1. Harlem School Health Program Stepping Up for Healthier School Environment Terry Marx, MD, MPH April 16, 2008

2. Harlem School Health Program Partnership between DOHMH Programs –East and Central Harlem District Public Health Office –Office of School Health 20 elementary schools in East and Central Harlem 2 Major components: –Enhanced services from school nurse/medical room –School-wide health promotion activities 8 key health issues: asthma, nutrition, physical activity, vision, insurance, immunizations, oral health, mental health

3. School Health Promotion Strategies –Facilitate new programs –Change policy and practice Methods –Engage school community (administration and staff, parents, students) –Develop school-specific action plans –Partner with CBOs, providers, etc

4. Nutrition Promotion Overview “Supply” –Food policies –Food access “Demand” –Education

5. Current Food Policies in NYC Schools SchoolFood Meals and Snacks –Improved nutritional standards overall –Free breakfast –1% or non-fat milk only NYC DOE Policies –Wellness Policies –Chancellor’s Regulations A-610 Fundraising A-660 Parent Associations A-812 Competitive foods

6. Initial HSHP Nutrition Activities Access to healthy food –Salad Bars –Breakfast promotion –Healthier school store and snack options Nutrition education – parents, students SchoolFood Partnerships and Wellness Councils

7. Realities in our 20 schools.... SchoolFood struggles –Low breakfast participation –Snacks, beverages of minimal nutritional value –Cafeteria milieu –Limited fresh fruits and vegetables Engaging the school community –Who speaks for parents? –Competing priorities (educational, financial)

8. Realities, cont’d….. Limitations of policies –Existing regulations not fully implemented –Vending machines are on during meals –Constant fundraising (bake, candy and ice cream sales)

10. http://www.huffingtonpost.com/casimir-nozkowski/bodega-a-new-food-pyrami_b_37726.html; Realities, cont’d…… School neighborhoods are ‘toxic food environments’

11. Opportunities ahead: Enhance existing policies Alternative fundraising options Breakfast promotion Linkages –School-level – parents, staff –Community partners and organizations –Interagency – DOHMH, DOE

12. DOHMH/DPHO Initiatives Healthy Bodegas Health Bucks Promote water Green carts

13. The End With many thanks to the HSHP Health Promotion Coordinators: Libby Carter-Otuya Sarah Sisco Sarah Timmons-DeGregory