It’s the same one-two punch that has hit many urban settings, but in the nation’s sixth biggest city, the combination of an often unsafe environment for physical activity and limited access to healthy food has led to a real public health crisis: Almost half of Philadelphia’s children are overweight or obese.

The specific ills that keep youth from playing outside, particularly in poorer neighborhoods, are easy to list: a high crime rate, tens of thousands of empty lots overtaken by weeds and trash, cracked sidewalks, narrow or congested streets.

The problems on the other side of the equation also stem from environmental conditions, such as food deserts and too few supermarkets for the city’s population of 1.4 million. For residents with limited transportation, grocery stores that are hard to reach—or out of reach—leave them limited options. Many spend much of their food budgets on the typically energy-dense items sold at the corner stores, chain drug stores and fast-food outlets in their communities. Nearly a third of Philadelphia’s children eat at fast-food or local chain restaurants more than three times a week.

But a well-utilized network of after-school programs could be Philadelphia’s chance to get out front of its counterparts and, through a comprehensive systems and policy approach, begin to reverse its childhood obesity epidemic.

For nearly a decade, the city-supported Out of School Time (OST) has provided funding for parochial, charter and some public schools, community organizations, churches, recreation centers and libraries to offer more opportunities for nutritious eating and active play to children participating in their programs. The 2009 OST plan supported 22,000 after-school slots at 329 locations plus programs at 54 library branches serving another 80,000 youth.

With funding through Healthy Kids, Healthy Communities, a new OST Partnership will create after-school program policies and standards for both nutrition and physical activity. They will be customized, age-specific and place-based, and their implementation will link after-school sites to existing neighborhood assets such as farmers markets, community gardens, parks and walking, running and biking trails.

The initiative, led by the Health Promotion Council of Southeastern Pennsylvania, Inc. (HPC), will pilot the guidelines at nine provider sites with the ultimate goal of implementation citywide.

“We all want the same thing; a community that supports healthy and active children. Our challenge is channeling our collective energy and resources in getting there,” said project director Marlin L. Williams.

HPC’s partners are the Public Health Management Corp., National Nursing Centers Consortium, University of Pennsylvania, Philadelphia Health Department’s Office of Health and Opportunity and The Food Trust. All have been integrally involved in other large initiatives to combat childhood obesity in Philadelphia, a city of considerable socioeconomic diversity. About 52 percent of Philadelphians are African-American and 41 percent White.

“We’re capitalizing on the momentum created by a host of other efforts,” Williams said. “This grant will leverage the existing momentum and allow us to add the missing piece, an after-school model.”