Health Disparities in South Los Angeles - LaVonna Lewis
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HEALTH DISPARITIES INHEALTH DISPARITIES INSOUTH LOS ANGELESSOUTH LOS ANGELES
Service Planning Areas 5/6
LaVonna B. Lewis, PhD, MPH
USC School of Policy, Planning, andDevelopment
mailto:[email protected]:[email protected] -
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POPULATION BY RACE FOR LOS ANGELESPOPULATION BY RACE FOR LOS ANGELES
COUNTYCOUNTY
2000 20062000 2006
Race 2000 2006
Asian 1,120,668 (12.1%) 1,270,774 (13.2%)
Black 766,724 (8.3%) 843,479 (8.8%)
Latino 4,310,940 (46.6%) 4,624,005(47.9)%
White 2,966,960 (32.1%) 2,877,851 (29.8%)
Other 61,229 (0.66%) 28,629 (0.3%)
Total 9,246,541 (100.0%) 9,644,738 (100.0%)
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MalibuMalibuMalibuMalibuMalibuMalibuMalibuMalibuMalibu
Pacific PalisadesPacific PalisadesPacific PalisadesPacific PalisadesPacific PalisadesPacific PalisadesPacific PalisadesPacific PalisadesPacific Palisades
West LAWest LAWest LAWest LAWest LAWest LAWest LAWest LAWest LA
BrentwoodBrentwoodBrentwoodBrentwoodBrentwoodBrentwoodBrentwoodBrentwoodBrentwood
Bel AirBel AirBel AirBel AirBel AirBel AirBel AirBel AirBel Air
Marina del ReyMarina del ReyMarina del ReyMarina del ReyMarina del ReyMarina del ReyMarina del ReyMarina del ReyMarina del Rey
Playa del ReyPlaya del ReyPlaya del ReyPlaya del ReyPlaya del ReyPlaya del ReyPlaya del ReyPlaya del ReyPlaya del Rey
Mar VistaMar VistaMar VistaMar VistaMar VistaMar VistaMar VistaMar VistaMar Vista
Santa MonicaSanta MonicaSanta MonicaSanta MonicaSanta MonicaSanta MonicaSanta MonicaSanta MonicaSanta Monica Culver CityCulver CityCulver CityCulver CityCulver CityCulver CityCulver CityCulver CityCulver City
Beverly HillsBeverly HillsBeverly HillsBeverly HillsBeverly HillsBeverly HillsBeverly HillsBeverly HillsBeverly Hills
Century CityCentury CityCentury CityCentury CityCentury CityCentury CityCentury CityCentury CityCentury City
WestchesterWestchesterWestchesterWestchesterWestchesterWestchesterWestchesterWestchesterWestchester
Ladera HeightsLadera HeightsLadera HeightsLadera HeightsLadera HeightsLadera HeightsLadera HeightsLadera HeightsLadera HeightsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor HillsView Park-Winsor Hills
Los Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City Limit
West ComptonWest ComptonWest ComptonWest ComptonWest ComptonWest ComptonWest ComptonWest ComptonWest Compton
Los Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City LimitLos Angeles City Limit
WillowbrookWillowbrookWillowbrookWillowbrookWillowbrookWillowbrookWillowbrookWillowbrookWillowbrook
Florence-GrahamFlorence-GrahamFlorence-GrahamFlorence-GrahamFlorence-GrahamFlorence-GrahamFlorence-GrahamFlorence-GrahamFlorence-Graham
LynwoodLynwoodLynwoodLynwoodLynwoodLynwoodLynwoodLynwoodLynwood
ComptonComptonComptonComptonComptonComptonComptonComptonComptonParamountParamountParamountParamountParamountParamountParamountParamountParamount
Geographical Boundaries forService Planning Areas 5 & 6
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Health Care AccessHealth Care Access
ACCESS Los Angeles County SPA 6
Uninsured Percentage 21.8% 31.7%
No Regular Source ofCare
19.8% 26.9%
Difficulty withAccess
30.1% 43.9%
No Access to DentalCarefor one year
25.6% 35.1%
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Population Health StatusPopulation Health Status
Health Condition SPA 6 SPA 5OverweightChildren(BMI >95thPercentile)
25.5 16.2
Percent Childrenwith CurrentAsthma
6 13
Diabetes 9.2 4.2
Hypertension(%Adults) 25.4 16.7Teen Births 85.7 8.4
Infant Mortality 6.5 3.7
Cancer DeathRate/100,000
209 150
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Health Related Quality ofHealth Related Quality ofLifeLife
Health RelatedQuality of Life
Los Angeles CountySPA 6
%of Children inPoor Health per
parents
12.7% 17.6%
% of Adultsreporting fair to
poor health
20.6%
33.4%
Average # days oflimited activitiesdue to poor health
2.4 days 3.3 days
Average # ofunhealthy days inthe past month
6.4 days
7.4 days
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Prevention and HealthPrevention and HealthOutcomesOutcomes
Cancer Death Rates National SPA 6
Lung 54.1% 46.0%
Breast 25.2% 27.8%
Colorectal 19.1% 23.2%
Cervical 1.3% **
% of Women who
had a screening in thepast 3 years
86.0% 83.3%
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Years of Potential Life Lost perYears of Potential Life Lost per100,000 population per year100,000 population per year
