New York City Looks to Comprehensive, Layered Approach to Prevent Obesity
Obesity has been a major challenge in New York City. Fifty-eight percent of adults there are overweight or obese. Obesity is a leading cause of preventable death, second only to tobacco. But in 2003 the city took stock, got serious about addressing the issue, and has not looked back.
Now New York City is seeing obesity rates for students in kindergarten through eighth grade drop―by 5.5 percent between the 2006-07 and 2010-11 school years. Obesity levels dropped significantly across all age ranges, neighborhood poverty levels, and racial and ethnic groups, although decreases were most dramatic among 5- and 6-year-olds and white and Asian students.
Although officials say far more needs to be done to reduce childhood obesity rates—roughly one out of every five young students remains obese—New York City’s comprehensive efforts represent an achievement in the movement to reverse the obesity epidemic.
Interventions are “not just in the schools, but in the community as well,” notes Cathy Nonas, senior advisor at New York City’s Department of Health and Mental Hygiene. “One thing we’ve learned is it is not just one policy, but a layering of policies and some shooting from the hip.” Over the last decade, the city has learned to stay flexible and tackle the problem from many angles.
The health department, for example, developed and distributes Health Bucks, worth $2 each, which lower-income residents can use to buy fresh fruits and vegetables at farmers’ markets. All 138 farmer’s markets in the city participate, giving one Health Buck to each customer for every $5 they spend with Supplemental Nutrition Assistance Program (SNAP) benefits.
The Green Carts program is another effort to increase access to healthy foods in city neighborhoods. With initial funding from the Laurie M Tisch Illumination Fund, the city launched 1,000 mobile vending carts that sell only raw fruits and vegetables, such as whole carrots, bananas, apples and berries.
Healthier foods are showing up indoors too, not just on city streets. In 2008 the city created nutritional standards for every city agency that buys or serves meals, so that students, hospital patients and city employees have healthier choices. That was followed in 2009 by a policy requiring chain restaurants to post calorie information on menus and menu boards.
Architects and urban designers have played a role in public health in the past, designing improvements to water systems and building codes to defeat cholera and other infectious diseases. New York City’s Active Design Guidelines are aimed at helping to prevent today’s chronic illnesses by designing buildings and spaces in ways that promote and support physical activity.
The school district has done its part too, serving healthier breakfasts and lunches, increasing fresh fruits and vegetables, hiring an executive chef, and switching from whole milk to 1 percent and skim milk in 2005. The city also reduced sodium and increased fiber in school meals, and in 2010 banned deep fryers. In addition, the district created Move-to-Improve guidelines to integrate physical activity breaks into class time. And the city passed regulations that help its youngest residents, those in child-care centers, get better meals and snacks, more activity time and less screen time.
“Don’t give up,” is the message Nonas wants to send to other jurisdictions trying to move the needle on obesity. “If you hold one initiative too responsible, kids lose out.” Now, New York City has set its sights on a new big goal: reducing childhood obesity rates by another 15 percent by 2016.