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The physical environment can affect health directly through such vehicles as lead paint and toxic emissions and indirectly through such vehicles as barriers to physical activity and relative ease of access to healthful foods and alcohol and tobacco.
- New York State and Monroe County communities determine who can sell alcohol, when and where it can be sold, and how densely places that sell alcohol can be situated within a neighborhood. The Healthy Start area has some of the highest density of liquor stores-to- population in the city of Rochester and Monroe County as a whole.
- Conversely, there are few traditional grocery stores within the city of Rochester. Limited availability of fresh produce and healthful foods in small stores and the higher prices, combined with the ready availability of cigarettes and alcohol produces an environment in which making healthful choices is much more difficult than making unhealthful choices.
- Lead poisoning, which results in central nervous system damage, is most often the result of ingesting deteriorated lead-based paint that is found in houses built before 1950. Within the city of Rochester, pre-1950 houses are overwhelmingly located in six of the nine Healthy Start zip codes. They are among the 36 identified ZIP Codes within New York State to have been identified as having the highest percentage of confirmed cases >10 μg/dL (micrograms per deciliter).
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