Tom Frieden
Encyclopedia
Dr. Thomas R. Frieden is the Director of the U.S. Centers for Disease Control and Prevention
(CDC) and Administrator of the Agency for Toxic Substances and Disease Registry
(ATSDR). He was New York City Health Commissioner from 2002–2009.
(BA), Columbia University College of Physicians and Surgeons
(MD) and Columbia University's Mailman School of Public Health (MPH). He completed training in internal medicine at Columbia-Presbyterian Medical Center and sub-specialty training in infectious diseases at Yale University
. One brother, Jeffry Frieden, is a noted international political economist and the Stanfield Professor of International Peace at Harvard University. His other brother, Ken Frieden, the B.G. Rudolph Professor at Syracuse University, specializes in nineteenth-century literature.
was controlled rapidly, reducing overall incidence by nearly half and cutting multidrug-resistant tuberculosis by 80%. The city's program became a model for tuberculosis control. From 1996 to 2002, Frieden was based in India, assisting with national tuberculosis control efforts. As a medical officer for the World Health Organization
on loan from the CDC, he helped the government of India implement the Revised National Tuberculosis Control Program (RNTCP). The 2008 RNTCP status report estimates the nationwide program resulted in 8 million treatments and 1.4 million saved lives. While in India, Frieden worked to establish a network of Indian physicians to help India's state and local governments implement the program and helped the Tuberculosis Research Center in Chennai
, India, establish a program to monitor the impact of tuberculosis control services.
agenda," Frieden led a period marked by improvements in the health of New Yorkers as well as sometimes fierce controversy.
Frieden has been criticized by interest groups from across the political spectrum – especially advocates for the tobacco and restaurant industries. The New York Post quipped that Frieden had turned the city into a “nanny state on steroids.” These criticisms did not diminish after he was appointed as Director of the Centers for Disease Control and Prevention. “Frieden's stick-over-carrot, for-your-own-good approach to public health is no longer confined to the Big Apple," the industry-backed Center for Consumer Freedom wrote on its blog. "Get ready, because the 'nanny state on steroids' is going national.” (Politico.com) Despite his contentious stance on many issues, Frieden was selected by Governing Magazine as a Public Official of the Year in 2005, and NY1's New Yorker of the Year in 2006.
rates. Frieden established a system to monitor the city's smoking rate, and worked with New York City Mayor Michael R. Bloomberg to increase tobacco taxes, ban smoking from workplaces including restaurants and bars, and run aggressive anti-tobacco ads and help smokers quit. The program reduced smoking prevalence among New York City adults from 21.6% in 2002 to 16.9% in 2007– a change that represents 300,000 fewer smokers and could prevent 100,000 premature deaths in future years. Smoking prevalence among New York City teens declined even more sharply, from 17.6% in 2001 to 8.5% in 2007, and is now less than half the national rate. The workplace smoking ban
prompted spirited debate before it was passed by the New York City Council
and signed into law by Mayor Bloomberg. Over time, the measure has gained broad acceptance by the public and business community in New York City. New York City's 2003 workplace smoking ban was among those following California's ban in 1994. Frieden supports increased cigarette taxes as a means of forcing smokers to quit, saying "tobacco taxes are the most effective way to reduce tobacco use." Frieden supported the 62-cent Federal tax on each cigarette pack sold in the United States, introduced in April 2009.
, prompting Catholic League president Bill Donohue to respond,"What's next? The city's own brand of clean syringes?" More than 36 million were given away in 2007.
diabetes registry that tracks patients' blood sugar
control over several months and report that information to treating physicians in an effort to help them provide better care. The New York City Board of Health's decision to require laboratories to report A1C test results has generated a heated debate among civil libertarians, who view it as a violation of medical privacy
and an intrusion into the doctor-patient relationship
. Even though patients can choose to not receive information from the program, there is no provision enabling patients to opt out of having their glycemic control data entered in the database. The New York City DHMH asserts that the A1C registry can help reduce the risk of blindness
, kidney failure, leg amputations and early death among people with diabetes. But according to a May 21, 2010 PowerPoint presentation prepared by the NYC Department of Health and Mental Hygiene, as of 31 December 2009, the program was only reaching 16% of New York City residents with diabetes. The New York City DHMH has provided little if any solid evidence to validate its assertions about improved patient outcomes, although "outcome evaluation [is] currently being designed" and completion is anticipated by 2011.
