Caguas sits in a valley nearly surrounded by mountains, just 20 miles south of Puerto Rico’s capital of San Juan. Historically, many people in the island’s fifth largest municipality worked in agriculture, especially sugar production. But recent years have seen a dramatic migration from farms and rural communities to urban areas, without, unfortunately, a significant shift in economic progress.

Even before the recession, nearly half of Caguas’ 142,000 residents had incomes below the federal poverty level, and 92 percent of public school students qualified for free or reduced-price lunch. Children’s health was dismally affected by families’ struggles, as well as by environmental factors. In 2004, 31 percent of local second-grade students were recorded as obese, a higher percentage than on the island as a whole. Another 16 percent were overweight.

As it confronts such daunting statistics, the Caguas Municipal government in partnership with SANOS as lead organization and other private and public organizations, will launch a comprehensive initiative to expand physical activity, nutrition and healthy lifestyles.

SANOS, a local nonprofit dedicated to health promotion and disease prevention, plans to adapt a toolkit created by the National Institutes of Health called We Can! Ways to Enhance Children’s Activity & Nutrition, translating the text into Spanish and making it culturally appropriate for families in Caguas. SANOS will share the new version of the kit within Puerto Rico and with other Latino communities elsewhere in the United States.

With funding through Healthy Kids, Healthy Communities, the new initiative also will pursue creation of a Ruta VidA, a biking and walking path through the city that will improve access to parks, recreation centers and other local attractions. At the same time, it will advocate the use of existing facilities to get children to be more active.

Its efforts will pull together public entities such as the Education, Health and Community Development departments; private groups such as the Puerto Rico Alliance for Healthy, Active and Well Nourished Children; and local residents’ associations.

“SANOS has been working to promote health with important local partners for years,” said project director Elba Vazquez Cardin. “I saw what a great opportunity it would be to work with the strategies we’ve developed in a broader context.”

In the initiative’s first year, the partnership will establish focus groups in two neighborhoods, or barrios, to identify barriers to active living and healthy eating habits. According to the focus groups’ needs assessments, it then will advocate public ordinances to support environmental changes that could help prevent childhood obesity.

SANOS and the other groups hope to expand these efforts to all 11 barrios in Caguas by year four. Additionally, to assist families in making healthier food decisions, a healthy eating certification program to identify healthy choices at restaurants and other food establishments will be established.

“We have a strong vision of Caguas as a healthy city,” Cardin said. “But we know we can’t do everything. That’s why we’re working closely with the mayor and emphasizing collaboration.”