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Los Angeles CountyHealth Survey
Office of Health Assessment and Epidemiology
Los Angeles County
Department of Health Services
Presented By
Gigi A. Mathew DrPH, CPHQ
Mission of the Office of Health Assessment and Epidemiology
• To ensure the availability of high quality and
comprehensive health data on the Los Angeles
County population and to facilitate its use for
public health assessment, policy development,
program planning and evaluation.
Role of Health Surveys Population health data increasingly used to drive public
health decision-making and community health improvement efforts.
Most local health jurisdictions lack important health data: chronic disease prevalence functional status and other measures of health-related
quality of life health behaviors access to health services
To address gaps in local health data, LA County Department of Health Services inaugurated the Los Angeles County Health Survey in 1997.
Key Analysis Objectives
To obtain reliable population estimates for selected health indicators by various demographics including sex, race/ethnicity (the 4 largest groups), and Service Planning Area (8 regions in the county).
To identify disparities across population sub-groups.
To track temporal trends.
To compare with state and national data and with national health objectives.
Methodology
• Population-based, random-digit-dialed telephone
survey of Los Angeles County residents
• Representative of Adults and Children in Los
Angeles County
• Conducted in 1997; 1999-2000; 2002-2003;
and 2005
Components and Sample Size1997 1999-2000 2002-2003 2005
Adult (n=8,004)
Adult (n=8,354)
Adult
(n=8,167)
Adult
(n= 8,648)
Child (n=2,363)
Child (n=6,016)
Child
(n=5,995)
Child
(n=6,032)
Tobacco Policy (n=519)
Tobacco Policy (n=481)
Elder health (n=1160)
Low-income Survey (n=1898)
8 Sub-samples (n~1,000 each)Bio-terrorism (2)
Tobacco Policy (2)
Health Dept./ Antibiotic Use
Food-borne Illness
Young Children & Families
Alcohol Policy
8 Sub-samples (n~1,000 each)Bio-terrorism (2)
Tobacco Policy (2)
Health Dept./ Antibiotic Use
Food-borne Illness
Young Children & Families
Alcohol Policy
Adult Component Content
Demographic Characteristics Chronic Disease Prevalence
Arthritis Cardiovascular Disease Diabetes Asthma / Chronic Respiratory Condition
Functional Status and Other Measures of Health-Related Quality of Life
Health Status Mental Health
Adult Component Content Health Behaviors
Tobacco Use Alcohol Use Physical Activity Sexual Practices and HIV Testing
Access to Health Services Health Insurance Ease of obtaining medical care Regular Source of Care Barriers to Accessing Health Care
Food Insecurity and Public Aid Assistance Medical Examinations and Vaccinations
Mammogram Colorectal Screening Flu
Child Component Content
• Demographics (child & parent)
• Child Health
• SHCNs, asthma, ETS, parent-perceived health status
• Child Health Insurance & Access to Care
• Status/type, gaps in coverage, difficulty accessing care, RSC, ER
use, LAC-DHS use
• Child Routines
• TV viewing, read to child*, tells stories to child*, play music/sing
songs with child*, bed times*, meal times*
*asked of parents with children aged 0-5 yrs.
Prenatal to Postpartum*
• HIV testing; breastfeeding, hospital practices post partum; infant
sleep position
Parent Behaviors/Risks/Perceptions
• Parental aggravation/stress*, ease of finding someone to talk to
about raising child*, safe park/playground accessible,
neighborhood belonging, cigarette use, mental health risk
Childcare*
• Type(s), difficulty obtaining child care, reasons why no child care
used
Child Component Content
*asked of parents with children aged 0-5 yrs.
