Intended for healthcare professionals

Feature Public Health

New York’s road to health

BMJ 2008; 337 doi: (Published 08 July 2008) Cite this as: BMJ 2008;337:a673
  1. Karen McColl, freelance writer
  1. karen{at}

    From paying poor families to attend health checks to a law requiring the energy content of food to be shown on menus, New York City is taking a bold and pioneering approach to public health. Karen McColl reports

    The appropriateness of giving people cash incentives to look after their health is fiercely debated.1 2 But both critics and enthusiasts of this approach will be watching New York, as one of the world’s richest cities experiments with a programme of conditional cash transfers to break the poverty cycle.

    Opportunity NYC is a pilot project that gives cash rewards to poor families for investing in their own health, education, and welfare. Opportunity NYC draws heavily on experience in Mexico, where the first major conditional cash transfer programme, Progresa (now known as Oportunidades), was launched in 1997. The scheme is currently privately funded, but it has the backing of New York’s mayor, Michael Bloomberg, and may be rolled out if the results of the pilot study are positive.

    Opportunity NYC pays families for, among other things, ensuring that they have health insurance and for using prevention services. For example, families are paid $20 (£10; €13) a month for maintaining subsidised health insurance for each parent and $20 a month for maintaining it for all their children. Families who keep up their private or employer insurance for all the family receive $50 a month. Payments of $200 are made for each family member attending an annual medical check-up and, if the doctor recommends a follow-up visit, then $100 is paid for each family member attending within the recommended timeframe. Families also receive $100 for each family member who attends regular preventive dental check-ups. Six community organisations have recruited families from areas with high levels of deprivation. In total 4800 families are taking part …

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