LOS ANGELES - To commemorate National Public Health Week, the Los Angeles County Department of Public Health released its Key Indicators of Health Report. The report provides a snapshot of health and well being among LA residents through analyses of 78 markers of physical, mental, and social health. The report shows that disparities exist across the region in health status, insurance coverage, access to medical care, and chronic disease mortality.
"Although we are making strides against smoking and getting more people health insurance coverage, the majority of Angelinos are not getting enough exercise, many are not following screening guidelines to help prevent and detect diseases early, and some communities still have difficulty accessing health care services," said Jonathan E. Fielding, MD, MPH, Public Health Director and County Health Officer. "We need to do more at every level of society to address these issues and improve the health of our community."
Data presented in the report were obtained from the 2005 LA County Health Survey and from various Public Health programs. The Department of Public Health uses the key indicators to identify threats to the public's health, to determine areas where the county is making progress in improving health, and to examine health disparities across geographic areas of LA County. Public Health divides the county into Service Planning Areas, or SPAs, to deliver health care services and address the health needs of local communities in the county. In this report, indicators are described for each of the county's SPAs and for the county overall, and are compared with national statistics.
The report shows that from 1997 to 2005 rates of obesity increased from 14% to 21% county-wide. Obesity rates were higher in South and East LA, as were diabetes rates. Contributing to the obesity epidemic, a substantial proportion of adults (37.5%) reported sedentary behavior, with more women than men reporting physical inactivity (42.9% vs. 31.8%). Conversely, more men than women met recommended guidelines for physical activity (57.3% vs. 46.7%).
One factor affecting physical inactivity or sedentary behaviors is the real or perceived lack of safe green spaces for people to exercise or children to play in. As described in the previous report, released in 2004, residents in Central and South LA were more likely to perceive their neighborhoods as unsafe and less likely to have a park or playground that was easily accessible. In South LA, adults reported higher rates of physical inactivity and hypertension, and experienced higher mortality rates due to coronary heart disease and stroke.
Although the percentage of adults and children uninsured declined from 1997 to 2005, disparities still persist. Central and South LA had higher rates of uninsured adults, while more uninsured children resided in South and East LA. Adults in these communities reported more difficulty obtaining access to medical care. Parents in central and South LA were most likely to report difficulty accessing medical care for their children and to describe their children as being in fair or poor health.
The report also shows that access to dental care varies geographically in LA County. Residents in the San Gabriel Valley and the Westside were less likely to report affordability as a barrier to accessing dental care, while residents in Central and South LA were more likely to report affordability as a barrier to accessing dental care among both adults and children.
Improvements in the key indicators of health, and reductions in disparities, will result from action among all sectors of the county. "While public health and medical professionals may lead certain efforts to promote health in Los Angeles, parents, teachers, policy makers, politicians, business, community leaders, and individuals can all play an essential role in improving the county's current state of health," said Paul Simon, MD, MPH, Director of the Chronic Disease and Injury Prevention Program.
"We need to work together to confront our communitys health disparities, particularly the obesity epidemic, and address the broad array of forces that contribute to this dangerous trend," said Fielding. "While doctors counsel their patients about the risks of being overweight and individuals strive to eat healthier and be more physically active, schools can improve access to more nutritious food for students, businesses can allow and encourage employees to engage in physical activity during work hours, and local government can partner with business and communities to build more walkable neighborhoods."
Other significant report findings include:
Cigarette smoking declined among Latinos, Whites, Asian/Pacific Islanders adults while the prevalence of smoking among African Americans increased. Breastfeeding initiation rates meet or exceeded Healthy People 2010 goals. Percent of low-birth weight infants is increasing especially among African Americans. Homicide rate among adolescents and young adults in the county is double the national rate. Respiratory health varied by geographic area. In the Antelope Valley and South LA, more parents reported that their young children are exposed to tobacco smoke at home. South LA, the Antelope Valley, and the South Bay have higher percentages of adult smokers and more people dying of lung cancer. In these areas and East LA, mortality rates from emphysema are also higher. Higher rates of children with asthma were reported in the Antelope Valley and the South Bay. Breast cancer screening rates for women 40 years and older are lower than the national average with women in Central LA less likely than all others to have had a mammogram in the past 2 years. Cervical cancer screening rates fell below the Healthy People 2010 goals but there were no disparities in screening across the county.
The full report can be accessed on the Department of Public Health Web site at http://www.lapublichealth.org/ha. Listed below are the Public Health Service Planning Areas (SPAs) and sampling of cities located in each area:
SPA 1: Antelope Valley (Lancaster, Quartz Hill, Palmdale, Littlerock, Lake Los Angeles) SPA 2: San Fernando Valley (Val Verde, Santa Clarita, Calabasas, Burbank, Glendale, parts of Los Angeles) SPA 3: San Gabriel Valley (Pasadena, Arcadia, Alhambra, El Monte, Azusa, San Dimas, Pomona, Diamond Bar) SPA 4: Metro (West Hollywood, central Los Angeles) SPA 5: West (Malibu, Santa Monica, Beverly Hills, parts of Los Angeles) SPA 6: South (Lynwood, Compton, parts of Los Angeles) SPA 7: East (Vernon, Montebello, Whittier, Downey, Norwalk, Cerritos) SPA 8: South Bay (Hawthorne, Redondo Beach, Carson, Torrance, Rolling Hills, Long Beach, Catalina Islands)
The Department of Public Health is committed to protecting and improving the health of the nearly 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, DPH overseas environmental health, disease control, and community and family health. Public Health comprises more than 4,000 employees and an annual budget exceeding $700 million.