The Neighborhood as a Unit of Change for Health: Early Findings from the East Harlem Neighborhood Health Action Center.

Place-based approaches have been promoted as one way to reduce health inequities by addressing community-level factors that shape health, such as housing quality, healthcare systems, the built environment, and social capital. In 2016-2017, the NYC Health Department's Center for Health Equity launched three Neighborhood Health Action Centers (Action Centers), which use a place-based approach to improve health in neighborhoods with disproportionate burdens of premature mortality. We describe this approach and the genesis of the Action Centers. We then describe the East Harlem Action Center, which was the first to open, and share findings from qualitative interviews with the East Harlem Action Center's Governance Council, a group comprised of Action Center staff and co-located partners and programs which supports Action Center coordination. Interviewees felt that collaboration, being responsive to community needs, and being community based were essential elements of the Action Center. Interviewees recognized the complex dynamic of a large city agency serving as the host for the Action Center while simultaneously aiming to establish more equitable relationships with partners. Governance Council members' expectations and hopes for the East Harlem Action Center were consistent with the overall vision and model for the Action Centers, which may facilitate implementation.

Teen use of flavored tobacco products in new york city.

INTRODUCTION: Teen use of flavored tobacco products is a concern. Menthol cigarettes have been found to influence teen smoking; however, less is known about the association between teen use of other flavored tobacco products, such as cigars and dip, and cigarette smoking. METHODS: The New York City 2010 Special Communities Putting Prevention to Work Youth Risk Behavior Survey data (N = 1,800 aged 13-17 years) were analyzed to examine the association between ever trying flavored tobacco products and current smoking, after we adjusted for demographics and ever-use of menthol cigarettes. RESULTS: Twenty percent of teens reported ever trying flavored tobacco products; youth who were current smokers (58%) were more likely to have tried flavored tobacco products than youth who were not current smokers (16%). Controlling for menthol cigarette use, teens who had ever tried flavored tobacco products were nearly 3 times more likely to be current smokers than those who had never tried flavored tobacco products (odds ratio = 2.70, 95% confidence interval = 1.47-4.98). CONCLUSIONS: Ever trying flavored tobacco products was strongly associated with current smoking among teens. The findings from this study suggest that regulations prohibiting sales of flavored tobacco products could decrease youth smoking.

Evaluation of the New York City breakfast in the classroom program.

OBJECTIVES: We determined the impact of Breakfast in the Classroom (BIC) on the percentage of children going without morning food, number of locations where food was consumed, and estimated calories consumed per child. METHODS: We used a cross-sectional survey of morning food consumed among elementary school students offered BIC and not offered BIC in geographically matched high-poverty-neighborhood elementary schools. RESULTS: Students offered BIC (n = 1044) were less likely to report not eating in the morning (8.7%) than were students not offered BIC (n = 1245; 15.0%) and were more likely to report eating in 2 or more locations during the morning (51.1% vs 30%). Overall, students offered BIC reported consuming an estimated 95 more calories per morning than did students not offered BIC. CONCLUSIONS: For every student for whom BIC resolved the problem of starting school with nothing to eat, more than 3 students ate in more than 1 location. Offering BIC reduced the percentage of students not eating in the morning but may contribute to excess calorie intake. More evaluation of BIC's impact on overweight and obesity is needed before more widespread implementation.