-related policies.

Professor Elbel describes the Mayor’s current proposal to prohibit the use of food stamps for the purchase of soda and sugary drinks as “an extremely innovative policy approach to tackle the complicated and multifaceted problem of obesity. It deserves a rigorous assessment, to evaluate its overall impact on healthy food choice and obesity,” says Professor Elbel, assistant professor of medicine and health policy. “The rest of the nation can then learn from the New York City experience as these and other policies to fight obesity are considered across the country.”

What’s your opinion of the Mayor’s food stamp initiative? Is it good public policy? Or should it just be allowed to fizzle out? Visit Wagner’s Public Service Today blog to post your comment today.

Conversation: "Aging: Global Health Crisis or Opportunity?" Dr. Alexandre Kalache of the World Health Organization with Prof. Victor Rodwin

Conversation: "Aging: Global Health Crisis or Opportunity?" Dr. Alexandre Kalache of the World Health Organization with Prof. Victor Rodwin

New York University's Master's Program in Global Public Health will convene a seminar on the world�s growing elderly population with special guest Dr. Alexandre Kalache of the World Health Organization on Monday, Dec. 4, at 5:30 p.m.

Part of an ongoing series titled Conversations in Global Public Health, the discussion will include Dr. Victor Rodwin, Professor of Health Policy and Management at NYU's Robert F. Wagner Graduate School of Public Service, and co-edits (with Michael K. Gusmano)Growing Older in World Cities: New York, London, Paris and Tokyo

Doctoral Program Grad Receives AJPH "Paper of the Year" Award

Doctoral Program Grad Receives AJPH "Paper of the Year" Award

Frederico C. Guanais, who earned his Ph.D. at NYU Wagner, is a recipient of the 2013 "Paper of the Year" award from the American Journal of Public Health. Guanais was recognized for his article entitled “The Combined Effects of the Expansion of Primary Health Care and Conditional Cash Transfers on Infant Mortality in Brazil, 1998-2010.”

AJPH’s editors termed Guanais’ article “an innovative paper looking at the synergic effects of two government programs, from two different areas, on infant mortality. Using a relatively innovative approach, the paper exemplifies something that the public health community has been emphasizing for ages: the importance of intersectoral approaches.”

Guanais received his Ph.D. in 2006. He wrote his dissertation on primary care in Brazil.

EMPA for Nurse Leaders

Video

  • Sonia Ospina | How does leadership happen?

    How does leadership happen?
    Leadership
    .
  • Victor Rodwin

    How does the healthcare in NYC compare to other world cities?
    Health
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  • David Schachter

    The Capstone Program
    Capstone
    .
  • Executive Master of Public Administration

    Executive Master of Public Administration

    Concentration for Nurse Leaders
    Health
    .
  • Anthony Kovner

    What greater role can Evidence-Based Management play in healthcare?
    Health
    .

My dream is to be in senior management...

Marcela Levine

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This program gives you the tools you need to do your job...

Donna Tinling-Solages

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I started to apply new skills to my job right away...

Peter Roppolo

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My favorite part of the program is the curriculum...

Amanda Ailleo

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Evidence-Based Management is the Road Less Traveled, Says Prof. Anthony Kovner

Evidence-Based Management is the Road Less Traveled, Says Prof. Anthony Kovner

[Anthony Kovner]

When organizations or businesses stumble, the search for an explanation often leads back to the quality of the evidence-gathering process. It is that process, known as Evidence-based Management (EBM), that fascinates Anthony R. Kovner, who has spent more than a decade trying to get managers to employ it when they seek ways to improve their organization’s performance and results.

Professor Kovner teaches EBM to students at the Robert F. Wagner Graduate School of Public Service, where he is a professor of public and health management and the director of the Executive MPA Program for Nurse Leaders. He is also the author of several books on healthcare management. Shortly before the publication of a chapter he recently wrote, entitled “Adventures in the Evidence-based Management Trade,” for the forthcoming Oxford Handbook of Evidence-Based Management (Oxford University Press), he sat down with NYU Research Digest (Spring 2012)  to discuss Evidence-based Management.

What’s the theory behind EBM?

Evidence-based Management comes out of medicine—the idea that if you make a medical intervention, it should have a predictable and positive outcome. We said, “Why can’t we apply this in management?” Well, the truth is, it’s not a simple matter. We know a lot less about management than medicine, for which there’s a huge medical research establishment, the randomized clinical trial, and an established process for scientific review.

What professional sector does EBM most lend itself to?

To every sector. So for example, when two large health organizations decide to merge, we say, “Wouldn’t it make sense to look at the best available evidence before making a decision to merge?” Instead, a very common managerial response is: “We want to merge—let’s find the evidence that justifies it.” So these managers need to do more than just type “hospital merger” in Google? Keep in mind that all managers make decisions based on evidence. The point is, what is the quality of the evidence? It can be pretty shabby.

What’s wrong with the process as it works now?

When, for instance, two large institutions decide to merge, to what extent do they ask in advance, “What do we know about successful and unsuccessful mergers?” Generally speaking, what they do is ask the consultants, and the consultants say, “This would work in Akron.” But of course that doesn’t mean that it would work in Brooklyn. Are the merging institutions’ two geographies compatible? What about their respective cultures? It’s not that you get to a solution—these kinds of problems are too messy, too wicked, and the causation is not as clear as in randomized clinical trials. But it informs your thinking so you can see and avoid the worst consequences of what might happen.

How should the evidence gathering begin?

Three basic steps: search and locate the best available evidence, learn from best practices, and try doing your own management research. If you are studying why nurses turn over so much in your hospital, it’s important for you to understand the differences between the 12-hour day shift and the 12-hour night shift. The most important step, though, is to ask the right question, and translate your management challenge into an answerable one.

If EBM is so effective, why don’t more organizations engage in it?

That’s the $64,000 question, and it’s not an easy question to deal with. What it really is about is power and hierarchy and organizations. Let’s say an employee comes up with a better way of doing something and tells the boss about it. You’d expect the boss to say it’s a great idea, let’s do it. But in practice the boss says, “You’re insulting the way I’m managing this place,” or “If you thought of it, then how good can it be, if I didn’t think of it,” or “Go ahead and present your ideas to the higher-ups, and if they like it I’ll take credit for it, and, if they don’t we’ll blame you. “

That sounds almost insurmountable.

The trick of it is to make the politics work for you. To get it implemented, you have to get the managers to see that it’s in their political interest to practice evidence-based management. And I believe it is.”

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