Community Heart Disease &Stroke
Rank1-129
LA County overall 1,183 NA
Compton 2,620 129
Florence 1,767 116
Marina del Rey 1,155 67
Santa Monica 749 26
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Major Areas of HealthMajor Areas of HealthDisparitiesDisparities
Lack of comprehensive health care in SPA 6 Lack of Specialty Care in SPA 6 Inadequate levels of health insurance coverage
among the residents of SPA 6 Lack of Providers who are culturally competent Need for Comprehensive Health Planning
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Addressing Areas of HealthAddressing Areas of HealthDisparitiesDisparities
Los Angeles County Board of Supervisors is working to opencomprehensive care hospital in SPA 6
Los Angeles County Department of Health Services has
obtained funding for intensive case management projectfor diabetic patients in SPA 6
Community Health Councils (Reach 2010 Project) has
worked on an assessment of Cardiovascular Disease andRenal Disease health care needs in SPA 6 and anassessment of nutrition resources in SPA 6
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SocialDeterminants of
Health
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ResultsMarketsResultsMarkets
Improving the Nutritional Resource Environment forHealthy Living Through Community-BasedParticipatory Research
Journal of General Internal Medicine 2003:18:568-575 USC, UCLA, CHC, REACH Coalition
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Number of Persons Per StoreNumber of Persons Per Store
Population African-AmericanPopulation PercentageAfrican AmericanGroceryStores People perStore
United States 281,421,906 36,419,434 13 66,694 4,015
California 33,871,648 2,513,041 7 9,738 3,305
Target areas 679,148 317,894 47 114 5,957
Contrast area 222,019 17,768 8 59 3,763
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Shopping List SurveyShopping List Survey
TargetArea(N = 261)
ContrastArea(N = 69) P Value
Chain Store 18.3 46.2 .001
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Shopping List SurveyShopping List Survey
TargetArea(N = 261)
ContrastArea(N = 69) P Value
Fruit/vegetablesold 49.4 66.7 .05
Nonfat milk sold 37.9 79.7 .001
Low-fat snackssold
42.2 69.6 .001
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Eat More Vegetables?Eat More Vegetables?
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ConclusionConclusion
Our research supports a growing literaturethat argues that African-Americancommunities have disproportionately been
the objects of increased marketing andadvertising for unhealthy foods whilereceiving less targeted marketing forhealthier products
JGIM, 2003
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Results-RestaurantsResults-Restaurants
African Americans Access to Healthy FoodOptions in South Los Angeles Restaurants
American Journal of Public Health 2005:95:668-673 USC, UCLA, CHC, AABLH Coalition
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Restaurant Physical Environment Profile in South LosRestaurant Physical Environment Profile in South LosAngelesAngeles
Target AreaComparison Area P-value
(n=348) (n=311)
Restaurant type (%)
Fast food restaurants 25.6 11.2
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ConclusionConclusion
Findings from our study indicate thatcommunities in our target area offered anutritional resource environment that
makes it more challenging for residents toeat a healthy diet. AJPH 2005
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Assessments of markets, restaurants, and physical activity resources were
conducted in the target and comparison areas
Community organizations and residents collected and presented the data
Differences noted between areas used to mobilize stakeholders
Results were shared with community via multiple methods: Letters
One on one
Community meetings
Hearing participation
Media packages
Journal articles
Assessments and ActionAssessments and Action
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The Neighborhood Food Watch
Incentives for Food Retailers http://www.crala.org/internet-site/Developme
Fast Food Interim Control Ordinance
Ordinance Number 180103
http://www.crala.org/internet-site/Development/upload/Market_Opportunities_08.pdfhttp://sites.google.com/site/seastlancp/07-1658_ord_180103.pdf?attredirects=0http://sites.google.com/site/seastlancp/07-1658_ord_180103.pdf?attredirects=0http://www.crala.org/internet-site/Development/upload/Market_Opportunities_08.pdf