Advancing Lifestyle Medicine in New York City's Public Health Care System.
John S Babich, Michelle McMacken, Lilian Correa, Krisann Polito-Moller, Kevin Chen, Eric Adams, Samantha Morgenstern, Mitchell Katz, Theodore G Long, Shivam Joshi, Andrew B Wallach, Sapana Shah, Rebecca Boas
Author Information
John S Babich: NYC Health + Hospitals/Bellevue, New York, NY.
Michelle McMacken: NYC Health + Hospitals/Bellevue, New York, NY.
Lilian Correa: NYC Health + Hospitals, New York, NY.
Krisann Polito-Moller: NYC Health + Hospitals, New York, NY.
Kevin Chen: Division of General Internal Medicine and Clinical Innovation, Department of Medicine, New York University Grossman School of Medicine, New York, NY.
Eric Adams: 110th Mayor of the City of New York, New York, NY.
Samantha Morgenstern: Sodexo, Healthcare, Sodexo USA, Gaithersburg, MD.
Mitchell Katz: NYC Health + Hospitals, New York, NY.
Theodore G Long: NYC Health + Hospitals, New York, NY.
Shivam Joshi: Division of General Internal Medicine and Clinical Innovation, Department of Medicine, New York University Grossman School of Medicine, New York, NY.
Andrew B Wallach: NYC Health + Hospitals/Bellevue, New York, NY.
Sapana Shah: NYC Health + Hospitals/Bellevue, New York, NY.
Rebecca Boas: Division of General Internal Medicine and Clinical Innovation, Department of Medicine, New York University Grossman School of Medicine, New York, NY.
Chronic diseases are the leading cause of death and disability in the United States, and much of this burden can be attributed to lifestyle and behavioral risk factors. Lifestyle medicine is an approach to preventing and treating lifestyle-related chronic disease using evidence-based lifestyle modification as a primary modality. NYC Health + Hospitals, the largest municipal public health care system in the United States, is a national pioneer in incorporating lifestyle medicine systemwide. In 2019, a pilot lifestyle medicine program was launched at NYC Health + Hospitals/Bellevue to improve cardiometabolic health in high-risk patients through intensive support for evidence-based lifestyle changes. Analyses of program data collected from January 29, 2019 to February 26, 2020 demonstrated feasibility, high demand for services, high patient satisfaction, and clinically and statistically significant improvements in cardiometabolic risk factors. This pilot is being expanded to 6 new NYC Health + Hospitals sites spanning all 5 NYC boroughs. As part of the expansion, many changes have been implemented to enhance the original pilot model, scale services effectively, and generate more interest and incentives in lifestyle medicine for staff and patients across the health care system, including a plant-based default meal program for inpatients. This narrative review describes the pilot model and outcomes, the expansion process, and lessons learned to serve as a guide for other health systems.