Languages of Interviews
Language• English• Spanish• Cantonese• Mandarin• Korean• Vietnamese• Armenian
Child 3521 (59%)2246 (37%)48 (<1%)34 (<1%)
132 (<2%)41 (<1%)10 (<1%)
Adult
6455 (72%)
1802 (23%)
64 (1%)
82 (1%)
189 (3%)
40 (<1%)
16 (<1%)
Service Planning Areas and Health Districts
Antelope Valley
Foothill
San Fernando
West
East Valley
West Valley
Pomona
Harbor
Whitt ier
Torrance
El Monte
Glendale
Long Beach
Central Alhambra
Bellflower
Inglewood
East LASouth-west
SanAntonio
Compton
North-east
Pasadena
South
Hollywood/Wilshire
South-east
SPA 1
SPA 2
SPA 3
SPA 8
SPA 5
SPA 7
SPA 4
SPA 6
Spas2002.shp
SPA 1 - Antelope Valley
SPA 2 - San Fernando
SPA 3 - San Gabriel
SPA 4 - Metro
SPA 5 - West
SPA 6 - South
SPA 7 - East
SPA 8 - South Bay
Service Planning Areas (SPA)
1) Chronic Disease1) Chronic Disease
• DiabetesDiabetes
• ObesityObesity
2) Health Behavior2) Health Behavior
• SmokingSmoking
Data Examples Adult Health
5%
12%
6%
14%
7%6%
8%7%
14%
3%
6%
14%
12%
3%
11%
17%
7%
2%
12%
18%19%
3%
18%18%
0%
10%
20%
30%
Overall 18+ 30-39 40-49 50-59 60-64 65+
1997 1999 2002 2005
Diabetes Trends by Age Groups, Diabetes Trends by Age Groups, 1997-20051997-2005
PrevalencePrevalence†† of Diabetes Among Adults in of Diabetes Among Adults in Los Angeles County, by Race/Ethnicity, 2005Los Angeles County, by Race/Ethnicity, 2005
7.1%
12.2%
11.9%
5.6%
0%
5%
10%
15%
20%
25%
Latino White African-American Asian/PacificIslander
† Age-adjusted to 2000 US population
Prevalence of Diabetes by Body Mass Index‡, 2005
15.6%
7.9%
4.1%
0%
5%
10%
15%
20%
25%
Obese Overweight Normal
‡Weight status is based on Body Mass Index (BMI) calculated from self-reported weight and height.
According to NHLBI clinical guidelines, a BMI < 18.5 is underweight, a BMI > 18.5 and < 25 is normal
weight, a BMI > 25 and < 30 is overweight, and a BMI > 30 is obese. [
25%29%
4%
22%
17%12%
7%
24%
20%
15%
5%
17%
30%
6%
17%
28%
0%
10%
20%
30%
40%
50%
White Latino African American Asian/PacificIslander
1997 1999 2002 2005
Prevalence of Obesity Among Prevalence of Obesity Among Adults (Adults (>>18 years old) by Race/Ethnicity, 18 years old) by Race/Ethnicity,
Los Angeles County, 1997-2005Los Angeles County, 1997-2005
Prevalence of Obesity Among Adults by Prevalence of Obesity Among Adults by Service Planning Area, Los Angeles County, 2005Service Planning Area, Los Angeles County, 2005
27.3%30.0%
14.1%
19.1%
17.0%
24.4%
21.0%20.0%
0%
10%
20%
30%
40%
AntelopeValley
SanFernando
San Gabriel Metro West South East South Bay
LA County20.9%
14.6%15.2%
18.1%18.2% 18.0%19.7%
22.1%22.2%
11.4%11.1%14.2%14.3%
0%
10%
20%
30%
1997 1999 2002 2005
Prevalence of Cigarette Smoking Among Prevalence of Cigarette Smoking Among Adults (Adults (>>18 years old), Los Angeles County, 18 years old), Los Angeles County,
1997-20051997-2005
Male
County
Female
Percent of Male Cigarette Smokers by Race/Ethnicity, Percent of Male Cigarette Smokers by Race/Ethnicity, 1997-20051997-2005
23%22%22%23%
22%22%23%22% 23%21%
18%19%20%
27%
17%17%
0%
10%
20%
30%
40%
Latino White African American Asian/Pacific Islander
1997 1999 2002 2005
Percent of Female Cigarette Smokers by Percent of Female Cigarette Smokers by Race/Ethnicity, 1997-2005Race/Ethnicity, 1997-2005
10%
21%20%
9%
18%
9%
19%
9%7%
20%
15%
7% 8%
23%
14%
7%
0%
10%
20%
30%
40%
Latina White African American Asian/PacificIslander
1997 1999 2002 2005
1)1) Childhood AsthmaChildhood Asthma
2)2) Children with Special Health Care NeedsChildren with Special Health Care Needs
3)3) Breastfeeding Breastfeeding
Data Examples Child Health
Prevalence of Asthma by Child’s Race/Ethnicity Prevalence of Asthma by Child’s Race/Ethnicity ((17 years old), Los Angeles County, 200517 years old), Los Angeles County, 2005
8.3%
18.3%
