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% of corner stores in Harlem sell leafy green vegetables, compared to 20% 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,” an associate commissioner of the East and Central Harlem District public health office, Dr. Andrew Goodman, said.

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, Mr. 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,” the city’s health commissioner, Thomas Frieden, said.