Dissemination Category: Policy Regulations for Day Care in New York City is an emerging intervention based on its use of evidence-based strategies. Developed in practice, it shows promise but evidence in support of effectiveness is not yet available.
Intent of the policy: The intent of the NYC health code revision and subsequent amendment to Article 47 (Child Care Services) of the New York City Health Code was to improve the physical activity and nutrition practices in NYC group day care facilities. This amendment included specific guidelines for outdoor play and physical activity, limits on television viewing, and requirements for food and food areas.
Intended Population: Children from birth to age 5 in group day care centers
Setting: Child care
Background: The New York City Department of Health and Mental Hygiene (NYCDOHMH) is mandated by law to protect and promote the health of all New Yorkers. The Bureau of Child Care, in the Department’s Division of Environmental Health, enforces Article 47 of the Health Code. Article 47 regulates public and private group day care services operating within New York City.
The Bureau of Chronic Disease Prevention and Control (BCDPC) reviewed the NYC health code in 2004; the review identified gaps in nutrition and physical activity in day care settings. As a result of these findings, the DOHMH requested that the Board of Health amend or add provisions relating to the operation of day care services regulated by Article 47 of the Health Code. These provisions included requirements to:
- establish minimum requirements on indoor and outdoor play (amendment),
- provide structured and guided physical activity (addition),
- establish limits on sedentary TV viewing (addition), and
- institute stricter nutritional standards (amendment).
In order to assess the day care practices prior to the implementation of this new policy, baseline data was collected in 40 NYC licensed group day care centers. Preliminary results identified some areas of concern including the use of white bread and whole milk, insufficient amounts of fresh fruits and vegetables1. Baseline physical activity in child care settings was assessed more generally through published literature analyzing national child care licensing regulations. The lack of structured physical activity requirements was an area of concern nationally2, and thus became an area that the NYCDOHMH chose to address in the amendment of Article 47.
Length of time in the field: The amendment to Article 47 of the New York City Health Code was adopted on June 15, 2006 and went into effect on January 1, 2007.
1 Erinosho T, Dixon BL. Involvement of nutrition and dietetic students in a community-based research project. Topics in Clinical Nutrition 2007;22(4)367-377.
2 Kaphingst KM, Story M. Child care as an untapped setting for obesity prevention: state child care licensing regulations related to nutrition, physical activity, and media use for preschool-aged children in the United States. Prev Chronic Dis 2009;6(1).