Summary of Selected Recent Needs Assessments and Food Studies in  East Harlem, 2003-2013 
Authors  Title Date Focus Key Findings /Recommendations
Columbia University School of Architecture Urban Planning and Preservation.  Baragona T, Chiu A, Loveman K, Marconi E,  Poole A,  Ranney A, Ripple S,  Song M  East Harlem
Preserving the Working ManÕs Manhattan
2011 Analyze an area of East Harlem with the goal of  creating a Historic Preservation Plan that identifies valuable historic resources and recommends strategies to ensure that these resources contribute to the present and future community, while preserving layers of history in this cultural enclave. Propose East Harlem Historic District be certified eligible for National Register eligible,  nominate 19 Individual Landmarks and two Historic Districts, the East Harlem Historic District and the Early East Harlem Historic District, to NYC Landmarks Preservation Commission, and amend current zoning  to compliment these Districts
Community Board 11  COMMUNITY BOARD 11 Statement of District Needs Fiscal Year 2014 2013 Overview of al community needs as perceived by CB 11 1. Renovate La Marqueta and create the environment to attract an anchor tenant that will create foot traffic at La Marqueta.                             
2. East HarlemÕs workforce development infrastructure must address the needs of a large number of residents who require employment. Local employment and training organizations and the Department of Small Business Services should work to connect local residents to employment opportunities in growth industries and local development-based employment.                                                                                
3. City agencies that regularly enforce codes and regulations which impact small businesses must create forums where local merchants can be educated on current and changing agency rules and solicit feedback from merchants with complaints of unfair treatment.                        
4. Increase availability of fresh and healthy foods in East Harlem by promoting and marketing the CityÕs FRESH program and by expanding the DOHMHÕs healthy bodegas initiative in East Harlem.                                   
5. Additional funding should be targeted to expand existing community-based peer-led interventions to promote weight loss and prevent diabetes.
6. Additional funding is needed for home health aid programs in East Harlem to expand the number of available aides and also pay higher wages to attract quality professionals who can assist seniors in their daily activities.
7. Plan for economic opportunities particularly on vacant lots, including the Park Avenue corridor
Dwyer JC Hunger and Obesity in East Harlem: Environmental Influences on Urban Food Access 2005 "Unearth the dimensions of choice and control faced by East Harlem in its relationship with food" Unbalanced mix of food choices  makes unhealthy food the default option for East Harlem, a neighborhood that can afford no better.The use of emergency food by East Harlem children quadrupled between 1994 and 2000.
¥ In 2004, 92% of East Harlem emergency food programs reported an increase in demand over the previous year.
¥ Half of these programs claimed demand had increased Ògreatly,Ó and 67% reported not being able to meet their increased demand.                                                                                         
¥ The death rate from diabetes in East Harlem has grown more than 230% in the last decade, twice the city average.
¥ Diabetes-related amputations in East Harlem are now five times the city average.                                                                              
¥ According to United Way of NYC, Food Stamp program participation rate among eligible East Harlem residents in 2004 was just 63%, thus more than 7,000 East Harlem residents who are eligible for Food Stamps benefits but do not receive them
Edwards TA, Jandorf L, Freemantle H, Sly J, Ellison J, Wong CR, Villagra C, Hong J, Kaleya S, Poultney M, Villegas C, Brenner B, Bickell N Cancer care in East and Central Harlem: community partnership needs assessment.            J Cancer Educ. 2013;28(1):171-8 2013 Analyze cancer care needs and  range of factors that impact the disparate rates of cancer in East and Central Harlem Major themes included: need for appropriate supportive services; health care access and financial challenges; beliefs related to stigma, trust, and accountability; and the impact of the physical environment on health. Education was seen as a critical area of need and intervention.
 Fox AM, Mann DM, Ramos MA,  Kleinman LC,  Horowitz CR.,  ÒBarriers to Physical Activity in East Harlem, New York,Ó Journal of Obesity, 2012,  8 pages, 2012 2012 Evaluated whether perceptions of safety and community-identified barriers were associated with lower levels of physical activity in a diverse sample Although safety concerns were prevalent in this low-income, minority community, it was individual barriers that correlated with lower physical activity levels.
Galvez  MP,Hong L, Choi E, Liao L, Godbold J, Brenner B. Childhood Obesity and Neighborhood Food Store Availability in an Inner City Community. Acad Pediatr. 2009 Sep–Oct; 9(5): 339–343.  2009 Impact of distribution of convenience stores and fast food outlets on childhood BMIs  Presence of convenience stores near a child's residence in EH was associated with a higher BMI-percentile. 
Galvez MP,  McGovern K, Knuff C, Resnick C, Brenner B Teitelbaum SL,Wolff M.  Associations Between Neighborhood Resources and Physical Activity in Inner-City Minority Children, Academic Pediatrics, 2013; 13(1): 20–26. 2013 Assess how availability of physical activity resources varies by individual and block characteristics and examine associations with physical activity levels of Latino and black children in East Harlem The more resources a child had available, greater the level of outdoor unscheduled physical activity.Neighborhood physical activity resource availability differs by demographic factors, potentially placing certain groups at risk for low physical activity level. Availability of select physical activity resources was associated with reported physical activity levels of East Harlem children but not with objective measures of physical activity.
