The effects of New York City's coordinated public health programmes on mortality through 2011.

Abstract

In 2003, New York City (NYC) implemented a series of coordinated policies designed to reduce non-communicable disease. We used coarsened exact matching (CEM) of individuals living inside and outside NYC between the years of 1992-2000 and 2002-10 to estimate difference-in-difference survival time models, a quasi-experimental approach. We also fitted age-period-cohort (APC) models to explore mortality impacts by gender, race, age, borough and cause of death over this same time period. Both CEM and APC models show that survival gains were large in the pre-2003 era of health policy reform relative to the rest of the USA, but small afterwards. There is no clear link between any policy and changes in mortality by age, gender, ethnicity, borough, or cause of death. NYC's gains in survival relative to the rest of the nation were not linked to the city's innovative and coordinated health policy efforts.