In some New York City neighborhoods, pedestrians dodge parents pushing jogging strollers and navigate a maze of fitness clubs and natural food stores. However, despite the health craze that has hit segments of the population, inactivity and poor diet threaten to overtake smoking as the leading cause of preventable death in the country. Obesity, one of the risk factors for chronic disease, has nearly doubled in adults nationwide in just the last decade, reports Mary Bassett ’79PS, deputy commissioner of the Division of Health Promotion and Disease Prevention at the New York City Department of Health and Mental Hygiene. Also an associate professor of clinical epidemiology at Columbia’s Mailman School of Public Health, she says, “When you see changes on this scale, you have to look at the environments in which people make choices about how they eat and exercise.”
Bassett notes that in the City, one in six adults and one in four elementary school children are obese. A 2003 survey of public elementary school students, conducted by the Department of Health in collaboration with the New York City Department of Education, found that only about half of the children, 53 percent, had a healthy weight (neither overweight nor obese), and more than 20 percent of kindergarteners were obese. “This tidal wave of obesity is driving the rising prevalence of diabetes, heart disease, arthritis, a number of cancers, and depression,” Bassett says.
Since unhealthy lifestyles can begin at a young age, the City’s health department is working with the schools to increase physical activity and to shift the paradigm from competitive sports—where just a few kids who are good take part while the rest sit on the sidelines—to a fitness model in which each child is encouraged to strive for his or her personal best. Convincing people to get physical has been easier than changing their dietary habits, Bassett concedes. “But we have worked with the Department of Education to develop new regulations that govern what foods are available in schools. Beginning with the current academic year, junk food has been effectively eliminated.”
Asked where her interest in public health was born, Bassett, who trained at Columbia-affiliated Harlem Hospital after graduating from P&S, answers, “When I finished high school in 1970, I worked as a census taker, mainly in West Harlem. Going door to door and talking to people in their homes, I saw all kinds of health problems, and I witnessed the circumstances of people’s lives that contributed to these problems. This got me interested in community-based health promotion.”
Community groups can be powerful tools in combating lifestyle problems such as obesity, she says. Through two City-wide neighborhood fitness programs for the whole family—the outdoor “Wake Up New York” and the indoor “Shape Up New York”—the health department works with local organizations to spread the word that adding just a half hour of exercise each day could reap major benefits. The NYC Department of Parks and Recreation and Columbia’s NewYork-Presbyterian Hospital are among the co-sponsors of these programs. “Change can begin with steps as simple as walking an extra stop from the subway or taking the stairs instead of the elevator,” Bassett says.
