Harlem bands together for healthier living

By Terri Coles

TORONTO, (Reuters) -- New York City's East Harlem is not only one of the poorest communities in North America, it has some of the highest rates of obesity and diabetes in the United States, a problem some say is directly related to its socioeconomic environment.

An initiative aimed at improving that environment -- and with that the health of East Harlem's residents -- has brought the community together to publish "Go Green East Harlem," a cookbook highlighting suggestions for healthy eating and living from community leaders and businesspeople. It's part of a model that could be applied elsewhere.

"We want to work with the community to bring down some of these alarming health rates," said Manhattan borough President Scott M. Stringer, who points out that asthma rates are worse than in some developing countries.

The cookbook is part of a wider health initiative of the same name. The idea began as a pamphlet, Stringer said, but grew as community fixtures in East Harlem became involved. The bilingual cookbook features 68 recipes from neighborhood eateries and local residents. Stringer contributed tips on selecting healthy takeout. Its recipes -- easy to prepare, with commonly available ingredients -- include dishes like quinoa banana muffins and sweet potatolicious, with sweet potatoes and pineapple, touching on the diverse backgrounds of the multicultural neighborhood.

The health problems associated with living in the inner-city are not unique to East Harlem. A variety of studies have shown that inner-city residents often bear a heavier toll from obesity and its related conditions than wealthier urban dwellers.

Research published in the American Journal of Preventive Medicine and released this week found that more of the restaurants in inner-city neighborhoods, and urban neighborhoods with a high minority population, serve fast food than those in richer areas of the city. A survey done in Winnipeg, Canada, found that premature mortality rates were higher among inner-city residents than suburban residents, and inner-city residents reported feeling less healthy and having less access to parks and adult recreation facilities. Back in New York, Mount Sinai's medical school found that proximity to and prevalence of convenience stores was an accurate predictor of body mass index and waist circumference in children in East Harlem.

Dr. Richard Glazier works with the Centre for Research on Inner City Health at St. Michael's Hospital in Toronto, Canada, where he and Dr. Gillian Booth recently published a diabetes atlas of the city. Their findings showed that the city's poorest neighborhoods, the ones most lacking services, had the highest diabetes rates. Those neighborhoods included both inner-city areas and inner suburbs, and their residents tended to be economically disadvantaged. Many were recent immigrants, Glazier said, with cultural backgrounds that put them at a higher risk of developing type 2 diabetes.

"I think we found quite a shocking disconnect between where the problems are and where the resources are."

His research shows that where a person lives can affect their health, Grazier said. Blaming only a person's lifestyle choices for their health isn't effective, he added. What the diabetes atlas does is highlight what needs to change at the neighborhood level: better public transportation, mixed residential and retail development, more access to fresh fruits and vegetables, safer neighborhoods for walking, improved health care access and increased rates of disease screening, particularly among minority populations. "There's a whole lot of those things we can do to help those populations be more active and make healthier choices," he said.

Toronto has identified 13 high-priority areas of the city that need work. "Those are neighborhoods that really have very few resources of any kind," Grazier said. Some neighborhoods are undergoing massive changes -- much of the inner-city neighborhood of Regent Park is being torn down and completely rebuilt -- while others will see more subtle development.

Change will continue in East Harlem as well: The Go Green East Harlem initiative is ongoing, and involves other projects like planting trees, adding access to farmer's markets, building green roofs on schools near high-congestion areas, and constructing a $3.5-million asthma center. Many East Harlem residents have already received free copies of the cookbook, and thousands more will be given away; the book is also available for sale on Amazon.com and Barnesandnoble.com, with the proceeds going to the non-profit Community Fund for Manhattan, which funded the book's publication.

Which is the greater threat to health: personal lifestyle choices or environment? Send your comments to: HealthMatters@reuters.com