, New York City has adopted regulations since 2006 to eliminate artificial trans fat
from all restaurants. The restaurant industry and its political allies condemned the trans-fat measure as an assault on liberty by an overzealous "nanny state," but compliance has exceeded 90% among New York City restaurants, and the measure has inspired similar laws in several US cities and the state of California. The Health Department also required chain restaurants to post calorie information to raise consumer awareness of fast food's caloric impact. The measure requires chains with 15 or more outlets to post calorie counts on menus and menu boards. It has prompted two lawsuits by the New York State Restaurant Association. In the first, New York State Restaurant Association v. New York City Board of Health
, a U.S. District Court judge ruled that federal law pre-empted New York City's action and overturned it. The NYC Board of Health then repealed and re-enacted the measure, which took effect in May 2008. Most chains now post calorie information in their New York City outlets, despite a pending legal challenge, and customers have experienced widespread "sticker shock.". National health reform legislation, the Patient Protection and Affordable Care Act, requires menu labeling nationally by 2012.
and the Department of Health and Human Services
named Dr. Frieden the 16th director of Centers for Disease Control and Prevention
(CDC) and administrator of the Agency for Toxic Substances and Disease Registry
(ATSDR); he assumed his position on 8 June 2009 from the acting head, Richard E. Besser
.
On announcing Frieden’s appointment, President Obama said, “America relies on a strong public health system and the work at the Centers for Disease Control and Prevention is critical to our mission to preserve and protect the health and safety of our citizens.” Frieden had previously worked for the CDC from 1990 to 2002 as an Epidemic Intelligence Service Officer in New York City and then as part of CDC’s tuberculosis control program.
, supporting the Bloomberg Initiative to Reduce Tobacco Use. This initiative aims to prevent more than 100 million tobacco-related deaths worldwide by promoting tobacco control in developing countries. By mid-2008, the initiative had funded more than 100 organizations in 36 nations, with a focus on China
and India
, where more than 40% of the world's smokers live. Bloomberg's effort was joined by the Bill & Melinda Gates Foundation
in 2008.
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
(CDC) and Administrator of the Agency for Toxic Substances and Disease Registry
Agency for Toxic Substances and Disease Registry
The Agency for Toxic Substances and Disease Registry is a federal public health agency within the United States Department of Health and Human Services. The agency focuses on minimizing human health risks associated with exposure to hazardous substances...
(ATSDR). He was New York City Health Commissioner from 2002–2009.
Education
Frieden graduated from Oberlin CollegeOberlin College
Oberlin College is a private liberal arts college in Oberlin, Ohio, noteworthy for having been the first American institution of higher learning to regularly admit female and black students. Connected to the college is the Oberlin Conservatory of Music, the oldest continuously operating...
(BA), Columbia University College of Physicians and Surgeons
Columbia University College of Physicians and Surgeons
Columbia University College of Physicians and Surgeons, often known as P&S, is a graduate school of Columbia University that is located on the health sciences campus in the Washington Heights neighborhood of Manhattan...
(MD) and Columbia University's Mailman School of Public Health (MPH). He completed training in internal medicine at Columbia-Presbyterian Medical Center and sub-specialty training in infectious diseases at Yale University
Yale University
Yale University is a private, Ivy League university located in New Haven, Connecticut, United States. Founded in 1701 in the Colony of Connecticut, the university is the third-oldest institution of higher education in the United States...
. One brother, Jeffry Frieden, is a noted international political economist and the Stanfield Professor of International Peace at Harvard University. His other brother, Ken Frieden, the B.G. Rudolph Professor at Syracuse University, specializes in nineteenth-century literature.
