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Eating In, Eating Out, Eating Well: Access to Healthy Food in North and Central Brooklyn 1. Bodegas are common: about 8 in 10 food stores in Bedford-Stuyvesant and Bushwick are bodegas. • While offering convenient locations and hours, bodegas carry a narrower range of products at higher prices than supermarkets and other stores. • Supermarkets offer more choices, but are less common and less accessible. 2. Healthy foods can be hard to find. • Only 1 in 3 bodegas sells reduced-fat milk, compared with 9 in 10 supermarkets. • About 28% of bodegas carry apples, oranges, and bananas, compared with 91% of supermarkets. • Leafy green vegetables are available at few bodegas (about 1 in 10). 3. Storefront advertisements heavily promote unhealthy products. • Storefront ads for sugary juices, energy drinks, and alcoholic beverages are plentiful. • 42% of bodegas carry tobacco ads. 4. Healthy eating strategies should take restaurants into account. • Almost 3 out of every 4 neighborhood restaurants sell only take-out food. • Pizza parlors and Chinese and Latin American restaurants are the common types. • National fast-food chains make up about 13% of the area’s 168 restaurants. Acknowledgements Our thanks to the following contributors, including staff from the Brooklyn District Public Health and Cornell University Cooperative Extension (New York City Branch): Jenny Carol Aguilera, Kelly Cantor, Estela Gonzalez, Christina Larkin, Mirian Nunez, Kwame Boakye-Yiadom, Kesha Crichlow, Sandra Guzman, Carol Parker-Duncanson, Evelyn Espinal, Gloribeth Cancel, Evelyn Ortiz, Leighton Hewitt, Philip Noyes, Ronica Webb, Ernesha Webb. Appreciation is expressed to the Publications Group of the New York City Department of Health and Mental Hygiene for editorial services and design of this report: Cortnie Lowe, M.F.A., Director; Caroline Carney, Managing Editor, and Judith Levine, Senior Editor. Suggested citation: Graham R, Kaufman L, Novoa Z, Karpati A. Eating in, eating out, eating well: Access to healthy food in North and Central Brooklyn. New York, N.Y.: New York City Department of Health and Mental Hygiene, 2006. Key Findings Brooklyn District Public Health Office Poorer neighborhoods have higher rates of obesity, and more deaths from diabetes and heart disease, than wealthier neighborhoods.1 About 30% of adults in Bedford-Stuyvesant and 29% in Bushwick are obese, compared with 20% in New York City as a whole. About 12% of adults in Bedford-Stuyvesant and 11% in Bushwick have diabetes, compared with 9% citywide.2 Convenient access to affordable, healthy food is vital to a healthy neighborhood. A healthy diet and physical activity are both needed for healthy weight. The reason for more obesity in low-income neighborhoods may be twofold: fewer safe places to exercise, such as parks, and less access to healthy food, including fresh fruits and vegetables. People tend to shop close to home3; the availability, price, and quality of food in the immediate neighborhood has a strong impact on diet.4 This report examines access to healthy food in Bedford-Stuyvesant and Bushwick. In 2004, the Brooklyn District Public Health Office, with permission from store owners and managers, conducted a brief assessment of every food store and restaurant in the 5-square-mile area, a total of 373 establishments. In food stores, we recorded the availability and price of selected foods and other products, as well as types of storefront ads.5 In restaurants, we documented type of cuisine, type of service (sit-down or take-out), and whether the establishment was part of a national chain. 1 Eating In, Eating Out, Eating Well: Access to Healthy Food in North and Central Brooklyn This Report Obesity is a major health problem in New York City – more than half of adult New Yorkers are overweight or obese. Having an unhealthy weight increases the risk for many conditions, including diabetes, high blood pressure, high cholesterol, cancer, and heart disease. 1. Bodegas are common in Bedford-Stuyvesant and Bushwick. Food is sold in a variety of stores.6 Among the 373 food stores, bodegas are the most common in both neighborhoods. They offer convenient locations and hours, but are more expensive and have a much narrower product selection than most other stores. Supermarkets have lower prices and a wider selection of food, but are less conveniently located. Bodegas Supermarkets Specialty Drug Stores Gas Stations Total 176 (81%) 12 (5%) 22 (10%) 3 (1%) 3 (1%) 216 131 (84%) 10 (6%) 11 (7%) 3 (2%) 2 (1%) 157 307 (82%) 22 (6%) 33 (9%) 6 (2%) 5 (1%) 373 Bedford-Stuyvesant Bushwick Total Bodegas far outnumber supermarkets in Bedford-Stuyvesant and Bushwick Bodegas Supermarkets 2. Healthy foods can be hard to find. Reduced-fat milk For people aged 2 and older, reduced-fat milk – 2%, 1%, or skim/fat-free – provides all the nutritional benefits of whole milk, with less fat and calories. In stores where milk is available, only about 1 in 4 in