Transforming policies, systems, and environments to achieve healthful changes across the lifecourse

INTRODUCTION: The NYC Department of Health and Mental Hygiene (DOHMH) CPPW-Obesity initiative employs policy, systems, and environmental approaches to improve nutrition and increase physical activity across the lifespan, especially for those living in high-need communities. METHODS: With CPPW funding, NYC has enhanced and expanded its mix of policy, environmental change, and media strategies to address multiple levels of the socio-ecologic model at different times of life. RESULTS: Through CPPW-Obesity the DOHMH developed new and expanded existing initiatives to reduce obesity. Nutrition-related efforts include: working with 13 hospitals towards being Baby Friendly; improving school food procurement; promoting a healthier food environment in businesses, faith-based organizations, bodegas and grocery stores; adding 200 “green carts” and promoting EBT use at 60 farmers' markets in high-need communities. Physical activity-related efforts include: expanding the reach of “Move to Improve”, resulting in the participation of 175,000 more public school children; training 2,000 design professionals on the Active Design Guidelines, most of whom (85%) report planning to incorporate them into upcoming projects; posting 28,000 stair prompts in 1,000 buildings, and encouraging New Yorkers to take the stairs. Also, high- impact media campaigns were developed to reduce sugary drink consumption, increase physical activity and raise awareness about excessive portion sizes. DISCUSSION: Through CPPW, we were able to expand work to prevent and decrease obesity across the life course by changing NYC policies, systems and environments.