OBJECTIVES: To examine the prevalence of overweight and associated characteristics in a representative sample of children from schools in New York City (NYC). DESIGN: A cross-sectional survey with an in-person interview (including measurements of height and weight) and a household questionnaire. SUBJECTS: Second and ®fth grade students from schools in NYC participated. A total of 1 396, including 692 second and 704 ®fth grade, children were included in the analysis. MEASUREMENTS: Prevalence of overweight based on the body mass index (BMI) and the 85th or 95th percentile cutoff points from Cycles II and III of the National Health Examination Survey reference recently developed by the Centers for Disease Control and Prevention (CDC). The characteristics of overweight examined were: age, gender, socio-economic status, Hispanic origin, family structure, number of children in the household, meal preparation by children, food diversity and participation in the National School Lunch Program. RESULTS: Overweight based on the 85th percentile of BMI was 37.5% among second grade and 31.7% among ®fth grade children. Based on the 95th percentile, overweight was 19.9% and 17.8%, respectively. Overweight was associated with Hispanic origin, fewer children in the household, family structure and meal preparation by children. CONCLUSIONS: Overweight is prevalent among elementary school children in NYC. Studies in diverse geographically de®ned areas with diverse populations, are necessary to design effective prevention efforts. Primary prevention efforts in NYC should target Hispanics and take into consideration individual behaviour and family characteristics.

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Data were gathered as part of a larger survey of 218 Head Start Programs in Region II (New York City, New York State (excluding New York City), New Jersey, Puerto Rico and U.S. Virgin Islands) in 1993-94. The general purpose of the survey was to obtain information on child health, screening practices, training needs, family health and community problems, barriers to diagnosis and treatment and the extent of linkages between Head Start programs and health and nutrition providers at the local level. In this study barriers to the care of Head Start children and their families were examined as perceived by the Health Coordinators or other health related staff of the Health Services Component of these programs. The extent of linkages with health and nutrition service providers were also examined. The most frequently reported barriers were lack of parent participation (72%), private transportation not available (67%), parents' perception of quality of care (64%), distance to provider (63%), cost of transportation (63%), lack of funding (56%), limited/inconvenient hours (56%), and health services not available in the community (55%). On average, programs reported linkages to 14.5 providers (including an average of 4 nutrition programs). More than 90% of them reported linkages with public health services, child protective services, WIC and private physicians/dentists. Finally, the extent of barriers and linkages were compared across different geographic areas. Significant barriers were identified in this study, yet the survey confirmed and validated the extensive nature of formal linkages with health and nutrition service providers at the local levels. These findings may indicate that the current levels of service availability may not be sufficient to meet the severity and diversity of health needs of this population.