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CommunityHealthNeedsAssessmentPRESENTEDBY:TheMartinLutherKing,Jr.CommunityHospital

June2017

MartinLutherKing,Jr.CommunityHospital|CommunityHealthNeedsAssessment 2

TableofContents

LetterfromOurChiefExecutiveOfficer 3

Introduction 4

CommunityHealthNeedsAssessmentOverview 7

CommunityProfile 11

SocialDeterminantsofHealth 16

OurPhysicalEnvironment 24

AccesstoHealthcareinOurCommunity 29

OurCommunity’sHealthStatusandHealthyBehaviors 43

Conclusions 59

AppendixA:CommunityStakeholderInterviewsCompleted 62

AppendixB:HealthcareResourcesAvailableinOurCommunity 64


LetterfromOurChiefExecutiveOfficer

Welcometoour2017CommunityHealthNeedsAssessment.Thisreportisourfirstneedsassessmentsincethehospitalopenedinmid-2015.Itpaintsapictureofthehealthcarelandscapeinourservicearea,andclearlyidentifiesthehealthcarechallengesimpactingourcommunity.Thesocial,economicandhealthcaredisparitiesacrossourcommunityaredaunting.Closingthegapbetweenthehealthinequitiesoftodayandthehealthequityweaspiretoachievetomorrowistheworkwehaveundertaken.

Wetakeheartintheprogresswearemaking.Thisyearourhospitalwilltreatmorethan80,000patientsinourEmergencyDepartment,makingusamongthebusiestemergencydepartmentsinLosAngelesCounty.Manyofthosewetreathavesufferedforyearswithoutadequateaccesstomedicalcarebecauseofthesevereshortageofphysiciansinourcommunity,andtheycometouswithchronicdiseasesthathavegoneuntreated,orevenundiagnosed,fortoolong.Topreventthesepatientsfrombeingreadmittedtothehospital,andtoprovidethemwithapermanentmedicalhome,wehaveformedanon-profitmedicalgroup.Thephysiciansinthispracticeprovidepost-dischargecaretoourpatientstomanagetheirdiseasesandpreventfurtherhospitalizations.We’reproud—andencouraged—thatthisuniquehospital-physicianpartnershipisalreadywellunderway.

Thefindingsinthiscommunityhealthneedsassessmentaffirmoursenseofurgencyandjoinourcurrentinitiativesininformingnextsteps.

Wewilldevelopanimplementationplanthatidentifiesthecommunityhealthneedswherewecanhavegreatestimpact,anddescribesspecificprogramsandserviceswewillprovidetoaddressthem.

Ourplanbenefitsfromdevelopmentduringatimeinwhichmultipleprojectsarealreadyunderwaytoexpandourreachandservices.Ourboardofdirectorsrecentlyapprovedaleasefordevelopmentofanewmedicalofficebuildingtohouseadditionalphysiciansonourcampus.Weareintheprocessofbuildingoutourfacility’sinfrastructuretoaddanendoscopysuite,spaceforcardiacandinterventionalradiologyprocedures,andasecondCTscanner.

GiventhelargerchallengeofreducinghealthinequitiesinSouthLosAngeles,thesemayseemlikesmallsteps.Nonetheless,theyareleavingpermanentfootprintsonourlandscape.Witheverypatientwetreat,weshowourcompassion,ourcommitmenttoequity,andourfaithinourmissionandvision.MartinLutherKing,Jr.oncesaid,“Humanprogressisneitherautomaticnorinevitable…Everysteptowardthegoalofjusticerequiressacrifice,suffering,andstruggle;thetirelessexertionsandpassionateconcernofdedicatedindividuals.”

Welookforwardtoournextsteps,takeninpartnershipwithmanyothers,onbehalfofhealthinSouthLosAngeles.

Dr.ElaineBatchlor,ChiefExecutiveOfficer


Introduction

ThenewMartinLutherKing,Jr.CommunityHospital(“MLKCH”orthe“Hospital”)openedinMay,2015asastate-of-the-art,131-bedacutecarehospitallocatedontheMartinLutherKing,Jr.MedicalCampus.WeservetheSouthLosAngelescommunityresidinginServicePlanningArea(“SPA”)61byprovidinginpatientgeneralacutecareservices,basicemergencyservices(24hours),andhealtheducationandoutreachservicestypicalofacommunityhospital.SPA6ishometoLosAngelesCounty’s(the“County”)mostvulnerablepopulation,withpovertyrates,unemployment,andmetricsofpoorhealthallexceedinganyotherregionoftheCounty.Thisunderservedpopulationof1.3millionindividualsis93%HispanicorAfricanAmerican,and45,000aredual-eligibleforbothMedi-CalandMedicareandhavesomeofthemostcomplexandcostlyhealthcareneedsinallofourcommunity.2ThisareahassomeoftheworsthealthoutcomesinLosAngeles,withstrokeandcoronaryheartdiseasemortalityrates30percenthigherthantheCountyoverall.WithsignificantproportionsofSPA6designatedasahealthprovidershortagearea,amedicallyunderservedareaorboth,residentsstruggletoaccessandreceiveessentialpreventive,primary,andspecialtycareservices,andutilizeEmergencyDepartments("ED")inplaceofthesecriticalservicesbecauseaccessissolimited.Further,educationopportunitiesandaccesstohealthy,affordablefood,qualityhousing,andgreenspaceisscarce.

