The state physical activity and nutrition program - background: new york state's (NYS) population of 19.8 million people includes a rural population of 2.5 million

NYS is diverse; 19.5% hispanic, 17.6% black non-hispanic, and 30.5% speak a language other than english at home. In NYS, 29.1% of adults have obesity. Rates are 35% or > among people who live in 25 upstate counties (35.6%-43.1%), people who live with disability (38.1%), people who are non-hispanic black (36.8%), people living in rural areas (35.9%), and people with < a high school education (35%). Rates are also high among people with household incomes < $25,000 (34.4%), people who are hispanic (33.5%), children (13.7%), and youth (18.2%, 20.9%). Physical activity (PA) and nutrition indicators also reveal similar disparities by race, ethnicity, education, income, and ability. Over 5.1 million adults in NYS do not participate in leisure time physical activity, and ~15 million do not meet the 2018 physical activity guidelines for americans. In NYS, 35.7% of adults eat fruit < once a day, 20.7% eat vegetables < once a day, and 19% consume =sugary drink each day. Although 86.7% of newborns initiate breastfeeding, only 58.8% continue through 6 months, and only 36.3% continue through 12 months. Purpose: through its bona fide agent, health research, INC., the NYS department of health (DOH), corning tower, empire state plaza, albany, NY, requests funding to support health and early life growth and development for all residents, especially those most impacted by chronic diseases. NYS will implement state level interventions that support community level nutrition, physical activity and breastfeeding. During the 5-year project period, DOH will collaborate with cross-sector state level partners, CDC and non-CDC programs and organizations, and leverage state resources from various sectors to implement state level policy, system, and environmental approaches, including those that improve health equity. The purpose is to reduce health disparities in priority populations, by implementing evidence-based strategies to improve nutrition, increase access to safe PA, and increase breastfeeding continuity of care; and to integrate nutrition, PA, and breastfeeding national standards and farm to early care and education (ECE) into statewide ECE systems. Major collaborators include 25 NYS-funded creating healthy schools and communities grantees and the physical activity and nutrition center of excellence that supports their training and technical assistance needs; 10 NYS-funded breastfeeding friendly new york grantees; nemours children's health; NYS education department; NYS departments of transportation, agriculture and markets, labor, corrections and community supervision; NYS offices of mental health, general services, children and family services; NY statewide breastfeeding coalition; university at albany school of public health; baby cafe USA; qualitystarsny; NYS council on children and families; head start; early care and learning council; parentchild+; and victory's child care incorporated. Outcomes: outcomes of the 5-year project include increased consumption of healthier food; increased percentage of individuals meeting physical activity guidelines, and decreased obesity; and reduced health disparities for individuals with chronic conditions such as hypertension, heart disease, type 2 diabetes and obesity. These outcomes will be accomplished by increasing access to and purchasing/distribution of healthier foods; increasing policies, plans and community design changes that increase access to places for physical activity; increasing access to programs that provide continuity of care for breastfeeding families, thereby increasing breastfeeding; and increasing state level ECE policies and activities that improve nutrition, physical activity, and breastfeeding standards and farm to ECE, thereby increasing ECE programs meeting nutrition, physical activity, and breastfeeding standards and increasing farm to ECE opportunities.