With Rulings on Rubbish and Tattoos, Safeguarding the City for Centuries

By SAM ROBERTS

The 11 largely faceless members of the New York City Board of Health who will decide Thursday whether to ban the sale of super-size sugary soft drinks in certain establishments trace their authority to 1805, when the power to monitor the city's health was formally vested in a city “inspector,” John Pintard, a Renaissance man who is most famous for popularizing Santa Claus.

Meeting for the first time, a board of health ordered the evacuation of neighborhoods plagued by yellow fever and began collecting mortality statistics to “furnish data for reflection and calculation.” (Sometimes, though, epidemics were declared only belatedly because they were bad for business.)

By the 1860s though, the enforcement of sanitary codes was riddled with corruption and the city's health had deteriorated to the point where nearly twice as many people were dying as were being born.

In 1866, the St ate Legislature empowered a Metropolitan Board of Health independent of politicians, which also included scientists and other medical professionals, to safeguard the city. Among its first rulings was banning free-ranging hogs and goats in the city and requiring a permit to keep them within 1,000 feet of any business or residence. The board was the modern predecessor of today's Board of Health.

“The basic principle is, the board writes the rules and the department implements them,” said Dr. Thomas Farley, the city's current health commissioner.

But health directives in New York actually date back much earlier to when the area was a Dutch settlement. In 1657, New Amsterdam officials barred the tossing of any “rubbish, filth, ashes, oyster-shells, dead animal or anything like it” into city streets.

Over four centuries, periodically spurred by epidemics of one kind or another, New York health officials have imposed quarantines; proscribed certain behavi or; imposed sanitary codes to regulate things like backyard privies and crowded tenements; and discouraged sewage discharges, air pollution, frigid subway cars, lead paint indoors, public sexual promiscuity, smoking and the consumption of foods containing trans fats.

Some decisions were sweeping, like the 2003 ban on smoking in all indoor workplaces. Some affected fewer people, like the prohibition against getting cocaine without a prescription in 1908 and a ban on tattooing in the 1960s to reduce the spread of hepatitis. Some were educational, like a reminder in the early 1900s that “Ten bottle-fed babies die to one that is breast fed.”

Many were controversial when they were imposed, like the ban on taking shellfish from local waters in 1924 and the fluoridation of the water supply in the 1960s, but have come to be widely accepted.

Regulations often reflected contemporary problems. Health officials worried, in the 1870s, about contaminated pickles, in the 1880s about street cars filthy from the expectorations of tobacco chewers (spitting in public places was prohibited in 1896), and in the 1890s about public baths as a source of germs.

On Thursday, concerned that “sugary drink consumption among New York residents is alarming,” the board is scheduled to vote on an amendment to Article 81 of the health code. Concerned that 64-ounce soft drinks from fast food restaurants can contain 780 calories and the equivalent of 54 teaspoons of sugar, the board would ban the sale of nonalcoholic sugary drinks in cups or containers that hold more than 16 ounces.

The 11-member board is headed by the health commissioner. Members are health professionals and experts appointed by the mayor with the consent of the City Council, who serve six-year terms and cannot be dismissed without cause.

Dr. Farley said that because members served fixed terms, the board was not in theory a rubber stamp for the mayor, though he could not recall the last time the board rejected a mayoral initiative.

Asked to identify where the vote on sugary soft drinks would rank in the pantheon of rule-making, Dr. Farley replied: “I would say it's extremely important and consistent with those actions that the board has taken over 150 years. All of them were designed to address the biggest health care problems of our day, and obesity is certainly one today.”

Among the original board's first reports was one dated Jan. 20, 1806, which included recommendations for a growing city that still seem sound more than two centuries later: an ample supply of pure potable water, construction of sewers, drainage of low-lying marsh lands, interment of dead bodies, a prohibition against the habitation of damp cellars and the planting of trees and healthy vegetables.