Early career
Frieden's work on TB in New York fostered public awareness and helped improve public funding (city, state and federal) for tuberculosis control. The epidemicEpidemic
In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...
was controlled rapidly, reducing overall incidence by nearly half and cutting multidrug-resistant tuberculosis by 80%. The city's program became a model for tuberculosis control. From 1996 to 2002, Frieden was based in India, assisting with national tuberculosis control efforts. As a medical officer for the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
on loan from the CDC, he helped the government of India implement the Revised National Tuberculosis Control Program (RNTCP). The 2008 RNTCP status report estimates the nationwide program resulted in 8 million treatments and 1.4 million saved lives. While in India, Frieden worked to establish a network of Indian physicians to help India's state and local governments implement the program and helped the Tuberculosis Research Center in Chennai
Chennai
Chennai , formerly known as Madras or Madarasapatinam , is the capital city of the Indian state of Tamil Nadu, located on the Coromandel Coast off the Bay of Bengal. Chennai is the fourth most populous metropolitan area and the sixth most populous city in India...
, India, establish a program to monitor the impact of tuberculosis control services.
Issues
Dr. Frieden served as head of the New York City DOHMH from 2002–2009. The agency employees more than 6,000 people with an annual budget of $1.5 billion. He also chaired the New York City Board of Health, pursuing "an unapologetically aggressive public healthPublic health
Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals" . It is concerned with threats to health based on population health...
agenda," Frieden led a period marked by improvements in the health of New Yorkers as well as sometimes fierce controversy.
Frieden has been criticized by interest groups from across the political spectrum – especially advocates for the tobacco and restaurant industries. The New York Post quipped that Frieden had turned the city into a “nanny state on steroids.” These criticisms did not diminish after he was appointed as Director of the Centers for Disease Control and Prevention. “Frieden's stick-over-carrot, for-your-own-good approach to public health is no longer confined to the Big Apple," the industry-backed Center for Consumer Freedom wrote on its blog. "Get ready, because the 'nanny state on steroids' is going national.” (Politico.com) Despite his contentious stance on many issues, Frieden was selected by Governing Magazine as a Public Official of the Year in 2005, and NY1's New Yorker of the Year in 2006.
Tobacco Control
Upon his appointment as Health Commissioner in January 2002, Frieden made tobacco control an immediate priority, resulting in a rapid decline after a decade of no change in smokingSmoking
Smoking is a practice in which a substance, most commonly tobacco or cannabis, is burned and the smoke is tasted or inhaled. This is primarily practised as a route of administration for recreational drug use, as combustion releases the active substances in drugs such as nicotine and makes them...
rates. Frieden established a system to monitor the city's smoking rate, and worked with New York City Mayor Michael R. Bloomberg to increase tobacco taxes, ban smoking from workplaces including restaurants and bars, and run aggressive anti-tobacco ads and help smokers quit. The program reduced smoking prevalence among New York City adults from 21.6% in 2002 to 16.9% in 2007– a change that represents 300,000 fewer smokers and could prevent 100,000 premature deaths in future years. Smoking prevalence among New York City teens declined even more sharply, from 17.6% in 2001 to 8.5% in 2007, and is now less than half the national rate. The workplace smoking ban
Smoking ban
Smoking bans are public policies, including criminal laws and occupational safety and health regulations, which prohibit tobacco smoking in workplaces and/or other public spaces...
prompted spirited debate before it was passed by the New York City Council
New York City Council
The New York City Council is the lawmaking body of the City of New York. It has 51 members from 51 council districts throughout the five boroughs. The Council serves as a check against the mayor in a "strong" mayor-council government model. The council monitors performance of city agencies and...
and signed into law by Mayor Bloomberg. Over time, the measure has gained broad acceptance by the public and business community in New York City. New York City's 2003 workplace smoking ban was among those following California's ban in 1994. Frieden supports increased cigarette taxes as a means of forcing smokers to quit, saying "tobacco taxes are the most effective way to reduce tobacco use." Frieden supported the 62-cent Federal tax on each cigarette pack sold in the United States, introduced in April 2009.
