Thomas R. Frieden, M.D., M.P.H., became Director of the Centers for Disease Control and Prevention (CDC) and Administrator of the Agency for Toxic Substances and Disease Registry (ATSDR) in June 2009. Dr. Frieden has worked to control both communicable and noncommunicable diseases in the United States and around the world. From 1992-1996, he led New York City’s program that rapidly controlled tuberculosis, including reducing cases of multidrug-resistant tuberculosis by 80 percent. He then worked in India for five years where he assisted with national tuberculosis control efforts. The program in India has treated more than 10 million patients and has saved more than one million lives.
As Commissioner of the New York City Health Department from 2002-2009, he directed one of the world′s largest public health agencies, with an annual budget of $1.7 billion and more than 6,000 staff. During his tenure, the number of smokers declined by 350,000, teen smoking decreased by half, and New York City became the first place in the United States to eliminate trans-fats from restaurants, rigorously monitor the diabetes epidemic, and require certain restaurants to post calorie information prominently. The Department also greatly increased colon cancer screening and eliminated racial/ethnic disparities in colon cancer screening rates. Under Dr. Frieden′s leadership, the department also established the largest community electronic health records project in the country.
Thomas Frieden: Understanding risk is the most important thing. We fear things that are very unlikely to result in us getting hurt or killed. And we’re way too nonchalant about things that are life and death threats to us. So understanding that if we can get regular physical activity, we will live a lot longer and feel a lot better. And thinking about ways to build that into our lives, we’re probably willing, if we really understood the risk of not getting physical activity, we probably would be willing to make big changes in our lives. But that’s not so clear.
On the other hand, we may fear things irrationally or out of proportion to their level of risk. We’re recently able to measure, for example, minute amounts of radioactive fallout from the nuclear disaster in Japan. We wished those things weren’t in our environment, but they’re being measured in the trillionths of a curie and they are no where near the level of a significant public health concern, and yet, that will get more attention over the coming weeks in all likelihood than things like air quality problems from fossil fuels, which are killing many people in this country or the lack of physical activity, which we can do something about by helping people and fostering activity by making our communities easier to walk, easier to bicycle, encouraging people to take the stairs. Lots of things we can do on a community level and on an individual level to live longer and healthier lives based on a better understanding of risk.
It’s important to recognize that there’s this interplay between what the individual can do and what society can do to empower individuals to live longer and healthier, more productive lives.