With the nomination of Robert F. Kennedy Jr. as health secretary, a formerly fringe opinion suddenly gets wide attention.At an aging water treatment plant north of New York City, the fluoride solution was leaking from a pump. It was intended to be added to the drinking water piped down from the Catskills, to strengthen teeth and prevent dental decay. But instead it was dripping onto the ground, where it had soon eaten through the concrete.That leak, in 2012, was followed by repairs and upgrades that took more than a decade. For much of that time, the town of Yorktown, in northern Westchester County, drank unfluoridated water. By the time the new fluoridation system was up and running in August 2024, the town supervisor, Ed Lachterman, had detected a shift in public opinion.He had grown accustomed to hearing from people who insisted that Yorktown’s water remain fluoridated. “It was, ‘fluoride, fluoride, fluoride,’” he recalled. But in the intervening years, his constituents seemed far more wary, voicing concerns about fluoridated water’s effect on the brain or framing it as an issue of autonomy — “my body, my choice,” he recalled.A month after resuming fluoridation, Mr. Lachterman reversed course, suspending it in September. He cited an unexpected development: A federal judge in San Francisco had just concluded that fluoride, long known to be toxic at high levels, “poses an unreasonable risk of reduced I.Q. in children” even in amounts close to what is typically added to the nation’s drinking water. The judge ordered the Environmental Protection Agency to do something about it.His ruling followed a report released in August by the National Toxicology Program, part of the U.S. Department of Health and Human Services, that concluded “with moderate confidence” that higher fluoride exposures “are consistently associated with lower I.Q. in children.”The judicial ruling was a surprising development in the nation’s running debate over the virtues and perils of adding fluoride to our water supply, a controversy that over 80 years has veered across a lot of territory — from public health to conspiracy theories. The debate had seemed to be settling down. A quarter-century ago, the Centers for Disease Control and Prevention had declared water fluoridation to be one of the 20th century’s greatest public health achievements, pointing to the dramatic decline in cavities and tooth decay.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

Dr. Ruth Gottesman, a longtime professor at the Albert Einstein College of Medicine, is making free tuition available to all students going forward.The 93-year-old widow of a Wall Street financier has donated $1 billion to a Bronx medical school, the Albert Einstein College of Medicine, with instructions that the gift be used to cover tuition for all students going forward.The donor, Dr. Ruth Gottesman, is a former professor at Einstein, where she studied learning disabilities, developed a screening test and ran literacy programs. It is one of the largest charitable donations to an educational institution in the United States and most likely the largest to a medical school.The fortune came from her late husband, David Gottesman, known as Sandy, who was a protégé of Warren Buffett and had made an early investment in Berkshire Hathaway, the conglomerate Mr. Buffett built.The donation is notable not only for its staggering size, but also because it is going to a medical institution in the Bronx, the city’s poorest borough. The Bronx has a high rate of premature deaths and ranks as the unhealthiest county in New York. Over the past generation, a number of billionaires have given hundreds of millions of dollars to better-known medical schools and hospitals in Manhattan, the city’s wealthiest borough.While her husband ran an investment firm, First Manhattan, Dr. Gottesman had a long career at Einstein, a well-regarded medical school, starting in 1968, when she took a job as director of psychoeducational services. She has long been on Einstein’s board of trustees and is currently the chair.In recent years, she has become close friends with Dr. Philip Ozuah, the pediatrician who oversees the medical college and its affiliated hospital, Montefiore Medical Center, as the chief executive officer of the health system. That friendship and trust loomed large as she contemplated what to do with the money her husband had left her.We are having trouble retrieving the article content.Please enable JavaScript in your browser settings.Thank you for your patience while we verify access. If you are in Reader mode please exit and log into your Times account, or subscribe for all of The Times.Thank you for your patience while we verify access.Already a subscriber? Log in.Want all of The Times? Subscribe.

New Yorkers’ life span dropped by 4.6 years in 2020 from the previous year. Health officials say it may take the city years to recover.A wave of illness hit New York City, with little warning. Soon, it was sending the death rate rocketing upward.It was 1834. New York City was just expanding its first railroad line. The penny press was flourishing. Cholera had struck. And smallpox was resurgent.It would be nearly 200 years before another shock that seismic, when the coronavirus pandemic in 2020 caused the death rate in New York City to once again climb about 50 percent over the previous year, according to new data released Friday by the city’s health department.Throughout the 19th century, periodic outbreaks of cholera, smallpox, and other infectious diseases caused the city’s death rate to surge. But by the early 20th century, vaccines, improved sanitation and a variety of public health advances — from the disinfection of drinking water to the pasteurization of milk — had largely subdued this cycle of epidemics. The city’s death rate began to see drops and plateaus, a pattern that largely held for more than a century — until 2020.The story of the city’s declining death rate, and how Covid upended that trend, is instantly communicated in a well-known chart published regularly by New York City’s health department, and now updated to include the first year of the pandemic.Called “The Conquest of Pestilence in New York City,” it showed how strides in public health eventually quelled the epidemics of the 19th century. For the last century or so, the death rate — measured as the number of deaths per 1,000 residents — was relatively flat or declining, until the pandemic’s disastrous first wave in early 2020.

