Tom Frieden

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Tom Frieden
Thomas Frieden official CDC portrait.jpg
16th Director of the Centers for Disease Control and Prevention
Assumed office
June 8, 2009
President Barack Obama
Preceded by Julie Gerberding
New York City Health Commissioner
In office
2002–2009
Mayor Michael Bloomberg
Personal details
Born 1960 (age 55–56)
Political party Democratic
Education

Thomas R. Frieden has been since 2009 the Director of the U.S. Centers for Disease Control and Prevention (CDC) and Acting Administrator of the Agency for Toxic Substances and Disease Registry. He was appointed by President Barack Obama.[1] He previously served as Commissioner of the New York City Department of Health and Mental Hygiene from 2002 to 2009.

Education[edit]

Frieden graduated from Oberlin College (B.A., 1982), Columbia University College of Physicians and Surgeons (M.D., 1986), and Columbia University Mailman School of Public Health (M.P.H., 1985). He completed a residency in internal medicine at Columbia-Presbyterian Medical Center and a sub-specialty fellowship in infectious diseases at Yale School of Medicine and Yale–New Haven Hospital.

Early career[edit]

Frieden's work on tuberculosis in New York City fostered public awareness and helped improve city, state and federal public funding for TB control.[2][3] The epidemic was controlled rapidly, reducing overall incidence by nearly half and cutting multidrug-resistant tuberculosis by 80%.[4] The city's program became a model for tuberculosis control.[5][6]

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.[7][8][9][10] The program's 2008 status report estimated that the nationwide program resulted in 8 million treatments and 1.4 million lives saved.[11] While in India, Frieden worked to establish a network of Indian physicians to help India's state and local governments implement the program[12] and helped the Tuberculosis Research Center in Chennai, India, establish a program to monitor the impact of tuberculosis control services.[13][14]

Impact[edit]

Frieden served as Commissioner of Health of the City of New York from 2002 to 2009.[15][16] At that time, the agency employed more than 6,000 people[17] and had an annual budget of about $1.5 billion.[18][19]

Tobacco control[edit]

Upon his appointment as Commissioner of Health, Frieden made tobacco control a priority,[20] resulting in a rapid decline[21] after a decade of no change in smoking rates. Frieden established a system to monitor the city's smoking rates, and worked with New York City Mayor Michael R. Bloomberg to increase tobacco taxes,[22] ban smoking in workplaces including restaurants and bars, and run aggressive anti-tobacco ads and help smokers quit.[23] The program reduced smoking prevalence among New York City adults from 21.6% in 2002 to 16.9% in 2007 – a change that represented 300,000 fewer smokers and could prevent 100,000 premature deaths in future years.[21][24] Smoking prevalence among New York City teens declined even more sharply, from 17.6% in 2001 to 8.5% in 2007, which was less than half the national rate.[25] The workplace smoking ban prompted spirited debate before it was passed by the New York City Council and signed into law by Mayor Bloomberg.[26] Over time, the measure gained broad acceptance by the public and business community in New York City.[27][28] New York City's 2003 workplace smoking ban followed that of California in 1994. Frieden supported increased cigarette taxes as a means of forcing smokers to quit, saying "tobacco taxes are the most effective way to reduce tobacco use."[29] He supported the 62-cent federal tax on each cigarette pack sold in the United States, introduced in April 2009.[30] One side effect of the increased taxes on tobacco in New York was a large increase in cigarette smuggling into the state from other states with much lower taxes, such as Virginia. The Tax Foundation estimated that "60.9% of cigarettes sold in New York State are smuggled in from other states".[31] In addition, some New Yorkers began to make their own cigarettes, and tobacco trucks were even hijacked. A 2009 Justice Department study found that “The incentive to profit by evading payment of taxes rises with each tax rate hike imposed by federal, state, and local governments”.[32]

Take Care New York[edit]

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.[33][34] By 2006, New York City had made measurable progress in eight of the ten priority areas.[35]

HIV and AIDS[edit]

As Health Commissioner, Frieden sought to fight HIV and AIDS with public health principles used successfully to control other communicable diseases.[36] The most controversial aspect of this strategy was a proposal to eliminate separate written consent for HIV testing. He believed the measure would encourage physicians to offer HIV tests during routine medical care,[37] as the CDC recommended.[38] Some community and civil liberties advocates fought this legislation, arguing it would undermine patients' rights and lead eventually to forced HIV testing.[39][40] In 2010, New York State passed a new law that eased the requirement for separate written consent in some circumstances.[41] On February 14, 2007, the New York City Department of Health and Mental Hygiene introduced the NYC Condom,[42][43] prompting Catholic League president Bill Donohue to respond, "What's next? The city's own brand of clean syringes?"[44] More than 36 million condoms were given away by the program in 2007.[45]

