aia los angeles 10 7 11_1
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Building Healthy Communities:
A Public Health Imperative
Paul Simon, MD, MPH
Director, Chronic Disease and Injury Prevention
Los Angeles County Department of Public Health
October 7, 2011
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Trend in Life ExpectancyLos Angeles County, 1991-2007
74
75
76
77
78
79
80
81
82
1991 1993 1995 1997 1999 2001 2003 2005 2007
LifeExpectancyinYe
ars
75.8
80.8
Los Angeles County Department of Public Health
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An Aging PopulationPercentage of U.S. Population over Age 65
Source: From Baby Boom to Elder Boom: Providing Health Care for an Aging PopulationCopyright 1996, Watson Wyatt Worldwide.
0
5
10
15
20
25
1930 1950 1970 1990 2010 2030 2050
Year
Percentage
ofP
opulation
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Prevalence of Chronic Conditions in the U.S.by Age Group, 2004
26%
40%
68%
90%
6%
15%
42%
72%
0%
20%
40%
60%
80%
100%
Ages 0-19 Ages 20-44 Ages 45-64 Ages 65+
Percentofpopulation
1 or more chronic conditions 2 or more chronic conditions
SOURCE: Medical Expenditure Panel Survey, 2004
Anderson, G., Public Health Reports, 2007
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Per Capita Healthcare Spending in the U. S. byNumber of Chronic Conditions, 2004
$994
$2,753
$5,062
$7,381
$10,091
$16,819
$0
$2,000
$4,000
$6,000
$8,000
$10,000
$12,000
$14,000
$16,000
$18,000
0 1 2 3 4 5+
Number of Chronic conditions
A
veragepercapitas
pending
SOURCE: Medical Expenditure Panel Survey, 2004
Anderson, G., Public Health Reports, 2007
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Prevalence of Obesity and Diabetes AmongAdults in Los Angeles County, 1997-2007
14.3%16.7%
18.9%20.9% 22.2%
5.7% 6.7%7.0%
8.1% 8.7%
0%
10%
20%
30%
40%
1997 1999 2002 2005 2007
Year
Prevalence(%)
Obesity Diabetes
Los Angeles County Department of Public Health
Los Angeles County Health SurveyDepartment of Public Health
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Average Weight Among Adults inLos Angeles County, 1997-2007
167.7166.8 lbs
164.5 lbs163.6 lbs160.9 lbs
140
150
160
170
180
1997 1999 2002 2005 2007
Year
Averageweight(
lbs)
The countys adult population gained51 million lbs from 1997-2007.
Los Angeles County Public Health, Office of Health Assessment and EpidemiologySource: Los Angeles County Health Survey
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Prevalence of Hypertension Among Adults inLos Angeles County, 1997-2007
15.8%
19.1%20.1%
23.4%24.7%
0%
10%
20%
30%
40%
1997 1999 2002 2005 2007
Year
Prevalence
(%)
Los Angeles County Department of Public Health
Los Angeles County Health SurveyDepartment of Public Health
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Obesity Prevalence Among School ChildrenLAUSD vs. Rest of L.A. County, 1999-2008
18.9% 19.5%19.8%
20.7% 20.3% 20.4%
22.6%
25.2%26.2% 26.0% 26.3%
15.9%
18.4%20.3%
26.1%24.4%
23.2%
20.2%
0%
5%
10%
15%
20%
25%
30%
35%
1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009
Healthy People 2010 Goal: 5%
LAUSD
LA County(excluding LAUSD)
Source: California Physical Fitness Testing Program, California Department of Education. Includes 5th, 7th, and 9th graders enrolled in
Los Angeles County public schools.
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Cities/Communities with Lowest and HighestChildhood Obesity Prevalence, 2008
*Table excludes cities/communities where number of students with BMI data < 500.Source: California Physical Fitness Testing Program, California Department of Education. Includes 5th, 7th, and 9thgraders enrolled in LA County public schools; 2000 Census
Top 10*
City/Community NameObesity
Prevalence(%)
Rank ofEconomicHardship(1 - 128)
Manhattan Beach 3.4 2
Calabasas 5.0 8
Hermosa Beach 5.1 1
Agoura Hills 5.3 10
Beverly Hills 5.4 19
Malibu 5.9 4
Palos Verdes Estates 7.3 5
San Marino 7.8 15
Rolling Hills Estate 8.4 9
La Canada Flintridge 8.5 18
Average 10 lowest 6.2%
Ave Median Household Income $99,555
Bottom 10*
City/Community NameObesity
Prevalence(%)
Rank ofEconomicHardship(1 - 128)
West Athens 30.6 94
South Gate 30.7 110
Florence-Graham 31.0 128
West Whittier-Los Nietos 31.1 81
West Carson 31.4 56
Vincent 32.2 69
East Los Angeles 32.9 117
Hawaiian Gardens 33.4 107
South El Monte 34.5 111
Walnut Park 38.7 113
Average 10 highest 32.7%
Ave Median Household Income $37,747
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Benefits of Physical Activity
Increased life span and improved function
Reduced hypertension, heart disease, andstroke
Prevention of diabetes and relatedcomplications
Decreased risk of colon cancer
Improved mental health
Body weight maintenance and obesitycontrol
Increased bone mass Improved immune function
Reduced health care costs
Surgeon Generals Report, 1996
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Physical Activity and Health
Dose-ResponseCurve
A=SedentaryB=Moderately Active
C=Active
Bene
fit
Baseline Activity StatusLow High
A B C
Source: Pate et.al., JAMA, 1995
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Community Guide Promoting PA:Summary of Findings
Recommended:
Community-wide info campaigns
Point-of-decision prompts
Individually-adapted health behavior change
School-based physical education
Social support interventions in community settings
Increasing access to places for PA with info outreach activities
Urban planning approaches (zoning and land use)
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traffic safety
air pollution
water quality & quantity
physical activity & diet
obesity & chronic disease
crime & violence
social capital elder health & mobility
mental health
health disparities
Community Design:Multiple Health Impacts
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Los Angeles CountyDepartment of Public Health Initiatives
PLACE Program (Policies for Livable Active
Communities and Environments)
RENEW LA County (Renewing Environments forNutrition, Exercise, and Wellness)
Community transformation grant
(ChooseHealthLA)
Community liaison program
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We shape our buildings
- Winston Churchillwww.theaerialphotographer.com
and thereafter
they shape us.