The air was crisp and the music was loud in the vast plaza in front of the New York State office building in Harlem as health advocates and vendors set up information tables for Harlem Wellness Week.
It is a wide-ranging effort to educate residents about non-communicable diseases - heart disease, cancer, lung disease, diabetes and obesity.
Economic impact
There is an economic effect to these diseases, especially in Harlem, one of the city's poorest districts. Without healthy employees and healthy customers, you cannot have healthy businesses, says Patricia Ricketts of the Greater Harlem Chamber of Commerce, which sponsors Wellness Week.
"Businesses, their assets leave every day at five o'clock - their primary assets being their employees. And so if their employees are not healthy then they are paying high health-care costs for those employees. They are paying higher costs in the fact that people are just not there to do the work."
Diet is a risk factor for disease, and sometimes traditional foods are not the most healthful. African American "soul" food for example, is often deep fried. But Ricketts says that one need not choose between one's culture and one's health. She encourages restaurants to offer healthy choices on their menus, and to advertise the number of calories in their entrees.
Soul food, she notes, can also be prepared in healthier ways. "So you might substitute a regular fat oil with something like olive oil. It does not change the flavor. In fact it might enhance the flavor a little bit."
Disadvantages
Dr. Jo Ivy Boufford, president of the New York Academy of Medicine, a Wellness Week partner, says education about better nutrition is key, but that people with low incomes often lack the means to put what they know into practice.
"When we talk to people in communities, even poor communities, the issue is not that they do not know what they should do, but they do not have fresh foods and vegetables they can afford," says Boufford. "They do not have parks. They do not have safe streets for their kids to play in. And these are the things that have to be changed."
But there is hope. New York is a trendsetter when it comes to enlightened public-health policy, according to Dr. Carlos Santos-Burgoa, an adviser to the Pan American Health Organization.?
"New York City has taken out smoking in public places either indoors or outdoors. That is a fantastic example that can be done without any impact on the economy," says Santos-Burgoa. "It is a city where you have bike paths. That is something that is a good message for the world because bikes make your transportation active. That is good for your health and lowers air pollution."
Good timing
Wellness Week is timed to coincide with high-level U.N. meetings about the prevention and control of non-communicable diseases.
Health advocates plan to lobby U.N. officials to pass resolutions that address infrastructure and other underlying causes of non-communicable disease. Boufford says it is not enough to focus on the management of disease through hospitalization or medication.?
"All those things are important. But in low-income communities or low-income countries, they are going to be making decision about infrastructure. They are going to be deciding do you build mass transit, do you create situations where people can walk safely or do you create ring roads and flyovers and highways with huge amounts of money you have?"
What it comes down to, she says, is do you make decisions with health in mind?