NEW YORK - In Harlem, fast-food restaurants are more prevalent than shops selling fresh vegetables, according to a city health report.

Food stores in the area in upper Manhattan are mostly bodegas, and the small groceries are half as likely to carry low-fat dairy products as their counterparts in swankier neighborhoods and seven times less likely to sell fresh vegetables, the report said. Only 3 percent of corner stores in Harlem sell leafy green vegetables, compared to 20 percent on the nearby Upper East Side, it said.

"Large health disparities exist between Harlem and other New York City neighborhoods, but we can close those gaps," said Dr. Andrew Goodman, associate commissioner of the East and Central Harlem District public health office, a division of the health department.

In addition, one in six restaurants in Harlem is a fast-food joint. All this adds up to serious health problems for neighborhood residents, who are three to four times more likely to be obese or have diabetes than people who live on the Upper East Side, Goodman said.

The health department, which conducted a block-by-block assessment of food establishments in Harlem in 2005 to produce the report, is working with community groups to launch a healthy food campaign.

"Diabetes and heart disease, which are related to an unhealthy diet, cause more than a third of deaths in east and central Harlem each year," said the city's health commissioner, Thomas Frieden. "All New Yorkers should have the option to buy healthy foods in their neighborhoods."

The report recommended working with food distribution networks to make fresh vegetables available at bodegas and stocking healthier foods and advertising their existence. It also recommended encouraging customers to try healthy foods through reduced-price campaigns and establishing farmers' markets.

A lack of healthy food isn't only a problem in Harlem; studies in other neighborhoods around the city had similar results.

Last November, Mayor Michael Bloomberg said his Healthy Bodegas Initiative would expand from 200 bodegas to more than 1,000 over the next two years. The initiative targets bodegas in communities that have the highest rates of poverty and diet-related health diseases, working with them to offer more nutritional items.

Since he took office in 2002, Bloomberg has been on a crusade to make New Yorkers healthier. He initiated a ban on trans fat in restaurants, which made New York the first U.S. city to outlaw the harmful manmade ingredient.

Bloomberg, a former smoker who watches his waistline, also outlawed smoking in city bars and restaurants during his first term.