8.3%7.3%8.8%
0%
5%
10%
15%
20%
25%
LA County Latino White African-American
Asian/PacificIslander
Activity Limitation and Emergency Room Visits by Income, Children with Asthma
(17 years old17 years old), 2005
50%
34%28%
19%
53%
26%
0%
10%
20%
30%
40%
50%
60%
Activity Limitation ER Use
< 100% FPL
100-199% FPL
>200% FPL
Percent of Children (17 years old17 years old) with Special Health Care Needs (SHCNs) by
Race/Ethnicity, 2005
15.8% 14.3%
19.3%22.5%
9.6%
0.0%
25.0%
L.A. County Latino White AfricanAmerican
Asian/PacificIslander
Percent of Children (17 years old17 years old) with Special Health Care Needs (SHCNs) by
Age Group, 2005
15.8%14.3%
19.3%
0.0%
25.0%
0-5 Years 6-11 Years 12-17 Years
Prevalence of Breastfeeding Initiation by Child Race/Ethnicity, 1994-2005
63% 68%
60%
82% 84%79% 78%
83%90%
82%92%
79%
92%91%90%
0%
20%
40%
60%
80%
100%
LA County Latina White African-American
Asian/PacificIslander
1994-1999 1998-2003 2001-2005
Prevalence of Breastfeeding 6 Months or Longer by Child Race/Ethnicity, 1994-2005
40%
50%
27%25%23%
42%50%
36%
62%
51% 49%
41%
61%57% 59%
0%
20%
40%
60%
80%
100%
LA County Latina White African-American
Asian/PacificIslander
1994-1999 1998-2003 2001-2005
Prevalence of Breastfeeding 12 Months or Longer by Child
Race/Ethnicity,1994-2005
17%20% 19%
*6%*11%
19% 18%14%
36%
30%29% 29%
35%33% 35%
0%
10%
20%
30%
40%
50%
LA County Latina White African-American
Asian/Pacific-Islander
1994-1999 1998-2003 2001-2005
* Estimate based on small sample size
Percent of Latina Mothers Who Initiated Breastfeeding and Breastfed at Least 6 Months by Birthplace,
2001-2005
84.1%92.5%
42.4%
63.3%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
100.0%
U.S. born Latinas Non-U.S. born Latinas
Initiated breastfeeding Breastfed at least 6 months
Limitations of Survey
• Self-reported data
• Non-telephone households not included in the sampling frame
• Questionnaire content limited by time constraints
• Does not represent those living in group quarters (e.g. nursing homes and college dormitories)
Users of the Data,Los Angeles County Health Survey
• LAC Department of Health Services
• Governmental organizations (local, county, & state)
• Non-profit health foundations
• Community-based organizations (health centers, hospitals, human services, providers, health-interested organizations)
• Policymakers (advocacy groups)
• Researchers
• Private health care organizations
• Academic health and health policy professionals
Uses of the Data
• LAC-DHS Evaluation and Program Planning
– Ambulatory care planning
– Medi-Cal and Healthy Families outreach and enrollment
targets
– Public health emergency response preparedness
– HIV counseling and testing
• Health services planning (e.g., Kaiser Kids)• Community Health Assessment (e.g., SB 697)• School Readiness Indicators
• Public Education• Advocacy (e.g., food security)• Funding proposals/grant applications
Dissemination of Results
• Health Briefs and Fact Sheets (L.A. Health)
• Comprehensive Reports for county as a whole
(e.g., Health Trends) and 8 Service Planning Areas
(e.g., Key Health Indicators)
• Custom data requests and reports
• On the Web (www.lapublichealth.org/ha)
• Press Releases and Press Conferences
• Presentations
Dissemination of Results
• DHS Newsletters (e.g., The Public’s Health mailed
to 30,000 LA Co. Physicians)
• Reports produced by other organizations
(e.g., Children’s Planning Council, United Way,
First 5 LA)
• Newsletters disseminated by other organizations
(e.g., advocacy groups)
• Peer-reviewed journal publications
For additional information, call the
Office of Health Assessment and Epidemiology
at (213) 240-7785
or
Go to our website:
www.lapublichealth.org/ha
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