TheHospital’shistoryinSouthLosAngelesisrelevanttoourcurrentimpact.Thefirsthospital,MLK-Harbor,openedin1972,andemergedoutoftheWattsRiots.ItwasanimportantandtangibleresponsetotheMcConeCommissionreport,whichcitedlackofadequatemedicalfacilitiesamongthecausesofthecivilunrest.In2007,afteralong-standinghistoryofqualityandoperationalchallenges,MLK-Harborlostitsaccreditationandclosed,leavingthesurroundingcommunitiesonceagainwithoutaccesstocriticalmedicalandsurgicalcare.

In2009LosAngelesCounty,theUniversityofCalifornia,andthestateofCaliforniacametogethertoformapublic-partnership—thefirstofitskindinthestate—toopenanew,privatehospitaltoserveasasafetynetproviderinSouthLosAngeles.WithLosAngelesCountybuildingthefacility,andtheUniversityofCaliforniaensuringmedicalqualitythroughsupportinrecruitingexperiencedphysicians,aprivatenonprofitcorporation,theMartinLutherKing,Jr.-LosAngelesHealthcareCorporation(“MLK-LA”)wasformed.

Sinceitsopeninginmid-2015,MLKCHhasmaintainedalong-termvisionofensuringalasting,coordinatedsolutionforservingahistoricallyunderservedanddistressedarea,andimprovingtheoverallhealthofthispopulation.

1DefinedbytheCountyofLosAngelesPublicHealthDepartmentasthecommunitiesofAthens,Compton,Crenshaw,Florence,HydePark,Lynwood,Paramount,andWatts.http://publichealth.lacounty.gov/chs/SPA6/index.htm

2DualeligibledefinedbytheHenryJ.KaiserFamilyFoundation.http://www.kff.org/tag/dual-eligible/


HospitalexecutiveandvolunteerleadershiphavedevelopedMLKCHasaleadingmodelofcommunityhealthcare,usingtechnology,dataandinnovationtoachievethisvisionofimprovingourcommunity’shealth.

Definition:HealthEquityistheattainmentofthehighestlevelofhealthforallpeople.(HealthyPeople2020)

Recognizingthateconomicopportunities,environmentalfactors,andsocialnetworksarekeydeterminantsofhealth,MLKCHisfocusedonreachingbeyondthewallsoftheHospitaltofilltheentirecontinuumofcareneededtoimprovepopulationhealth.ThisCommunityHealthNeedsAssessment(“CHNA”)ReportisourfirstreportsinceMLKCHopenedinmid-2015,andweareproud

OurMissionToprovidecompassionate,

collaborativequalitycareandimprovethehealthofour

community.

OurCoreVaues:•Caring•Collaboration•Accountability•Respect•Excellence

OurVisionTobealeadingmodel

forinnovative,collaborativecommunity

healthcare.


topresentourassessmenttoyou.Thisanalysiswillserveasthecriticalfoundationtobuildhealthequitywithourcommunitypartnersinanareathathasbeenfacedwithhealthinequityanddeservingforsolong.Wefirmlybelievethateveryonedeservesafairchancetoleadahealthylife,andnobodyshouldbedeniedthischancebecauseofwhotheyare,wheretheylive,ortheirsocioeconomicstatus.

“Formanyyears,whentheoldKingDrewMedicalCenterwasclosed,therewasnoaccesstoanearbyhospital.Ifsomeonehadanemergency,theyhadtogotoSt.FrancisorLongBeach.Peopleoftendidnothavetransportationoranymeanstogettohospitalsanddoctors.ThischangedwiththeopeningofMLKCH.Thereisalotofinterestingettinghealthcare,andtheMLKcampushasreallybloomedwithawealthofopportunitiesforourcommunity.”