Patients will be asked if their genetic sequence can be added to a database — shared with a pharmaceutical company — in a quest to cure a multitude of diseases.The Mount Sinai Health System began an effort this week to build a vast database of patient genetic information that can be studied by researchers — and by a large pharmaceutical company.The goal is to search for treatments for illnesses ranging from schizophrenia to kidney disease, but the effort to gather genetic information for many patients, collected during routine blood draws, could also raise privacy concerns.The data will be rendered anonymous, and Mount Sinai said it had no intention of sharing it with anyone other than researchers. But consumer or genealogical databases full of genetic information, such as Ancestry.com and GEDmatch, have been used by detectives searching for genetic clues that might help them solve old crimes.Vast sets of genetic sequences can unlock new insights into many diseases and also pave the way for new treatments, researchers at Mount Sinai say. But the only way to compile those research databases is to first convince huge numbers of people to agree to have their genomes sequenced.Beyond chasing the next breakthrough drug, researchers hope the database, when paired with patient medical records, will provide new insights into how the interplay between genetic and socio-economic factors — such as poverty or exposure to air pollution — can affect people’s health.“This is really transformative,” said Alexander Charney, a professor at the Icahn School of Medicine at Mount Sinai, who is overseeing the project.The health system hopes to eventually amass a database of genetic sequences for 1 million patients, which would mean the inclusion of roughly one out of every 10 New York City residents. The effort began this week, a hospital spokeswoman, Karin Eskenazi, said.This is not Mount Sinai’s first attempt to build a genetics database. For some 15 years, Mount Sinai has been slowly building a bank of biological samples, or biobank, called BioMe, with about 50,000 DNA sequences so far. However, researchers have been frustrated at the slow pace, which they attribute to the cumbersome process they use to gain consent and enroll patients: multiple surveys, and a lengthy one-on-one discussion with a Mount Sinai employee that sometimes runs 20 minutes, according to Dr. Girish Nadkarni of Mount Sinai, who is leading the project along with Dr. Charney.Most of that consent process is going by the wayside. Mount Sinai has jettisoned the health surveys and boiled down the procedure to watching a short video and providing a signature. This week it began trying to enroll most patients who were receiving blood tests as part of their routine care.A number of large biobank programs already exist across the country. But the one that Mount Sinai Health System is seeking to build would be the first large-scale one to draw participants primarily from New York City. The program could well mark a shift in how many New Yorkers think about their genetic information, from something private or unknown to something they’ve donated to research.The project will involve sequencing a huge number of DNA samples, an undertaking that could cost tens or even hundreds of millions of dollars. To avoid that cost, Mount Sinai has partnered with Regeneron, a large pharmaceutical company, that will do the actual sequencing work. In return, the company will gain access to the genetic sequences and partial medical records of each participant, according to Mount Sinai doctors leading the program. Mount Sinai also intends to share data with other researchers as well.Though Mount Sinai researchers have access to anonymized electronic health records of each patient who participates, the data shared with Regeneron will be more limited, according to Mount Sinai. The company may access diagnoses, lab reports and vital signs.When paired with health records, large genetic datasets can help researchers search out rare mutations that either have a strong association with a certain disease, or may protect against it.It remains to be seen if Mount Sinai, among the city’s largest hospital systems, can reach its target of enrolling a million patients in the program, which the hospital is calling the “‘Mount Sinai Million Health Discoveries Program.” If it does, the resulting database will be among the largest in the country, alongside one run by the U.S. Department of Veterans Affairs as well as a project run by the National Institutes of Health that has the goal of eventually enrolling 1 million Americans, though it is currently far short.(Those two government projects involve whole-genome sequencing, which reveal an individual’s complete DNA makeup; the Mount Sinai project will sequence about 1 percent of each individual’s genome, called the exome.)A health system in northeast Pennsylvania, Geisinger Health System, has also built a database of more than 185,000 DNA sequences, through a partnership with Regeneron. That database played a role in the discovery of mutations that can protect against obesity and fatty liver disease.Mt. Sinai Health System, in partnership with a pharmaceutical company, is planning to build a massive database of patient genetic information to be used in research.Spencer Platt/Getty ImagesRegeneron, which in recent years became widely known for its effective monoclonal antibody treatment for Covid-19, has sequenced and studied the DNA of approximately 2 million “patient volunteers,” mainly through collaborations with health systems and a large biobank in Britain, according to the company.But the number of patients Mount Sinai hopes to enroll — coupled with their racial and ethnic diversity, and that of New York City generally — would set it apart from most existing databases.“The scale and the type of discoveries we’ll all be able to make is quite different than what’s possible up until today with smaller studies,” said Dr. Aris Baras, a senior vice president at Regeneron.People of European ancestry are typically overrepresented in genomic datasets, which means, for example, that genetic tests people get for cancer risk are far more attuned to genetic variants that are common among white cancer patients, Dr. Baras said.“If you’re not of European ancestry, there is less information about variants and genes and you’re not going to get as good a genetic test as a result of that,” Dr. Baras said.Mount Sinai Health System, which has seven hospitals in New York City, sees about 1.1 million individual patients a year and handles more than 3 million outpatient visits to doctor’s offices. Dr. Charney estimated that the hospital system was drawing the blood of at least 300,000 patients annually, and he expected many of them to consent to having their blood used for genetic research.The enrollment rate for such data collection is usually high — around 80 percent, he said. “So the math checks out. We should be able to get to a million.”Mark Gerstein, a professor of Biomedical Informatics at Yale University, said there was no question that genomic datasets were driving great medical discoveries. But he said he still would not participate in one himself, and he urged people to consider whether adding their DNA to a database might someday affect their grandchildren.“I tend to be a worrier,” he said.Our collective knowledge of mutations and what illnesses they are associated with — whether Alzheimer’s or schizophrenia — would only increase in the years ahead, he said. “If the datasets leaked some day, the information might be used to discriminate against the children or grandchildren of current participants,” Dr. Gerstein said. They might be teased or denied insurance, he added.He noted that even if the data was anonymous and secure today, that could change. “Securing the information over long periods of time gets much harder,” he said, noting that Regeneron might not even exist in 50 years. “The risk of the data being hacked over such a long period of time becomes magnified,” he said.Other doctors urged participation, noting genetic research offered great hope for developing treatments for a range of maladies. Dr. Charney, who will oversee the effort to amass a million sequences, studies schizophrenia. He has used Mount Sinai’s existing database to search for a particular gene variant associated with psychotic illness.Of the three patients in the existing Mount Sinai BioMe database with that variant, only one had a severe lifelong psychotic illness. “What is it about the genomes of these other two people that somehow protected them, or maybe it’s their environment that protected them?” he asked.His team has begun calling those patients in for additional research. The plan is to take samples of their cells and use gene-editing technology to study the effect of various changes to this particular genetic variant. “Essentially what we’re saying is: ‘what is schizophrenia in a dish?’” Trying to answer that question, Dr. Charney said, “can help you hone in on what is the actual disease process.”Wilbert Gibson, 65, is enrolled in Mount Sinai’s existing genetic database. Healthy until he reached 60, his heart began to fail rapidly, but doctors initially struggled with a diagnosis. At Mount Sinai, he discovered that he suffered from cardiac amyloidosis, in which protein builds up in the heart, reducing its ability to pump blood.He received a heart transplant. When he was asked if he would share his genome to help research, he was happy to oblige. He was included in genetics research that helped identify a gene variant in people of African descent linked to heart disease. Participating in medical research was the easiest decision he faced at the time.“When you’re in the situation I’m in and find your heart is failing, and everything is happening so fast, you go and do it,” he said in an interview in which he credited the doctors at Mount Sinai with saving his life.

