"Economic disparity is an enormous predictor of health, and you'll find that the counties around the city are some of the healthiest in the state because they are some of the wealthiest."
Schwarz is right: Chester, Montgomery and Bucks counties all rank in the top 10 for the Keystone State in the study.
Fixing this disparity requires some major, citywide changes. Schwarz and other health-care experts have targeted five areas that need to be improved:
* ACCESS TO HEALTHY FOODS: In Carolyn Cannuscio's experience, the desire to eat healthy sometimes isn't enough.
"Organic food is generally not on sale," said Cannuscio, an assistant professor of family medicine and community health at the University of Pennsylvania medical school. "It's much easier and more comfortable for low-income families to buy calorically dense, cheap food at corner stores than making the trip to a real supermarket," she said.
* SMOKING: Philadelphia has more smokers (25 percent) than the 21 percent statewide average, according to the study. Organizations like the nonprofit Public Health Management Corporation are organizing programs to nip the problem in the bud.
Last year, the PHMC organized its Tobacco Control Merchant Education Initiative, aimed at preventing the sale of tobacco products to minors by educating the vendors who sell them.
* SAFE ACCESS TO RECREATIONAL FACILITIES: Although the city's Parks and Recreation Department operates hundreds of rec centers, they're not always used to their full potential, said Vanessa Briggs, PHMC's managing director of health promotion services.
"If a neighborhood isn't safe, parents don't want to send their kids down the block to go play basketball," she said.
* SEXUAL HEALTH: The survey lists Philadelphia's rate of sexually transmitted infections at 1,251 per 100,000, much higher than the state's 346 average.
Schwarz and his office have introduced programs like the Freedom Condom to help combat this, but he admits it's still an issue.
* VIOLENT CRIME: Experts say this is the largest problem facing the city, one from which all other issues stem.
"When people are afraid of being shot, they aren't actively concerned about how to curb their risk for diabetes," Cannuscio said.
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