Bedford-Stuyvesant offers a reduced-fat option; in Bushwick, about half do. Even when reduced-fat milk is available in bodegas, gallon sizes are hard to find. Milk is more expensive in bodegas than supermarkets. In Bedford-Stuyvesant, a gallon of milk costs about 79¢ more in bodegas than supermarkets; in Bushwick, bodegas charge about 19¢ more. Fresh fruits and vegetables Fruit is high in vitamins and fiber. About 72% of all stores in both neighborhoods carry some fresh fruit, with supermarkets offering the greatest variety. Of three common fruits – apples, oranges, and bananas – only 21% of bodegas in Bedford-Stuyvesant carry them all, compared with 83% of supermarkets. In Bushwick, only 38% of bodegas stock all three fruits, while 80% of supermarkets do. Leafy greens, such as spinach, kale, and collards, are excellent sources of calcium and are low in calories. Only 6% of bodegas in the two neighborhoods carry leafy green vegetables, while 67% of supermarkets do. 2 Brooklyn District Public Health Office Bodegas in North and Central Brooklyn offer fewer healthy food options than supermarkets. 92 90 41 83 80 38 75 4 60 8 20 21 0 20 40 60 80 100 Bed-Stuy Supermarkets Bed-Stuy Bodegas Bushwick Supermarkets Bushwick Bodegas % of stores with items available Reduced-fat milk Apples, oranges, and bananas Leafy green veg Bodegas in North and Central Brooklyn offer fewer healthy food optios than supermarkets. 3 Eating In, Eating Out, Eating Well: Access to Healthy Food in North and Central Brooklyn 3. Storefront advertisements heavily promote unhealthy products. Ads have a powerful influence on food and other choices, especially among children. Most storefronts in Bedford-Stuyvesant and Bushwick (about 90%) feature ads. The most common are for less-healthy, sugar-added juices, energy drinks, and sodas.7 More than half advertise alcoholic beverages, especially beer, but ads for water and diet soda are rare. Smoking is the leading cause of preventable illness and premature death in New York City. Tobacco companies routinely target low- income neighborhoods,8 and storefront ads for cigarettes are common, especially for Newport, Marlboro, and Kool brands. In Bedford-Stuyvesant, 44% of stores display cigarette ads; in Bushwick, 40% do. It’s not easy for children in either neighborhood to avoid these ads. A typical school has 5 stores advertising cigarettes within a 3-block radius. About 3 out of 4 stores that display cigarette ads are located within 4 blocks of a school. Storefront ads for alcohol and sugary drinks are common. Ads for water, diet soda, and milk are rare. Bedford Stuyvesant Bushwick 54 26 20 14 4 0.5 38 16 18 7 3 1 0.5 65 1 1 68 51 0 10 20 30 40 50 60 70 80 90 % of stores displaying adsAlc oh olic Dr ink s Ju ice Dr ink s En erg y D rin ks 100 % Ju ice So da Co ffe e/T ea Wa ter Die t S od a Mi lk Storefont ads for alcohol and s iks are comon. Ads for water, diet soda, il are rare. Stores advertising cigarettes are located near every elementary school Food stores with cigarette ads Elementary schools 4. Healthy eating strategies should take restaurants into account. New Yorkers eat out and take out frequently. Any strategy for healthy eating should take local restaurants into account. There are 94 restaurants in Bedford-Stuyvesant and 74 in Bushwick, 168 in all. The most common foods served are Chinese, Latin American, and pizza. National fast-food chains, such as McDonald’s and Kentucky Fried Chicken, represent 13% of restaurants in both communities. Most restaurants (73%) offer only take-out service. 1. Karpati A, Kerker B, Mostashari F, et al. Health disparities in New York City. New York: New York City Department of Health and Mental Hygiene, 2004. 2. Karpati A, Lu X, Mostashari F, Thorpe L, Frieden, TR. The health of Bushwick and Williamsburg. NYC Community Health Profiles 2003; 1(1):1-12. 3. Kaufman, L. “Understanding the social and cultural roots of childhood obesity: The politics of food and fatherhood.” Presented at 133rd annual meeting of the American Public Health Association; December 12, 2005; Philadelphia, PA. 4. See, for example: • Horowitz CR, Colson KA, Hebert PL, Lancaster, K. Barriers to buying healthy foods for people with diabetes: Evidence of environmental disparities. Am J Public Health. 2004;94:1549-1554. • Morland K, Wing S, Diez Roux A. The contextual effect of the local food environment on residents’ diets: The atherosclerosis risk in communities study. Am J Public Health. 2002;11:1761-1767. 5. Data were collected on: • Beverages (whole and reduced-fat milk; juice, soda, water, and alcohol) • Fruits (apples, bananas, oranges) • Vegetables (potatoes, tomatoes, carrots, and leafy green vegetables – not iceberg lettuce) • Snack foods (cakes, candy, and bagged goods such as potato chips) Advertisements were categorized as: deli meats, other foods, beverages (alco- holic and non-alcoholic), cigarettes, and other products. Although food availability, price, and store location were determined, food quality was not assessed. 