Galvez MP, Morland K, Raines C,  Kobil J, Siskind J,  Godbold J , Brenner B.  Race and Food Store Availability in an Inner-city Neighborhood: Public Health Nutrition 2008
11 (6): 624–631
2008 Study examined whether census blocks either 75% African American (AA) or 75% Latino (L) are associated with food store availability, as compared with racially mixed (RM) census blocks, in East Harlem, New York.  AA census blocks were less likely to have convenience stores (prevalence ratio (PR) = 0.25, 95% confidence interval (CI) 0.07-0.86) compared with RM census blocks. In contrast, predominantly L census blocks were more likely to have convenience stores (PR = 1.8, 95% CI 1.20-2.70), specialty food stores (PR = 3.74, 95% CI 2.06-7.15), full-service restaurants (PR = 1.87, 95% CI 1.04-3.38) and fast-food restaurants (PR = 2.14, 95% CI 1.33-3.44) compared with RM census blocks. Inequities in food store availability exist by race/ethnicity in East Harlem, New York. 
Gordon C, Ghai N, Purciel M, Talwalkar A, Goodman A.(NYC DOHMH)  Eating Well in Harlem: How Available Is Healthy Food?  2007 Examines retail food environment in
Central and East Harlem and comapares to Upper East Side 
1. Bodegas are more abundant and supermarkets less common in East and Central Harlem compared with the Upper East Side.
2. Bodegas carrying healthy foods are less likely to be located in East or Central Harlem than on the Upper East Side.
3. Restaurants are common in all 3 neighborhoods, but fast-food establishments are more prevalent in East and Central Harlem than on the Upper East Side.                                                                             
1. Provide healthier offerings at local food establishments, especially in neighborhoods with few healthy food options.
2. Promote consumer demand for nutritious food at affordable prices through education and social marketing.
3. Encourage new venues for purchasing healthy foods.
Horowitz CR, Arniella A, James S, Bickell NA. Using community-based participatory research to reduce health disparities in East and Central Harlem. Mt Sinai J Med. 2004; 71(6):368-74. 2004 Develop an approach to educate and work together with Harlem residents to study health disparities, and use peer-led classes to improve chronic disease management and outcomes. Four individuals were trained to  become master peer-education trainers. The community board then helped recruit more than 60 community members and leaders for our first two peer-education courses in order to create a cadre of community-based experts to inform the community about ways to reduce health disparities.
Horowitz CR, Goldfinger JZ, Muller SE, Pulichino RS, Vance TL, Arniella G, Lancaster KJ. A model for using community-based participatory research to address the diabetes epidemic in East Harlem. Mt Sinai J Med. 2008;75(1):13-21 2008 Coalition used their experiences, research, outreach, and literature review to build a conceptual model describing how local factors affect health behaviors and health outcomes such as obesity and diabetes. This type of collaboration and the model may be useful tools to help communities identify and address the deficits that prevent their residents from enjoying the health benefits of improved nutrition and increased physical activity, and that also lead to racial and ethnic disparities in health
Horowitz CR, Williams L, Bickell NA. A community-centered approach to diabetes in East Harlem. J Gen Intern Med. 2003;18(7):542-8. 2003 To determine potentially remediable problems underlying this condition, a community-based collaboration of health providers, community advocates, and researchers, surveyed East Harlem residents with diabetes to assess their knowledge, behaviors, barriers to care, and actions taken in response to barriers. While 90% of respondents said they know how to take their medicines, between 19% and 39% do not understand other aspects of their diabetes management. Many limit their diabetes care due to concerns about money (16% to 40%), and other barriers, such as language and transportation (19% to 22%). In multivariate analyses, Latinos (relative risk [RR] = 0.77and those who do not keep a diabetic diet due to concerns about money (RR = 0.85) had poorer health status. Even among those with access to care there remain significant financial barriers to good diabetes care, and a need to address and optimize how individuals with diabetes manage their disease.
Jandorf L, Fatone A, Borker PV, Levin M, Esmond WA, Brenner B, Butts G, Redd WH Creating alliances to improve cancer prevention and detection among urban medically underserved minority groups. The East Harlem Partnership for Cancer Awareness. Cancer. 2006;107(8 Suppl):2043-51. 2006 East Harlem Partnership for Cancer Awareness formed in 1999 to reduce disparities in cancer screening and prevention among medically underserved minorities residing in East Harlem by increasing awareness of cancer risk, prevention, and treatment, and promoting greater participation in breast, cervical, colorectal, and prostate cancer screening and early detection.  Needs assessments revealed that although the majority of the population (86%) was insured and had a source of primary care, cancer screening guidelines for breast, cervical, prostate, and colorectal cancers were not being followed. Outreach strategies, targeted curricula, educational sessions, and screening programs have been developed and implemented to improve knowledge levels and increase screening participation.
