We explore how a 1987 New York State court decision-Boreali v. Axelrod-affected public health rule-making nationally and, with considerable impact, locally in New York City (NYC).We discuss the history of the origin of the NYC Board of Health (BOH), and establish that legislatures can be challenging venues in which to enact public health-related laws. We describe how, as the NYC Department of Health and Mental Hygiene began to tackle modern public health problems (e.g., chronic diseases caused by food and tobacco), the regulatory power of its BOH was challenged.In an era when industry funds political causes and candidates, the weakening of the independence of rule-making boards of health, such as the NYC BOH, might result in illness and death.