It was a bad day for Jorge Rivera. What should have been a routine colonoscopy at Mount Sinai Hospital turned into an afternoon of sitting in waiting rooms and being prodded by various medical personnel in clinics.
When he came in, the 65-year-old diabetic’s blood pressure was so high that he was at severe risk for a heart attack, stroke or even death. With his arms folded and head propped against the wall, Rivera dozed off as his wife, Abigail Cameron, waited patiently for an attendant to call his name.
“It’s a hard illness,” Cameron said after the long emergency visit.
Rivera lives in East Harlem, where one in six adults has diabetes. The neighborhood has fewer and more expensive options for healthy eating, according to the Communities IMPACT (Inspired and Motivated to Prevent And ConTrol) Diabetes Center at Mount Sinai School of Medicine.
Grocery stores and bodegas in East Harlem are stocked with plenty of snack foods and a poor selection of fresh produce compared to other city neighborhoods, according to a 2004 collaborative study led by Dr. Carol Horowitz of IMPACT. The report revealed that only 18 percent of 173 East Harlem stores surveyed offered five doctor-recommended food items for diabetes. In contrast, nearly 60 percent of 152 Upper East Side stores surveyed offered healthy selections.
Fresh foods are also pricier, making it more difficult for lower-income consumers to afford the recommended daily fresh vegetable and fruit servings. About 37 percent of households in East Harlem live below the poverty level, according to a 2007 study by the New York City Department of Health and Mental Hygiene. Just blocks away, on the Upper East Side, only about 7 percent of households live below the federal poverty line.
However, it’s not just about affordability.
“It’s kind of oversaturated with fast food,” said Michelle Ramos, community project manager at IMPACT.
That’s why IMPACT has worked to bring healthier food to the table in the mostly lower-income neighborhood. Over the last few years, things have been changing – slowly.
Mayor Michael Bloomberg and the Department of Health jumped on board to make healthier foods available in areas like East Harlem with the Green Cart initiative, a plan to issue 1,500 two-year licenses to street vendors selling fresh fruits and vegetables in communities with little access to healthy foods. Upper Manhattan was allotted 200 green cart licenses.
The changes are visible, said Alma Collazo, a Mount Sinai social worker. “I mean now we have on certain corners, you know, those cart vendors. That we didn’t have several years ago.”
Collazo, who is stationed at a senior home on East 118th Street, then ticked off all the places she now sees fruit and vegetable vendors at on weather-permitting days.
Ramos said that while the green carts have filled a fresh food void, “People in the neighborhood don’t think it’s the best quality.”
Elana Behar, a researcher at Hunter College’s Center for Community Planning & Development, argued that making fresh foods available through pushcarts will not curb the staggering diabetes numbers in East Harlem.
“Often if people are used to a certain diet that has a lot of sugar and a lot of salt, it’s harder for them,” she said.
Public health officials should focus on incorporating fruits and vegetables into people’s eating routine, social framework, and consciousness, Behar stated in a recent report. To supplement the initiative, Behar said, cooking demonstrations, free samples of healthy food and nutrition awareness programs need to be available in schools and workplaces.
Collazo, who works mainly with elderly Latino residents, said, “I mean the group tends to eat what they are culturally accustomed to.”
Food is not addressed in the mayor’s 2030 sustainability watch, and it should be, said Tom Angotti, director of the Center for Community Development and Planning at Hunter College. The green cart program is not likely to have a sweeping impact in a “food desert” like East Harlem that has a high rate of diabetes, said Angotti.
Poverty and education are also major factors to take into consideration. “The problem is there is no magic bullet,” said Angotti, who suggested expanding the green cart initiative and developing other similar programs.
Reporting by Eugenia Miranda. Map by Shane Kavanaugh.