Kleinman LC, Lutz D, Plumb EJ, Barkley P, Nazario HR, Ramos MA, Horowitz CR. A partnered approach for structured observation to assess the environment of a neighborhood with high diabetes rates. Prog Community Health Partnersh. 2011;5(3):249-59. 2011 Describes partnered approach that integrates simultaneous structured observation by community and academic partners with "on-the-spot" resolution of differences to collect baseline data regarding the built and food environments in a two census tract area of East Harlem and presents select findings. Structured observation identified many sidewalks in disrepair or obstructed, few benches, and highly variable times allocated for pedestrians to cross at cross walks.
New York Presbyterian Hopsital   New York-Presbyterian Hospital 2008 Community Service Plan Three Year Comprehensive Report 2009 In 2006, New York-Presbyterian commissioned a formal, academic Community Health Needs Assessment that included both quantitative measures as well as community-based focus group and key informant interviews. Study was conducted by  faculty at Mailman School of Public Health; findings  were updated in 2008. Focus on Wash Hgts-Inwood, but some data on EH.  Access to care is limited by:
1. Lack of health insurance. A significant number of residents in these communities are Eligible for Public Health Insurance but Not Enrolled
2. Large number of patients have not seen a primary care provider, particularly among WH/I residents.
3. Cancer, heart disease, accidents and injuries, mental illness, diabetes, HIV/AIDS, asthma, assault and homicide are consistently the leading causes of hospitalization and/or death.                                                      
4. Cultural competency in the form of Spanish language skills, health literacy strategies and cross-cultural communication skills are necessary to earn the trust of the  population.
4. Obesity, diabetes, asthma, and mental health are major health concerns. 
New Yorkers for Parks  East Harlem Open Space Index  2011 OSI seeks to  empower New Yorkers to identify existing open space and identify space investments needed to meet communities needs  East Harlem meets OSI standards in number of fields, courts, play areas, community gardens and permeable surfacing in parks but fails to meet standards in active, passive and total open space; walking distance to pocket, neighborhood and large parks, recreation centers, overall park maintenance and tree canopy coverage.  Recommendations:                                                                                                                          
1. Maximize public use of existing open space by developing an open space strategy for NYCHA Properties; ensuring  that community gardens
are truly public; continuing successful PlaNYC Open Space Initiatives; and building upon and enhancing existing open space resources.                   
2. Connect people to parks by making passageways to parks safer; promoting streets as connectors among parks; and  expand access from East Harlem to RandallÕs Island.  
NYC Dept of Parks and Recreation. Rosen L,  Greenfeld J.  Greening East Harlem A Community Forestry Management Plan 2006 Guide to greening of East Harlem,  a vision of a greener, healthier neighborhood with a primary focus on planting and caring for street trees. 1. Increase street tree stocking level from 63% to 90% by 2030;                         
2. Increase tree survival.                                                                                              
3. Establish programs that increase the communityÕs appreciation for street trees.                                                                                                                       
4. Identify policies that influence the urban forest.                                                 
5. Track progress on the overall vision and action items specified in this plan.
6. Design and construct a walking tour of East Harlem. The tour will be marked by tree-lined streets, art, and signs. Programming that encourages sustained interest in the walk will be advertised through the print media, public events and the Internet.
NYC Health and Hopsitals Corporation  2013 Community Health Needs Assessment and Implementation Strategy--Harlem Hopsital Center  2013 Focus groups were asked to discuss the following
five questions: 1) the greatest strengths of health care in
the community served by Harlem Hospital Center: 2) the
greatest weaknesses of health care in the community; 3) the
greatest health care needs; 4) their ranking, and 5) how we
can better respond to these needs. 
Greatest health care needs identified were:
diabetes and pre-diabetes; lack of education on medication management for men with diabetes, i.e. impotence; high blood pressure; high cholesterol; obesity; HIV/AIDS, smoking; alcohol and substance abuse; depression/mental health/ stress; domestic violence; geriatrics. Harlem Hopsital proposes , among other recommendations ,enhancements in diabetes prevention and care and  cardiovascular disease management. 
NYU Wagner School of Public Service.  Diaz H, Johnson  K, Lissar N, O'Toole L, Collignon KD.  A Community Engagement Study of  East Harlem and the Upper East Side
NYU Capstone Final Report
2011 Conduct  comprehensive
Community Engagement Study  of the Upper East Side and East Harlem to determine local concerns as identified by members of the communities. Through the Study,CIVITAS sought to ensure  current efforts are in touch with the communityÕs needs, and engage a broader spectrum of the community than they have historically.
Land use: Responses relating to size and scale of local development issues included vacant lots and abandoned buildings, existing public housing and a desire for more affordable housing. East River waterfront viewed  as site with great potential for development, particularly as a waterfront esplanade. 
Transportation: Respondents recognized a need for more transit options; respondents were only somewhat satisfied with the reliability of service. Respondents expressed concerns about number of pot holes, trash pickup, turn signals, speeding motorists, crosswalk safety, sidewalk conditions and sidewalk obstructions.
Environmental Quality: concern about the air quality, water quality, marine transfer station, noise pollution, street cleaning and trash collection in both neighborhoods. Several respondents  mentioned negative health impacts, particularly asthma, and the burning of heating oil. 
Streetscape: Most frequent comment was a request for more trees.