Child Health, Obesity, and Environment in East Harlem, NY

We combined multiple assessments of the health and environment of children as part of a community-partnered project to reduce diabetes-related disparities in the Sector of Excellence for the Elimination of Disparities SEED, a 2 census tract area of East Harlem, NY. We administered surveys at community sites to 117 adults regarding their children. We performed a block by block assessment of the neighborhood environment. Most respondents (83%) were mothers. The average child was 7 years (range 3-15). 36% of parents reported the health of their children as only good, fair or poor. 55% of children were overweight or obese by BMI. Overweight or obese was related to worse health status: 69% of children in the poor to good health category were measured as overweight or obese, compared to 57% with very good and 38% with excellent health, p=.04.Among overweight or obese children in very good or excellent health, daily physical activity time was 44 minutes longer in those felt to be of normal weight than those viewed as overweight or obese (N=36, p=.17). There was an average of 1 park or playground every 7 blocks: parks were used more frequently than playgrounds.A typical child had 1 fast food meal and one food purchase from a bodega per week. A minority of food stores surveyed carried healthy foods- 43% had apples, 38% tomatoes, and 19% fat-free milk. Of 21 restaurants surveyed, 52% were either national fast food chains, pizza, or Chinese take out. Most (67%) of restaurants had at least one healthy item (usually salad). Sidewalks were not always easily walkable, with 51% in disrepair and 21% obstructed. Children's health status is concerning, as are rates of obesity. Multiple aspects of the food, built, and behavioral environments may combine to produce high rates of local childhood obesity.