—CommunityMember


CommunityHealthNeedsAssessmentOverview

OverviewTheCHNAbringstogetherpartnerstoidentifyandprioritizehealthneedsintheSPA6community.WhileitiswidelyknownthatmanyoftheleadingcausesofdeathintheUnitedStates(e.g.,heartdisease)arecausedbypreventablefactorssuchaspoordietandphysicalinactivity,thereisgrowingawarenessoftheimportantlinkbetweenhowcommunitiesarestructuredandtheopportunitiesforpeopletoleadsafe,active,andhealthylifestyles.TheCHNAisconductedtonotonlytofulfilltherequirementofCalifornia’sCommunityBenefitLegislation(SB697),butalsoinresponsetotheHospital’smissionofprovidingcompassionate,collaborativequalitycareandimprovingthehealthofourcommunity.TheCHNAalsomeetstherequirementsofthePatientProtectionandAffordableCareActof2010(H.R.3590)fornot-for-profithospitals.

TheCHNAprocessidentifiestophealthneeds,includingsocialdeterminantsofhealth,inthecommunity,andanalyzesabroadrangeofsocial,economic,environmental,behavioral,andclinicalcarefactorsthatmayactascontributingfactorsforeachhealthneed.Inordertoidentifyhealthneeds,thisCHNAreviewedquantitativedataavailablefromnational,state,andlocalresourcestobetterunderstandoverallhealthinourcommunity.Thesedataelementswerecomparedagainstbenchmarkdata,suchascountyandstatewidedata,andHealthyPeople2020objectives,whenavailable.Inaddition,primaryissuesthatimpactthehealthofthecommunity,aswellasexistingresourcesandnewideastoaddressthoseneeds,werecollectedfromlocalstakeholders,includingpublichealthexpertsandrepresentativesofmedicallyunderserved,low-incomeandminoritypopulations.


ConsultantsTheCHNAincludesacomprehensivequantitativeandqualitativeassessmentofthecriticalfactorsthataffectoverallhealthandwellnessinourcommunity.Theseassessmentswereconductedbythefollowingconsultants:

• Premier,Inc.,anationallyrecognizedhealthcareconsultingorganizationthatspecializesinadvisoryservicesandidentifyingcommunityneedsforunderservedpopulations

• BielConsulting,Inc.,anindependentconsultingfirmthatworkswithhospitals,clinicsandcommunity-basednonprofitorganizations

QuantitativeDataDataonkeyhealthindicators,morbidity,mortality,healthcareaccess,communitydemographics,andvarioussocialandeconomicdeterminantsofhealthwerecollected.Sourcesofdatainclude:CaliforniaDepartmentofEducation,CaliforniaDepartmentofPublicHealth,CaliforniaEmploymentDevelopmentDepartment,CaliforniaHealthInterviewSurvey,CountyHealthRankings,LosAngelesCountyDepartmentofPublicHealth,LosAngelesHomelessServicesAuthority,U.S.CensusAmericanCommunitySurvey,UniformDataSystem,andothervariouslocal,stateandfederaldatabases.Analyseswereconductedatthemostlocallevelpossiblefortheservicearea,andarecomparedtoLosAngelesCountyandthestateofCalifornia,framingthescopeofanissueasitrelatestothebroadercommunity.

QualitativeDataInputwasobtainedfromcommunitymembersandleaderswhorepresentthebroadinterestsofSPA6throughkeyinformantinterviews.Intervieweesincludedpublichealthexperts;representativesofmedicallyunderserved,low-income,andminoritypopulations;localhealthcareproviders;andlocalhealthandotherdepartmentsoragenciesthathavecurrentdatarelevanttothehealthneedsofthecommunityservedbyMLKCH.Duringtheinterviewsparticipantswereaskedtoidentifymajorhealthissuesinthecommunity,andsocioeconomic,behavioral,environmentalorclinicalfactorscontributingtopoorhealth.Intervieweessharedtheirperspectivesontheseissues,identifiedchallengesandbarrierstoimprovingcommunityhealth,anddiscussedpotentialresourcestoaddressthesehealthneeds.Atotalof28informantinterviewswereconductedforthisneedsassessment.Foracompletelistofindividualswhoprovidedinputviathestakeholderinterviews,pleaserefertoAppendixA.Additionally,MLKCHhostedaCommunityConveningtodiscusshealthcareinequityanddisparitiesinourcommunity,andobtaininputonhowtoaddressthesechallenges.


DataLimitationsandInformationGapsAnumberofdatasources,includingnational,state,county,andlocalresourceswereexaminedaspartofthisCHNA.Onelimitationofthisstudyisthatsomedatasourceswerenotavailableforgeographicboundariesattheselocalizedlevels(e.g.,SPA).Additionally,datawasnotalwayscollectedonanannualbasis,meaningthatsomedataestimatesareseveralyearsold.Inconsiderationoftheselimitations,theprocessofidentifyinghealthneedswasbasedonboththequantitativeandqualitativeanalyses.

