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Healthy in the City Program is Making a Difference | Overview

Girl holds pieces of sliced onion over her eyes

For more than a decade, Boston Children’s Hospital has worked to address disproportionately high rates of childhood obesity in low-income Boston neighborhoods through its Healthy in the City program. Healthy in the City is a community-based program that uses a case management model and family based approach to healthy weight promotion. The program is implemented at 10 community health centers throughout the city and serves 1,000 children annually — 98% of whom identify as Black, Latino, or Asian. Program participants are either overweight or obese, or at risk for obesity. A Healthy in the City case manager provides these families with resources and support to achieve their health goals and maintain a healthy weight, including nutrition counseling and education, cooking classes, and physical activity opportunities. These resources are culturally appropriate, affordable, and accessible — often located right in their own communities.

In more recent years, the program has expanded its focus to also address food insecurity among families, many of whom live in neighborhoods that lack access to fresh, healthy food. Case managers coordinate food access initiatives at the health centers, including mobile produce markets, farmers market vouchers, grocery store gift cards, food distribution, and community gardening. They also connect families to helpful resources such as food pantries, meal sites, hunger hotlines, federal nutrition programs, and local incentive programs that encourage purchasing fresh produce with public benefits. These resources are offered in conjunction with health education, including how to prepare healthy meals using food pantry items or how to shop for groceries on a budget.

By ensuring families have access to healthy food, resources, and education, Boston Children’s is able to prevent and address childhood obesity. Each year, more than two-thirds of program participants reduce their body mass index (BMI) — a key indicator of program effectiveness. They also report healthier lifestyle changes such as increased consumption of fruits and vegetables, decreased consumption of fast food and sugar-sweetened beverages, greater time spent exercising, and less sedentary screen time.