Like other Great Lakes cities, Rochester has spent the past several decades confronting a shrinking manufacturing base, job losses and deepening poverty. The health of many residents has suffered as a consequence, and perhaps hardest hit have been residents of the Crescent, as the deteriorating neighborhoods immediately surrounding downtown are known.

This inner city is plagued by the health problems typical of poor urban areas, including high rates of obesity and overweight among children and adults. Not surprisingly, access to safe places to play and more nutritious foods remains an everyday challenge for the predominantly African-American and Latino community there.

Boarded-up houses and persistent crime often combine with transportation issues to keep people indoors, particularly during Rochester’s harsh winters. Local convenience stores, offering cheap processed foods plus easy check-cashing and credit purchases, frequently are the default destination for grocery shopping.

Yet here on the shores of Lake Ontario in upstate New York, Rochester is ahead of other cities as it works to change the Crescent’s health fortunes. At a time when supermarket chains were fleeing many urban cores, Rochester succeeded in attracting new supermarkets. Its Public Market is a thriving, year-round site that allows food stamp purchases of fresh, locally grown fruits and vegetables. The city at large has 11 full-time and many part-time recreation centers.

In addition, Rochester has a broad-based coalition of citizens, called HEALTHi KIDS. Already it has succeeded at gaining more funding for school meals and bringing in a school food-service contractor committed to healthier, more appealing offerings.

The coalition, led by the Finger Lakes Health Systems Agency, will use Healthy Kids, Healthy Communities funding on initiatives in four Crescent neighborhoods. Among other goals, its Healthi Kids Expansion project will develop “playability” plans to increase the number of safe places for children to be active; one primary policy strategy will be improving public access to outdoor play areas at local schools. The project also will collaborate with the city’s Head Start programs and child-care providers to improve their efforts to serve more nutritious foods.

“Rochester has a history of activism that dates back to the days of Susan B. Anthony and Frederick Douglass, both of whom were important civic figures here,” project director Katherine Lewis said. “We’re not afraid of tackling big issues as a community.”

With its partners, which include groups from the University of Rochester Medical Center, a regional food bank, the school district and several government agencies, business representatives and community groups, the coalition is moving forward even as the city targets the four neighborhoods for focused capital investment. The combined action could maximize opportunities.

“Three years ago, a coalition of local partners seeking to lower the number of childhood deaths from lead poisoning succeeded in getting the city and the county to change their housing policy,” Lewis said. “We hope this new coalition will be able to achieve this kind of positive change in the healthy eating and active living arena.”