Diabetes[edit]

Frieden worked to raise awareness about diabetes in New York City, particularly among pregnant women,[46] and established an involuntary, non-disclosed hemoglobin A1C 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.[47][48]

The New York City Board of Health's decision to require laboratories to report A1C test results generated a heated debate among civil libertarians, who view it as a violation of medical privacy and an intrusion into the doctor-patient relationship. Although patients may elect not to receive information from the program, there is no provision enabling patients to opt out of having their glycemic control data entered in the database.[49][50]

Food policies[edit]

To combat cardiovascular disease, New York City started to adopt regulations in 2006 to eliminate trans fat from all restaurants.[51][52][53] The restaurant industry and its political allies condemned the trans-fat measure as an assault on liberty by an overzealous "nanny state"[54][55] and the measure inspired similar laws in several other U.S. cities and the state of California.[56] The Health Department also required chain restaurants to post calorie information to raise consumer awareness of fast food's caloric impact. The measure required restaurant chains with 15 or more outlets to post calorie counts on menus and menu boards. It 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.[57] The New York City Board of Health then repealed and re-enacted a slightly different measure.[58] Most chains now post calorie information in their New York City outlets.[59][60] Section 4205 of the Patient Protection and Affordable Care Act, signed into law in 2010, requires menu labeling nationally, for restaurant chains, disclosing on the menu boards, calories, total calories, calories from fat, amounts of fat and saturated fat, cholesterol, sodium, total and complex carbohydrates, sugars, dietary fiber, and protein.[61]

Epidemiology[edit]

During Frieden's tenure as Commissioner, the Health Department expanded the collection and use of epidemiological data, launching an annual Community Health Survey[62] and the nation's first community-based Health and Nutrition Examination Survey.[63][64]

Electronic health records[edit]

To improve quality and efficiency of medical care, the agency launched a large community-based electronic health records project to improve preventive care for more than one million at-risk New Yorkers.[65]

Ebola outbreak[edit]

Frieden is decontaminated after visiting Ebola treatment unit in Liberia, August 2014

Frieden has been a prominent figure in the US and global response to the West African outbreak of Ebola. In a Congressional hearing on October 16, 2014, Frieden was questioned for his handling of the Ebola crisis following the spread of the disease to two nurses from the original patient in the US.[66] The previous day, the response of the CDC to the crisis led Rep. Tom Marino (R-PA) to call for Frieden's resignation.[67]

Gun deaths[edit]

Despite his outspokenness, Frieden has had little to say about high rates of gun deaths in the United States. Asked CNN, "Why is the nation's leading public health official, a nonstop messaging machine, not talking about something that kills more than 30,000 people a year in the United States? That's more than the number of Americans who die of AIDS or colon cancer or prostate cancer. That's more than the number of people who died in the entire international Ebola outbreak last year."[68]

Director of CDC and Administrator of the Agency for Toxic Substances and Disease Registry[edit]

On May 15, 2009 the White House and the Department of Health and Human Services named Dr. Frieden the 16th director of Centers for Disease Control and Prevention and administrator of the Agency for Toxic Substances and Disease Registry; he assumed his position on June 8, 2009 from the acting head, Dr. Richard E. Besser.[69]

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”.[70] 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[edit]

Frieden also served as health advisor to New York City Mayor Bloomberg, supporting the Bloomberg Initiative to reduce tobacco use.[70]

Publications[edit]

Awards[edit]

References[edit]

