Economy, Environment Linked To Poor Health Trends In LA
The economy and the environment play significant roles in health disparities among residents in Los Angeles County, according to a Los Angeles County Department of Public Health report released today. The Key Indicators of Health report finds that residents of the South and Metro Service Planning Areas (SPAs), the areas of the county with the highest rates of poverty, report the least safe neighborhoods, least access to healthy foods, greatest barriers to medical care, and among the highest rates of disease, injury, and death in the county.
"Again and again we see that unhealthy living conditions place the most vulnerable segments of our population even more at risk," said Jonathan E. Fielding, MD, MPH, Director of Public Health and Health Officer. "This report not only tells us where and what the problems are, but also reiterates the need for policies and programs that make it easier for residents to engage in healthy behaviors, such as physical activity and improved nutrition."
The Key Indicators of Health Report provides a snapshot of the health and well-being of Los Angeles County residents. It allows public health officials to identify health threats, and determine where the county is making progress in improving health. The report breaks down measures of individual and community health according to the county's eight Service Planning Areas, and compares them to national statistics.
The report indicates that the South SPA, the region with the highest rate of poverty in the county, has the highest rate of obesity in adults (35.5%) and children (28.9%), and a 30% higher rate of heart disease deaths than the county average. In comparison, the West SPA, the region with the lowest rate of poverty, has the lowest rate of obesity in adults (10%) and children (16.6%), and a 25% lower rate of heart disease deaths than the county average. Even larger disparities were seen for diabetes - those living in the Antelope Valley and South SPAs were approximately three times more likely to die from diabetes than those living in the West SPA.
"These findings highlight the stark health disparities seen in the county, and the need to not only increase access to medical and social services in underserved communities, but also to work across both public and private sectors to improve the physical, social, and economic environments in which we live," said Dr. Fielding.
Similar patterns were found for measures of the physical and social environments. Only 63% of parents in the South SPA reported having a park, playground, or other safe place for their children to play, compared to 87.5% in the West SPA and 85.3% in the San Gabriel SPA. Only one in three adults countywide reported that the fresh fruits and vegetables where they shop are high quality, with the lowest percentage (27.6%) reported in the South SPA. Nearly 50% of children ate fast food at least once in the past week, with the highest percentage reported in the East SPA (53.7%).
Countywide, the high school graduation rate (defined as the percentage of 9th graders that graduated four years later) was only 58.1%, with the lowest graduation rates in the South and Metro SPAs (35.1% 44.2%, respectively). "Level of education is one of the most powerful predictors of future health," said Dr. Fielding. "Increasing the high school graduation rate represents one of the most important and under-appreciated strategies for improving the health of our population, as well as reducing health care costs and increasing economic productivity."
The report includes several disturbing findings related to early childhood health and development. Just 50.3% of children less than five years of age in the county were read to daily by a parent or family member. This is an important activity that helps prepare young children for success in school. Conversely, over two-thirds of children under age two years watched television every day. The American Academy of Pediatrics advises that children this young should not watch TV at all. More than one in three parents of children less than 5 years of age reported difficulty finding needed child care. Nearly one in five parents reported that they could not easily find someone to talk to when they needed advice about raising their child.
"From the day they are born, children's lives are altered when, instead of daily TV, they have access to books, reading and other literacy activities," said Evelyn V. Martinez, Executive Director of First 5 LA, a child advocacy and grant-making organization. "Facilitating early literacy skills in preschool-aged children is a critical foundation for higher education, good jobs, lower crime rates, and later health. It is a precious inheritance for future generations. And it's achievable."
Other key findings in the report:
* The homicide rate among adolescents and young adults (<35 years old) was nearly 300% higher in the South SPA than the countywide average; the rate was also significantly higher in the South Bay SPA.
* The rate of childhood asthma was highest in the Antelope Valley SPA (9.7%) and the South Bay SPA (9.5%) - this latter region has been disproportionately impacted by air pollution from the Los Angeles and Long Beach ports and related truck and rail traffic.
* The rate of syphilis increased by 36% between 2003 and 2007, with the highest rate seen in the Metro SPA (more than 300 percent higher than the county average).
* Infant mortality in the Antelope Valley SPA was more than 50% higher than in the county overall and was highest among African American babies (18.3 deaths per 1,000 live births).
* The percentage of adults with high blood pressure increased by 60% between 1997 and 2007, with the highest percentage reported in the South SPA (29%).
* The death rate from Alzheimer's disease nearly doubled between 2000 and 2006, with the highest mortality reported in the San Fernando and Antelope Valley SPAs.
* Nearly one-half of adults aged 50 and older in the county have not received a flu vaccination in the past year.
* More than one in five adults in the county does not have health insurance, including one in three in the South SPA.
* Motor vehicle crash mortality in the Antelope Valley SPA was more than double the rate seen countywide.