Take Care New York
Frieden also introduced Take Care New York, the city's first comprehensive health policy. This program targeted ten leading causes of preventable illness and death for concerted public and personal action. By 2006, New York City had made measurable progress in eight of the ten priority areas.HIV/AIDS
New York City is an epicenter of the HIV epidemic in the United States. As Health Commissioner, Frieden has sought to fight HIV/AIDS with public health principles used successfully to control other communicable diseases. The most controversial aspect of this strategy was a proposal to eliminate separate written consent for HIV testing. Frieden believes the measure would encourage physicians to offer HIV tests during routine medical care, as the CDC recommends. Some community advocates and civil libertarians fought this legislation in the belief that it would undermine patients' rights and lead eventually to forced HIV testing. In 2010, New York State passed a new law that eased the requirement for separate written consent in some circumstances. On 14 February 2007, the NYCDHMH also introduced the NYC CondomNYC Condom
The NYC Condom, funded by New York City's Department of Health, is a program run by the New York City Department of Health and Mental Hygiene to distribute free condoms.The NYC Condom is the first municipally branded condom in the United States.-Launch:...
, prompting Catholic League president Bill Donohue to respond,"What's next? The city's own brand of clean syringes?" More than 36 million were given away in 2007.
Diabetes
Confronted with what he called a growing "epidemic" of diabetes in New York City (in reality, the rate of growth mirrored national trends), Frieden worked to raise awareness, particularly among pregnant women, and established an involuntary, non-disclosed hemoglobin A1CGlycosylated hemoglobin
Glycated hemoglobin is a form of hemoglobin that is measured primarily to identify the average plasma glucose concentration over prolonged periods of time. It is formed in a non-enzymatic glycation pathway by hemoglobin's exposure to plasma glucose...
diabetes registry that tracks patients' blood sugar
Blood sugar
The blood sugar concentration or blood glucose level is the amount of glucose present in the blood of a human or animal. Normally in mammals, the body maintains the blood glucose level at a reference range between about 3.6 and 5.8 mM , or 64.8 and 104.4 mg/dL...
control over several months and report that information to treating physicians in an effort to help them provide better care. The New York City Board of Health's decision to require laboratories to report A1C test results has generated a heated debate among civil libertarians, who view it as a violation of medical privacy
Medical privacy
The main subject of medical privacy or health privacy is the 'medical record' which historically has been a paper file of the entire medical history of the patient. Various electronic forms of medical records have existed in western countries, but mostly in an unintegrated fashion. This lack of...
and an intrusion into the doctor-patient relationship
Doctor-patient relationship
The doctor-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics...
. Even though patients can choose to not receive information from the program, there is no provision enabling patients to opt out of having their glycemic control data entered in the database. The New York City DHMH asserts that the A1C registry can help reduce the risk of blindness
Blindness
Blindness is the condition of lacking visual perception due to physiological or neurological factors.Various scales have been developed to describe the extent of vision loss and define blindness...
, kidney failure, leg amputations and early death among people with diabetes. But according to a May 21, 2010 PowerPoint presentation prepared by the NYC Department of Health and Mental Hygiene, as of 31 December 2009, the program was only reaching 16% of New York City residents with diabetes. The New York City DHMH has provided little if any solid evidence to validate its assertions about improved patient outcomes, although "outcome evaluation [is] currently being designed" and completion is anticipated by 2011.
Food Policies
To combat cardiovascular diseaseCardiovascular disease
Heart disease or cardiovascular disease are the class of diseases that involve the heart or blood vessels . While the term technically refers to any disease that affects the cardiovascular system , it is usually used to refer to those related to atherosclerosis...