  1. ^ "President Obama Appoints Dr. Thomas Frieden as CDC Director". May 15, 2009. 
  2. ^ Lobato, M.N.; Wang, Y.C.; Becerra, J.E.; Simone, P.M.; Castro, K.G. (2006). "Improved Program Activities Are Associated with Decreasing Tuberculosis Incidence in the United States". Public Health Reports. 121 (2): 108–115. PMC 1525263free to read. PMID 16528941. 
  3. ^ Leff, D.R.; Leff, A.R. (November 1, 1997). "Tuberculosis Control Policies in Major Metropolitan Health Departments in the United States. VI. Standard of Practice in 1996". American Journal of Respiratory and Critical Care Medicine. 156 (5): 1487–1494. doi:10.1164/ajrccm.156.5.9704105. PMID 9372665. 
  4. ^ TB Annual Summary: 2006 (PDF). New York: New York City Department of Health and Mental Hygiene. 2008. [page needed]
  5. ^ World Health Organization Tuberculosis Programme (1995). "New York City's Success Story". Stop TB at the Source. Geneva: World Health Organization. ISBN 978-0-11-951529-9. OCLC 181876135. [page needed]
  6. ^ Steinhauer, Jennifer (February 14, 2004). "Gladly Taking The Blame For Health In the City". New York Times. Retrieved July 8, 2009. 
  7. ^ Drazen J.M. (October 2002). "A milestone in tuberculosis control". New England Journal of Medicine. 347 (18): 1444. doi:10.1056/NEJMe020135. PMID 12409549. 
  8. ^ Khatri, G.R.; Frieden, T.R. (October 2002). "Controlling tuberculosis in India". New England Journal of Medicine. 347 (18): 1420–1425. doi:10.1056/NEJMsa020098. PMID 12409545. 
  9. ^ Udwadia, Z.F.; Pinto, L.M. (2007). "Review series: the politics of TB: the politics, economics and impact of directly observed treatment (DOT) in India". Chronic Respiratory Disease. 4 (2): 101–106. doi:10.1177/1479972307707929. PMID 17621578. 
  10. ^ Chauhan, L.S.; Tonsing, J. (2005). "Revised National TB Control Programme in India". Tuberculosis. 85 (5–6): 271–276. doi:10.1016/j.tube.2005.08.003. PMID 16253562. 
  11. ^ TB India 2008: RNTCP Status Report: I am Stopping TB (PDF). New Delhi: Ministry of Health and Family Welfare. March 2008. p. 3. ISBN 81-902652-3-7. Retrieved July 8, 2009. 
  12. ^ Frieden, T.R.; Khatri, G.R. (September 2003). "Impact of national consultants on successful expansion of effective tuberculosis control in India". International Journal of Tuberculosis and Lung Disease. 7 (9): 837–841. PMID 12971666. 
  13. ^ Subramani, R.; Radhakrishna, S.; Frieden, T.R.; et al. (August 2008). "Rapid decline in prevalence of pulmonary tuberculosis after DOTS implementation in a rural area of South India". International Journal of Tuberculosis and Lung Disease. 12 (8): 916–920. PMID 18647451. 
  14. ^ Narayanan, P.R.; Garg, R.; Santha, T.; Kumaran, P.P. (2003). "Shifting the Focus of Tuberculosis Research in India". Tuberculosis. 83 (1–3): 135–142. doi:10.1016/S1472-9792(02)00068-9. PMID 12758203. 
  15. ^ Cooper, Michael (December 28, 2001). "Bloomberg Appoints Five To Be City Commissioners". New York Times. Retrieved 12 December 2015. 
  16. ^ Chen, David W. (May 16, 2009). "Tulane Doctor Is Expected to Lead Health Dept.". New York Times. p. A27. Retrieved 12 December 2015. 
  17. ^ Public Health in New York City, 2004–06 (PDF). New York City Department of Health and Mental Hygiene. p. 3. Retrieved July 8, 2009. 
  18. ^ Public Health in New York City, 2004–06 (PDF). New York City Department of Health and Mental Hygiene. p. 61. Retrieved July 8, 2009. 
  19. ^ Frieden, T.R.; Bassett, M.T.; Thorpe, L.E.; Farley, T.A. (October 2008). "Public health in New York City, 2002–2007: Confronting Epidemics of the Modern Era". International Journal of Epidemiology. 37 (5): 966–977. doi:10.1093/ije/dyn108. PMID 18540026. 
  20. ^ Steinhauer, Jennifer (February 15, 2002). "Commissioner Calls Smoking Public Health Enemy No. 1 and Asks Drug Firms for Ammunition". New York Times. Retrieved July 8, 2009. 
  21. ^ a b Centers for Disease Control and Prevention (CDC) (June 2007). "Decline in smoking prevalence – New York City, 2002–2006". Morbidity and Mortality Weekly Report. 56 (24): 604–608. PMID 17585290. 
  22. ^ Altman, Alex (June 6, 2008). "When Are Cigarette Taxes Too High?". Time. Retrieved July 8, 2009. 