The patient is under care at Bellevue Hospital while further testing is conducted.Days after unusual clusters of the rare monkeypox virus emerged in Europe, New York City health authorities announced on Thursday that they were investigating a possible case of the rare disease.The authorities said little about the patient, who is currently in isolation at Bellevue Hospital, according to a statement from the city health department. The patient arrived to the hospital Thursday, according to one official.Patient samples will be sent to the city’s public health lab for a preliminary test, and if that comes back positive, samples will be sent to the Centers for Disease Control and Prevention to confirm whether the illness is in fact monkeypox, according to the health authorities.News of the possible case comes a day after a man in Massachusetts was diagnosed with the disease. He had recently traveled to Canada, which is currently investigating more than 15 suspected cases in and around Montreal.Clusters of monkeypox cases have recently been identified in Britain and Portugal, while Spain is investigating suspected cases of the virus. Sweden and Italy reported cases on Thursday. The patients in Britain and those in Canada are mostly men who have sex with men.Monkeypox, according to the C.D.C., can spread through respiratory droplets from an infected person, as well through contact with body fluids and the sores that the virus is known for. It can also spread via contaminated objects.The viral disease is related to smallpox, but it’s milder and less infectious. It usually does not cause large outbreaks.The first outbreak in the United States occurred nearly 20 years ago and most likely infected some 47 people. It is believed to have begun with the importation of infected squirrels and other rodents from Ghana. They in turn infected prairie dogs that were subsequently sold as pets.Infected people usually experience fever and body aches before developing the disease’s characteristic rash. Red bumps turn to pus-filled blisters that crust over. The illness can be treated with an antiviral drug.The city’s health authorities on Thursday said that investigators will try to locate people who were recently in contact with the patient at Bellevue.

What It’s Like to Be Vaccinated in a Subway StationJoseph Goldstein📍Reporting from New York CityAt the Jamaica-179th Street Station in Queens, the nurses administering the vaccines began wrapping up at 1 p.m.“I got two extra Covid shots,” Dolfina Arloro, a pharmacist, called out to a trickle of people coming through the turnstiles. “Anyone want a Covid vaccine?”There were no takers, but already 300 people had been vaccinated at that station that day. The program is continuing through Saturday.