NEW YORK Critics call him a puritanical scold, Gotham's Dr. No and a nursemaid to Mayor Michael Bloomberg's nanny state. Meet Thomas Farley, New York City's health commissioner.
Farley, a pediatrician and endurance athlete, says they are wrong about his efforts to help New Yorkers eat better, smoke less and exercise more -- moves that have been linked to New York's recent gains in average life expectancy, the biggest gains of any metro area in the country.
"Anybody who is first at doing something is going to get a lot of criticism. And this is New York, this is the way we deal with each other," said Farley, who hopes to roll out two of his most controversial health initiatives this month.
One is a plan to restrict the size of sugary drinks to 16 ounces or less nearly everywhere they are sold, which is expected to be approved soon by the city health board. The other is a push to have hospitals promote breastfeeding by making baby formula less available to new mothers.
Behind the desk in Farley's office in Queens are reminders of the marketing muscle he's up against: eye-catching tobacco products, colorful 23-ounce sugary drinks and a cache of baby formula sent unsolicited to an expectant mother on his staff.
The unquestionably fit Farley shared his height - 6 foot 2 inches - but declined to reveal his weight or age, although he appears to be in his mid-50s. Each day he leaves the Manhattan apartment he shares with his wife, also a pediatrician, and their four daughters for a 4-mile run, a 10-mile bike ride or weight lifting and a swim.
His chief vice is pastries, and he immediately regretted telling a reporter that as a boy in New Jersey he ducked into the woods to smoke cigarettes with friends until he was caught.
Farley graduated with honors from Haverford College. After receiving his medical degree from Tulane University, he spent 11 years with the Louisiana Office of Public Health.
He took the helm in New York in 2009 after Thomas Frieden left to run the U.S. Centers for Disease Control and Prevention. As the head of an agency with 6,000 employees and a $1.6 billion budget, Farley today shoulders what he calls Bloomberg's legacy as "the world's first public health mayor."
Along with his predecessor, Farley is credited with pioneering bans on smoking and trans fats, mandates to reduce salt and post calorie counts, and initiatives that pushed junk food to the back of corner grocery stores.
At the same time, the city has reclaimed streets and created construction incentives to transform bike riding, walking and stair climbing into almost unavoidable exercise.
Those efforts are being replicated in cities across the globe -- calories are now printed on menus in Seattle, and in Hanoi smoking is no longer allowed in public places -- even as they come under fire from restaurant groups, food and beverage companies, and small business owners.
Farley brushed off criticism that he's trampling personal freedoms as a gripe from industries motivated by unfounded fears of lost profits.
"We're creating a healthier environment that gives people the freedom to just go about their business without having to worry so much about being vigilant about their health behavior," Farley said.
"He really said that?" asked Andrew Moesel, spokesman for the New York City chapter of the New York State Restaurant Association, which opposes the proposed soda ban. "There have been many times when this administration thinks they know what's best for citizens and that just rubs people the wrong way."
While Farley's approach may bristle, results are cropping up that may shift the conversation.
A study discussed in the June 2012 medical journal Lancet shows New York City far outpaced the rest of the nation in gains in life expectancy. Some success is due to the city preventing and controlling AIDS, but more than 60 percent of the increase in life expectancy since 2000 can be attributed to reductions in heart disease, cancer, diabetes and stroke, the report said.
"A major role was played by the health department, especially the programs and policies to promote healthy living," lead researcher Ali Mokdad, a professor at the University of Washington's Institute for Health Metrics and Evaluation, told Reuters.
Farley's crusade for a healthier New York has faced setbacks. A tempest swirled in January when an obese actor complained that his photo had been altered to depict him as an amputee in a city advertisement on the dangers of diabetes.
And in July the courts ruled the city could not scare smokers by requiring delis to hang posters of a stroke-damaged brain, a cancerous lung and a rotting tooth.
Farley credited Bloomberg for the health department's success. It also helps to have a city board of health to pass rules that might otherwise get bogged down in a broader state legislature, he said.
"It's very rare for public health agencies around the country to have all those things working in their favor, so we feel obligated, in a way, to make headway here," he said. "Then the rest of the country often follows us."
(Editing by Paul Thomasch and Douglas Royalty)