  23. ^ Frieden, T.R.; Mostashari, F.; Kerker, B.D.; Miller, N.; Hajat, A.; Frankel, M. (June 2005). "Adult Tobacco Use Levels After Intensive Tobacco Control Measures: New York City, 2002–2003". American Journal of Public Health. 95 (6): 1016–1023. doi:10.2105/AJPH.2004.058164. PMC 1449302free to read. PMID 15914827. 
  24. ^ "Michael Bloomberg and Bill Gates Join to Combat Global Tobacco Epidemic" (Press release). Bill & Melinda Gates Foundation. July 23, 2008. Retrieved July 8, 2009. 
  25. ^ The Lancet (January 2008). "New York City's bold antitobacco programme". Lancet. 371 (9607): 90. doi:10.1016/S0140-6736(08)60078-1. PMID 18191665. 
  26. ^ Chang, C.; Leighton, J.; Mostashari, F.; McCord, C.; Frieden, T.R. (August 2004). "The New York City Smoke-Free Air Act: second-hand smoke as a worker health and safety issue". American Journal of Industrial Medicine. 46 (2): 188–195. doi:10.1002/ajim.20030. PMID 15273972. 
  27. ^ Cooper, Michael (October 23, 2003). "Poll Finds Smoking Ban Popular". New York Times. Retrieved 8 July 2009. 
  28. ^ Rutenberg, Jim; Lily Koppel (February 6, 2005). "In Barrooms, Smoking Ban Is Less Reviled". New York Times. Retrieved July 8, 2009. 
  29. ^ Altman, Alex (June 6, 2008). "When Are Cigarette Taxes Too High?". Time. Retrieved August 11, 2010. 
  30. ^ Jonsson, Patrik (November 17, 2009). "Federal and state governments look to smokers for more tax revenue: Though they hit poor Americans hardest, stiff taxes on tobacco can reduce healthcare costs by billions". Christian Science Monitor. Retrieved August 8, 2010. 
  31. ^ Smith, Aaron (January 10, 2013). "60% of cigarettes sold in New York are smuggled: report". CNN Money. Retrieved December 4, 2014. 
  32. ^ Mathias, Christopher (April 3, 2014). "Inside New York City's Dangerous, Multimillion-Dollar Cigarette Black Market". Huffington Post. Retrieved December 4, 2014. 
  33. ^ "Cause of Death or Illness, New York City, 2002, and Amenability to Intervention". Take Care New York: A Policy for a Healthier New York City (PDF). New York City Department of Health and Mental Hygiene. March 2004. pp. 57–61. Retrieved July 9, 2009. 
  34. ^ Pérez-Peña, Richard (March 24, 2004). "City sets goals for the health of New Yorker". New York Times. Retrieved July 8, 2009. 
  35. ^ Take Care New York: A Policy for a Healthier New York City (Third Year Progress Report) (PDF). New York City Department of Health and Mental Hygiene. August 2007. p. 2. Retrieved July 9, 2009. 
  36. ^ Frieden, T.R.; Das-Douglas, M.; Kellerman, S.E.; Henning, K.J. (December 2005). "Applying Public Health Principles to the HIV epidemic". New England Journal of Medicine. 353 (22): 2397–2402. doi:10.1056/NEJMsb053133. PMID 16319391. 
  37. ^ Mandavilli, A. (April 2006). "Profile: Thomas Frieden". Nature Medicine. 12 (4): 378. doi:10.1038/nm0406-378. PMID 16598275. 
  38. ^ Branson, B.M.; Handsfield, H.H.; Lampe, M.A.; et al. (September 2006). "Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings". Morbidity and Mortality Weekly Report. 55 (RR–14): 1–17; quiz CE1–4. PMID 16988643. 
  39. ^ Chan, Sewell (December 25, 2006). "Rifts Emerge on Push to End Written Consent for H.I.V.Tests". New York Times. Retrieved July 9, 2009. 
  40. ^ Fairchild, A.L.; Alkon, A. (August 2007). "Back to the future? Diabetes, HIV, and the boundaries of public health". Journal of Health Politics, Policy and Law. 32 (4): 561–593. doi:10.1215/03616878-2007-017. PMID 17639012. 
  41. ^ "HIV Testing Is Now a Routine Part of Health Care in New York" (Press release). New York City Department of Health and Mental Hygiene. September 1, 2010. Retrieved February 8, 2011. 
  42. ^ Chan, Sewell (February 15, 2007). "A New Condom in Town, This One Named 'NYC'". New York Times. Retrieved July 8, 2009. 
  43. ^ "Health Department Launches The Nation's First Official City condom" (Press release). New York City Department of Health and Mental Hygiene. February 14, 2007. Retrieved July 8, 2009. 
  44. ^ "NYC-Branded Condoms Are a Big Apple First". Gothamist. Retrieved October 13, 2014. 
