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In the 1990s, New York City pioneered a crime-fighting system called Compstat, that used extensive computer databases to target specific areas with police personnel and programs. In this decade, the city has done something similar with health – conducting sweeping surveys to learn about conditions neighborhood-by-neighborhood in order to deploy resources. WNYC’s Fred Mogul looked at one area where the Health Department has used data to improve residents’ health, with mixed results.

REPORTER: On a recent afternoon in the Tremont section of the South Bronx, Martha Clavell stops by a produce stand and looks at the apples and grapes. Clavell says she eats pretty nutritiously. But without knowing it, she’s one of the reasons the Health Department has targeted this area.

CLAVELL: I got high blood pressure, diabetes. I go to dialysis – kidney failure, you know.

REPORTER: Clavell’s shopping at a “Green Cart”, a produce stand with a special permit from the city. The program’s one of several to improve the food options in poor neighborhoods like this. Clavell says when you consider the “Green Cart” and the weekly green-market, another city initiative, there’s more and more choices.

CLAVELL: We got [the Green Cart] here. We got the market that comes on Tuesdays, with the WIC tickets. I think we got a lot.

REPORTER: It wasn’t just an ‘educated guess’ that the Tremont area needed more produce. Assistant Commissioner Bonnie Kerker says access to good food is something the Health Department looks at closely.

KERKER: We looked at data on fruit and vegetable consumption in different areas of the city, as well as obesity and diabetes data, and were able to select the areas of the city with the highest need to put the Green Carts.

REPORTER: Since 2002, the Health Department has conducted an annual “Community Health Survey” across the five boroughs, modeled after a nationwide survey by the CDC.

The data flesh out in detail what’s been long known, generally, about the city’s health disparities: hypertension is 40 percent more prevalent in the South Bronx than in the rest of the city. Diabetes, 44 percent. Asthma, 96 percent. And so on with almost every chronic health problem, infectious disease, mental illness and environmental concern. Kerker says it’s not just the South Bronx.

KERKER: All of those data sources point to certain areas of the city having the highest rates of poverty, poor health, poor access to care and high levels of mortality.

REPORTER: The Health Department decided that three particular areas should be targeted: the South Bronx, northern Manhattan and central Brooklyn. Each would get a “DPHO”, a District Public Health Office – to learn more about the neighborhood, work with different community groups, disseminate information, and develop new programs, like the Green Carts.

Jane Bedell, who leads the South Bronx DPHO, says it’s crucial to locate these activities IN the affected area, not out of the Department’s downtown Manhattan headquarters.

BEDELL: Either myself or a member of my staff can be physically there to attend a meeting or to see something going on at a school or in a church function. There’s something about being there that I think is not so measurable, but you get a sense of how important that is.

REPORTER: Bedell’s office is on Arthur Avenue – but not the stretch that’s a Mecca for Italian food. The office sits above the Cross-Bronx Expressway, near a site featured in the movie “Fort Apache the Bronx”.

Bedell focuses her 35 staffers and $1.2 million budget on a few main issues: for instance, on asthma, they work with school nurses, daycare providers, hospitals, clinics, and doctors’ offices.

The goal is to help local institutions better identify kids with asthma, refer them to treatment programs, update people on the latest research. Diane Strom, administrator of the South Bronx Asthma Partnership, has frequently turned to Bedell’s office for help.

STROM: Her staff comes and distributes information about asthma, about smoking cessation, about asthma action plans. We can always pick up the phone and say, ‘Do you have x or y that you can help us with?’ And they generally say Yes.

REPORTER: But not all groups say their voice is welcome. Joe Perez is the director of the Freedom Community Center, says none of the neighborhood groups he collaborates with have worked the District Public Health Office.

In the past, Perez’s center has offered flu shots to the elderly, thanks to a Health Department program with the Visiting Nurses Association. But this year, he says, a woman at the DPHO told him his group wouldn’t get the vaccine, and that his community members should come to the public health office instead.

PEREZ: And she says they can go out and get it: they can come to Arthur Avenue in the Bronx. These are old people. We got senior citizens here. To pay - what is it, $4.50? - to go stand on line? Let’s get real.

REPORTER: A spokeswoman says in order to streamline distribution, the Health Department only provides vaccine to groups with more than 50 people, and Perez’s community center has fallen short in recent years.

But regardless of how many grass roots groups they’re working with, it’s not clear how much of a difference the District Public Health Offices are making. The numbers are mixed.

The South Bronx’s high diabetes rate decreased slightly from 2002 to 2008 – while the much lower city-wide diabetes rate increased slightly. That’s an example of a disparity that's closing.

On the other hand, South Bronx asthma climbed from seven to night percent in the same period and remains about twice as high as the rest of the city. Jane Bedell, the director of the Bronx public health office, says it’s very difficult to look at statistics and say a given program is or isn’t having an impact – especially in an area with as many health problems as the South Bronx.

BEDELL: There’s a big picture that can be sometimes paralyzing. There’s so much here, you feel you can’t move anywhere. The truth of public health work is that you have to strategically figure out where are the places you can chip away at something and be successful.

REPORTER: Bedell cites as a success story local pilot program to limit school cafeteria milk to skim or one-percent, a program that’s been picked up city-wide.

BEDELL: The south Bronx group helped chip away at this and demonstrate that this could work in this area, and if for this area, why not for the city?

REPORTER: Across the street from the Bronx DPHO, 17-year-old Eudy Gonzalez is working out in the park with his daughter and sisters. Like a lot of people in the neighborhood, he has no idea what happens in the Health Department building. But Gonzalez, in a way, embodies a public health best-case scenario: you could say he took the city’s advice and ran with it – literally.

GONZALEZ: One year ago, I used to be, like, fat, like really fat, I had a lot of people in school telling me to work out, so I decided to really listen to them. And I lost a couple of pounds. REPORTER: How many pounds? GONZALEZ: Like fifty pounds.

REPORTER: Gonzalez was winding down his run around the park and his push-ups, sit-ups and pull-ups. His entourage of little girls was tugging on him to go. He promised to take them to McDonald’s – though he says he’s mainly eating salads these days. For WNYC I'm Fred mogul

For a photo essay on the Tremont area of the South Bronx, go to our news blog.