HEALTH DISPARITIES IN SOUTH

LOS ANGELES

Service Planning Areas 5/6

LaVonna B. Lewis, PhD, MPH

USC School of Policy, Planning, and Development
llewis@usc.edu
 POPULATION BY RACE FOR LOS ANGELES COUNTY
2000 – 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%)
Geographical Boundaries for
Service Planning Areas 5 & 6

Bel
Bel Air
Air
Beverly
Beverly Hills
Hills
Pacific
Pacific Palisades
Palisades
Brentwood
Brentwood
Brentwood
Brentwood
Malibu
Malibu Century
Century City
City
West
West LA
LA
LA
Santa
Santa Monica
Monica Culver
Culver City
City
Los Angeles City
Los Angeles City Limit
Limit
Limit
Mar
Mar Vista
Vista
View
View Park-Winsor
Park-Winsor Hills
Hills
Ladera
Ladera Heights
Heights
Marina del
Marina del Rey
Rey
Florence-Graham
Florence-Graham
Playa
Playa del Los
Westchester
del Rey
Rey Angeles City
Los Angeles City Limit
Limit
Westchester

WillowbrookLynwood
WillowbrookLynwood
West
West Compton
Compton Paramount
Paramount
Compton
Compton
 Health Care Access

ACCESS Los Angeles County SPA 6

Uninsured Percentage 21.8% 31.7%

No Regular Source of 19.8% 26.9%

Care
Difficulty with Access 30.1% 43.9%

No Access to Dental 25.6% 35.1%

Care
for one year
 Population Health Status
Health Condition SPA 6 SPA 5
Overweight Children 25.5 16.2
(BMI >95th
Percentile)
Percent Children 6 13
with Current Asthma
Diabetes 9.2 4.2
Hypertension 25.4 16.7
(%Adults)
Teen Births 85.7 8.4
Infant Mortality 6.5 3.7
Cancer Death 209 150
Rate/100,000
 Health Related Quality of Life
Health Related Los Angeles County SPA 6
Quality of Life
%of Children in Poor 12.7% 17.6%
Health per parents
% of Adults reporting 20.6% 33.4%
fair to poor health
Average # days of 2.4 days 3.3 days
limited activities due
to poor health
Average # of 6.4 days 7.4 days
unhealthy days in the
past month
 Prevention and Health Outcomes
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 86.0% 83.3%

screening in the past 3
years
 Years of Potential Life Lost per 100,000
population per year
Community Heart Disease & Stroke Rank
1-129

LA County overall 1,183 NA

Compton 2,620 129

Florence 1,767 116

Marina del Rey 1,155 67

Santa Monica 749 26

 Major Areas of Health Disparities
 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
 Addressing Areas of Health Disparities
 Los Angeles County Board of Supervisors is working
to open comprehensive care hospital in SPA 6

 Los Angeles County Department of Health Services has

obtained funding for intensive case management
project for diabetic patients in SPA 6

 Community Health Councils (Reach 2010 Project) has

worked on an assessment of Cardiovascular Disease
and Renal Disease health care needs in SPA 6 and an
assessment of nutrition resources in SPA 6
 Social
Determinants
of Health
 Results—Markets

 Improving the Nutritional Resource

Environment for Healthy Living Through
Community-Based Participatory Research
 Journal of General Internal Medicine
 2003:18:568-575
 USC, UCLA, CHC, REACH Coalition
 Number of Persons Per Store

Population African- Percentage Grocery People per

American African Stores Store
Population American

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

 Shopping List Survey
Target Contrast
Area Area
(N = 261) (N = 69) P Value

Chain Store 18.3 46.2 .001

 Shopping List Survey

Target Contrast
Area Area
(N = 261) (N = 69) P Value
Fruit/vegetable 49.4 66.7 .05
sold

Nonfat milk sold 37.9 79.7 .001

Low-fat snacks 42.2 69.6 .001

sold
Eat More Vegetables?
 Conclusion

 Our research supports a growing literature that

argues that African-American communities
have disproportionately been the objects of
increased marketing and advertising for
unhealthy foods while receiving less targeted
marketing for healthier products
 JGIM, 2003
 Results-Restaurants

 African Americans’ Access to Healthy Food

Options in South Los Angeles Restaurants

 American Journal of Public Health

 2005:95:668-673
 USC, UCLA, CHC, AABLH Coalition
 Restaurant Physical Environment Profile in South Los Angeles

Target Area Comparison Area P-value

(n=348) (n=311)
Restaurant type (%)
Fast food restaurants 25.6 11.2 <.001
Restaurant environment (% excellent)
Cleanliness 3.6 21.6 <.001
Customer service 3.9 22.8 <.001
Clear menu 5.5 25.5 <.001
First impressions 3.0 19.6 <.001
Parking 4.9 20.0 <.001
Public transportation 4.6 26.2 <.001
Safety/security 2.7 24.0 <.001
 Conclusion
 Findings from our study indicate that
communities in our target area offered a
nutritional resource environment that makes it
more challenging for residents to eat a healthy
diet.
 AJPH 2005
 Assessments and Action
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
 The Neighborhood Food Watch

 Incentives for Food Retailers

 http://www.crala.org/internet-site/Developm
ent/upload/Market_Opportunities_08.pdf

 Fast Food Interim Control Ordinance

 Ordinance Number 180103