, New York City has adopted regulations since 2006 to eliminate artificial trans fat
Trans fat
Trans fat is the common name for unsaturated fat with trans-isomer fatty acid. Because the term refers to the configuration of a double carbon-carbon bond, trans fats are sometimes monounsaturated or polyunsaturated, but never saturated....
from all restaurants. The restaurant industry and its political allies condemned the trans-fat measure as an assault on liberty by an overzealous "nanny state," but compliance has exceeded 90% among New York City restaurants, and the measure has inspired similar laws in several US cities and the state of California. The Health Department also required chain restaurants to post calorie information to raise consumer awareness of fast food's caloric impact. The measure requires chains with 15 or more outlets to post calorie counts on menus and menu boards. It has prompted two lawsuits by the New York State Restaurant Association. In the first, New York State Restaurant Association v. New York City Board of Health
New York State Restaurant Association v. New York City Board of Health
New York State Restaurant Association v. New York City Board of Health is a case decided by the Second Circuit United States Court of Appeals. The case arose after New York City passed a law in January 2007 to become the first American city to require restaurant chains to state the number of...
, a U.S. District Court judge ruled that federal law pre-empted New York City's action and overturned it. The NYC Board of Health then repealed and re-enacted the measure, which took effect in May 2008. Most chains now post calorie information in their New York City outlets, despite a pending legal challenge, and customers have experienced widespread "sticker shock.". National health reform legislation, the Patient Protection and Affordable Care Act, requires menu labeling nationally by 2012.
Epidemiology
During Frieden's tenure as Commissioner, the Health Department has greatly expanded the collection and use of epidemiological data, launching an annual Community Health Survey and the nation's first community-based Health and Nutrition Examination Survey.Electronic Health Records
To improve quality and efficiency of medical care, the agency also launched the nation's largest community-based electronic health records project to improve preventive care for more than one million at-risk New Yorkers.Director of CDC and Administrator of ATSDR
On 15 May 2009 the White HouseWhite House
The White House is the official residence and principal workplace of the president of the United States. Located at 1600 Pennsylvania Avenue NW in Washington, D.C., the house was designed by Irish-born James Hoban, and built between 1792 and 1800 of white-painted Aquia sandstone in the Neoclassical...
and the Department of Health and Human Services
United States Department of Health and Human Services
The United States Department of Health and Human Services is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. Its motto is "Improving the health, safety, and well-being of America"...
named Dr. Frieden the 16th director of Centers for Disease Control and Prevention
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
(CDC) and administrator of the Agency for Toxic Substances and Disease Registry
Agency for Toxic Substances and Disease Registry
The Agency for Toxic Substances and Disease Registry is a federal public health agency within the United States Department of Health and Human Services. The agency focuses on minimizing human health risks associated with exposure to hazardous substances...
(ATSDR); he assumed his position on 8 June 2009 from the acting head, Richard E. Besser
Richard E. Besser
Richard E. Besser, MD, is an ABC News Medical editor and formerly the acting director of the American Centers for Disease Control and Prevention and Agency for Toxic Substances and Disease Registry ....
.
On announcing Frieden’s appointment, President Obama said, “America relies on a strong public health system and the work at the Centers for Disease Control and Prevention is critical to our mission to preserve and protect the health and safety of our citizens.” Frieden had previously worked for the CDC from 1990 to 2002 as an Epidemic Intelligence Service Officer in New York City and then as part of CDC’s tuberculosis control program.
Bloomberg Philanthropies
Dr. Frieden also served as health advisor to New York City Mayor Michael BloombergMichael Bloomberg
Michael Rubens Bloomberg is the current Mayor of New York City. With a net worth of $19.5 billion in 2011, he is also the 12th-richest person in the United States...
, supporting the Bloomberg Initiative to Reduce Tobacco Use. This initiative aims to prevent more than 100 million tobacco-related deaths worldwide by promoting tobacco control in developing countries. By mid-2008, the initiative had funded more than 100 organizations in 36 nations, with a focus on China
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
and India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
, where more than 40% of the world's smokers live. Bloomberg's effort was joined by the Bill & Melinda Gates Foundation
Bill & Melinda Gates Foundation
The Bill & Melinda Gates Foundation is the largest transparently operated private foundation in the world, founded by Bill and Melinda Gates. It is "driven by the interests and passions of the Gates family"...
in 2008.