6. There are also two farmers’ markets in Bedford-Stuyvesant and one in Bushwick. 7. “Energy drinks” are beverages such as Red Bull, Venom, Adrenaline Rush, 180, and ISO Sprint that contain large doses of caffeine and other legal stimulants such as ephedrine, guarana, and ginseng. Energy drinks may contain as much as 80 mg of caffeine, the equivalent of a cup of coffee; see Brown University, Health Education: Caffeine and Energy Boosting Drugs. Available at: http://www.brown.edu/ Student_Services/Health_Services/ Health_Education/atod/energydrinks.htm 8. Bassett MT. Smoking among deprived populations: Not just a matter of choice. Am J Public Health. 2003;93:1035. References 4 Brooklyn District Public Health Office Bedford-Stuyvesant Bushwick 39 (41%) 20 (27%) 8 (9%) 31 (42%) 9 (10%) 6 (8%) 6 (6%) 5 (7%) 8 (9%) 2 (3%) 4 (4%) 2 (3%) 5 (5%) 0 4 (4%) 0 11 (11%) 5 (7%) Chinese Latin American Pizza Fried chicken Caribbean Burgers Southern Seafood/fried fish Other 5 Eating In, Eating Out, Eating Well: Access to Healthy Food in North and Central Brooklyn 2-Step Recipe for Creating a Healthy Neighborhood Food Environment Step 1. Provide healthier offerings at local food establishments In bodegas: • Stock healthy foods: reduced-fat milk, fresh fruits and vegetables, and whole-grain foods. • Advertise for health by promoting healthy foods in storefront ads, at the register and on shelves and cooler doors. Eliminate cigarette advertising, especially around schools. • Encourage customers to try new healthy foods through reduced-price campaigns. In restaurants: • Encourage the use of healthier cooking methods and products (for example, eliminate the use of partially hydrogenated vegetable oils). • Provide healthier menu options. Step 2. Create new venues for purchasing healthy foods • Establish neighborhood farmers’ markets, cooperatives and community-supported agriculture programs. Recommendations 1% Milk Campaign The Health Department has partnered with bodega owners in Central Brooklyn to promote the availability of 1% milk. A Neighborhood Report from the Brooklyn District Public Health Office New York City Department of Health and Mental Hygiene Resources Preventing overweight and obesity – healthy eating and physical activity: • Dietary guidelines for Americans 2005: www.health.gov/dietaryguidelines/dga2005/document/pdf/dga2005.pdf • Finding your way to a healthier you: www.health.gov/dietaryguidelines/dga2005/document/pdf/brochure.pdf • Fruits and vegetables – Eat 5 to 9 a day: www.5aday.gov/ • Take small steps to get healthy: www.smallstep.gov/ • Keeping your child healthy and ready to learn: www.nyc.gov/html/doh/html/scah/scah-healthy.shtml • Obesity – what everyone should know: www.nyc.gov/html/doh/html/cdp/cdp_pan_know_obesity.shtml Choosing healthy foods in Bedford-Stuyvesant and Bushwick: Magnolia Tree Earth Center Community-Supported Agriculture Program (Bedford-Stuyvesant and surrounding areas) 677 Lafayette Ave, bet. Tompkins & Marcy Aves Contact: (347) 403-4050 Getting active in Bedford-Stuyvesant and Bushwick: A Guide to Fitness Programs in Bedford Stuyvesant and Bushwick www.nyc.gov/html/doh/downloads/pdf/cdp/cdp-resource-brooklyn.pdf Brooklyn Food and Fitness Task Force To become a member, contact the Brooklyn DPHO at (646) 253-5700 Learning about the health of your neighborhoods: Bedford-Stuyvesant: www.nyc.gov/html/doh/downloads/pdf/data/2003nhp-brooklyna.pdf Bushwick: www.nyc.gov/html/doh/downloads/pdf/data/2003nhp-brooklynk.pdf Bedford Stuyvesant Greenmarket Community Vision Council Bushwick Market Lewis Ave at McDonough St Linden Blvd, bet. Central & Wilson Aves Saturdays 8 am – 3 pm Wednesdays 9 am – 3 pm July - mid-November Late June – mid-November Contact: (718) 636-2220, ext. 2227 Contact: (718) 670-3360 Graham Avenue Farmer’s Market Weeksville Farm Stand (Bushwick/East Williamsburg) (Bedford-Stuyvesant/Brownsville) Graham Ave at Cook St 1698 Bergen St, bet. Buffalo & Rogers Aves Saturdays & Sundays 8 am – 5:30 pm Saturdays 9 am – 2 pm July – Late October July – Late September Contact: (718) 387-6643 Contact: (718) 756-5250 To help reduce health disparities and improve the health of all New Yorkers, the New York City Department of Health and Mental Hygiene established three District Public Health Offices in 2003 to target public health efforts and resources to New York City neighborhoods with the highest rates of illness and premature death: the South Bronx, East and Central Harlem, and North and Central Brooklyn. This neighborhood report was prepared by the Brooklyn District Public Health Office. We hope this report fosters dialogue and collaboration among our many partners: other city agencies, community-based organizations, hospitals and clinics, businesses, elected officials, and, most important, the New Yorkers who live and work in Bedford-Stuyvesant and Bushwick. For more information on the District Public Health Offices: www.nyc.gov/html/doh/html/dpho/dpho.shtml Neighborhood Reports HPD7346001 - 06.06