  45. ^ "Health Department Releases New NYC Condom Wrapper" (Press release). New York City Department of Health and Mental Hygiene. February 13, 2008. Retrieved July 8, 2009. 
  46. ^ Kleinfield, N.R. (February 22, 2006). "City to Warn New Mothers of Diabetes Risk". New York Times. Retrieved July 9, 2009. 
  47. ^ Steinbrook R. (February 2006). "Facing the Diabetes Epidemic – Mandatory Reporting of Glycosylated Hemoglobin Values in New York City". New England Journal of Medicine. 354 (6): 545–548. doi:10.1056/NEJMp068008. PMID 16467539. 
  48. ^ "The New York City A1C Registry". New York City Department of Health and Mental Hygiene. Retrieved July 9, 2009. 
  49. ^ Goldman, J.; Kinnear, S.; Chung, J.; Rothman, D.J. "New York City's Initiatives on Diabetes and HIV/AIDS: Implications for Patient Care, Public Health, and Medical Professionalism". American Journal of Public Health. 98 (5): 807–813. doi:10.2105/AJPH.2007.121152. PMC 2374815free to read. PMID 18381989. 
  50. ^ Frieden T.R. (September 2008). "New York City's Diabetes Reporting System Helps Patients And Physicians". American Journal of Public Health. 98 (9): 1543–1544; author reply 1544. doi:10.2105/AJPH.2008.142026. PMC 2509589free to read. PMID 18633070. 
  51. ^ "Healthy Heart – Avoid Trans Fat". New York City Department of Health and Mental Hygiene. Retrieved July 9, 2009. 
  52. ^ Okie S. (May 2007). "New York to Trans Fats: You're Out!". New England Journal of Medicine. 356 (20): 2017–2021. doi:10.1056/NEJMp078058. PMID 17507699. 
  53. ^ "Calorie Posting". New York City Department of Health and Mental Hygiene. Retrieved July 9, 2009. 
  54. ^ Lueck, Thomas J.; Kim Severson (December 6, 2006). "New York Bans Most Trans Fats in Restaurants". New York Times. Retrieved July 9, 2009. 
  55. ^ Halpern, Dan (December 17, 2006). "Dr. Do-Gooder". New York (magazine). Retrieved July 9, 2009. 
  56. ^ Steinhauer, Jennifer (July 26, 2008). "California Bars Restaurant Use of Trans Fats". New York Times. Retrieved July 9, 2009. 
  57. ^ Feuer, Alan (September 12, 2007). "Judge Throws Out New York Rule Requiring Restaurants to Post Calories". New York Times. Retrieved July 9, 2009. 
  58. ^ Rivera, Ray (October 25, 2007). "New York City Reintroduces Calorie Rule". New York Times. Retrieved July 9, 2009. 
  59. ^ Barron, James (July 19, 2008). "Restaurants That Lack Calorie Counts Now Face Fines". New York Times. Retrieved July 9, 2009. 
  60. ^ Rabin, Roni Caryn (July 16, 2008). "New Yorkers try to swallow calorie sticker shock". MSNBC. Retrieved July 9, 2009. 
  61. ^ "Menu & Vending Machines Labeling Requirements". FDA. Retrieved October 16, 2014. 
  62. ^ "Community Health Survey". New York City Department of Health and Mental Hygiene. February 2009. Retrieved July 9, 2009. 
  63. ^ "NYC HANES Datasets and Related Documentation". New York City Department of Health and Mental Hygiene. Retrieved July 9, 2009. 
  64. ^ Thorpe, L.E.; Gwynn, R.C.; Mandel-Ricci, J.; et al. (July 2006). "Study Design and Participation Rates of the New York City Health and Nutrition Examination Survey, 2004". Preventing Chronic Disease. 3 (3): A94. PMC 1637802free to read. PMID 16776895. 
  65. ^ "Primary Care Information Project". New York City Department of Health and Mental Hygiene. Archived from the original on 16 April 2009. Retrieved July 9, 2009. 
  66. ^ Sabrina, Tavernise (October 16, 2014). "Congress Scrutinizes Handling of Ebola Cases in Texas". New York Times. Retrieved August 5, 2016. 
  67. ^ "White House scrambles to ease concerns over Ebola, lawmakers demand changes: CDC". Fox News. October 15, 2014. Retrieved October 15, 2014. 
  68. ^ Cohen, Elizabeth (December 14, 2015) "What happened to the CDC's courage on guns?" CNN. (Retrieved 7-13-2016.)
  69. ^ Profile, foxbusiness.com; accessed October 16, 2014.
  70. ^ a b "President Obama Appoints Dr. Thomas Frieden as CDC Director". The White House. May 15, 2009. 

External links[edit]

Awards and achievements
Preceded by
Neal L. Cohen
New York City
Department of Health and Mental Hygiene
Commissioner

2002–2009
Succeeded by
Thomas A. Farley
Preceded by
Monique Dixon
Diana Reyes
NY1's New Yorker of the Year Succeeded by
Common Cents