Thekeyinformantswerenotchosenbasedonrandomsamplingtechnique,butwereinsteadinvitedbecausetheircommentsrepresentedtheunderserved,lowincome,minority,andchronicallyillpopulations.Thus,themesidentifiedduringtheinterviewswerelikelysubjecttotheexperienceofindividualsselectedtoprovideinput,andMLKCHsoughttoreceiveinputfromarobustanddiversegroupofstakeholderstominimizethisbias.

MethodologyReviewofQuantitativeandQualitativeDataPreliminaryhealthneedswereidentifiedbaseduponareviewofpublishedquantitativehealthstatusdataspecifictoourcommunity.Ourassessmentincludedconsiderationoftherelativesizeoftheissue(e.g.,theportionofourcommunityafflictedbythisissue),andtheoverallseriousnessoftheissue(e.g.,impactatindividual,family,andcommunitylevels).

• Todeterminethesizeandseriousnessoftheissue,healthneedindicatorsidentifiedinthequantitativedatawerecomparedtobenchmarkdata(e.g.,LosAngelesCounty,Californiaoverall,HealthyPeople2020Targets).Healthneedswereidentifiedwhenourcommunitydemonstratedoutcomesthatdidnotachieveorexceedthesebenchmarks.

Intervieweeswereaskedtoprovideinputontheidentifiedhealthneeds(quantitativeanalyses),andsharetheirperspectivesontheseissues.Thestakeholderinterviewsweredesignedtovalidateourquantitativefindings,identifyadditionalcommunityissues,solicitinformationondisparitiesamongsubpopulations,ascertaincommunityassetstoaddressneeds,andidentifypotentialgapsinresourcesavailabletoday.

ResourcestoAddressSignificantNeedsPotentialcommunityresourcestoaddresshealthcaredisparitieswereidentifiedthroughmarketresearch,andinputreceivedfromkeystakeholdersduringinterviews.AcomprehensivelistingoftheseresourcesisprovidedinAppendixB.


ImpactEvaluationThisisthefirstcommunityhealthneedsanalysisthatwehavecompletedsinceMLKCHopenedinmid-2015.Becausethisisourfirstreport,wehavenotbeenabletoevaluateourimpactbasedonpastactions.


CommunityProfile

ServiceAreaOverviewMLKCH’sserviceareaisdefinedasthegeographicregionconsistingofServicePlanningArea(“SPA”)6,aswellasthoseZIPCodeslocatedwithinathree-mileradiusfromtheHospital.ThemapandtableprovidedbelowidentifyeachofthecommunitiesincludedintheHospital’sservicearea.

Source:MartinLutherKing,Jr.CommunityHospital

PopulationThetotalpopulationwithintheMLKCHserviceareaisestimatedtobe1,314,330.ThemajorityoftheservicearearesidentsliveinLosAngeles(60.6%),withtheremaining39.4%livinginComptonandsurroundingcommunities.


EstimatedPopulation,CY2014

CommunityName ZIPCode Population PercentofTotal

Carson 90746 26,738 2.0%Compton 90220 50,222 3.8%Compton 90221 53,657 4.1%Compton 90222 32,362 2.5%Gardena 90247 47,374 3.6%Gardena 90248 9,936 0.8%HuntingtonPark 90255 76,206 5.8%LosAngeles 90001 56,314 4.3%LosAngeles 90002 50,098 3.8%LosAngeles 90003 66,913 5.1%LosAngeles 90007 43,779 3.3%LosAngeles 90008 33,012 2.5%LosAngeles 90011 102,926 7.8%LosAngeles 90016 47,786 3.6%LosAngeles 90018 48,852 3.7%LosAngeles 90037 61,536 4.7%LosAngeles 90043 43,118 3.3%LosAngeles 90044 88,412 6.7%LosAngeles 90047 46,999 3.6%LosAngeles 90059 42,470 3.2%LosAngeles 90061 28,641 2.2%LosAngeles 90062 32,675 2.5%LosAngeles 90089 3,326 0.3%Lynwood 90262 70,650 5.4%Paramount 90723 54,813 4.2%SouthGate 90280 95,515 7.3%MLKCHServiceArea 1,314,330 100.0%LosAngelesCounty 9,974,203 Source:U.S.CensusBureau,AmericanCommunitySurvey,2010-2014,DP05.http://factfinder.census.gov


AgeandGenderDistributionAgeandgenderdistributionarecriticalcomponentsofunderstandingourcommunity’sprofileandprovideelementsinplanningforneededhealthservices.Youngerpopulationsrequiremorepreventionandhealtheducationwhileolderpopulationsarepronetocertainchronicdiseasesandrequirehealthservicesinhigheracuitysettings.SpecifictoMLKCH’sservicearea:

• 48.2%oftheservicearea’spopulationismale,and51.8%isfemale.

• WhiletheserviceareapopulationisrelativelyyoungercomparedtothatoftheCounty(30.6yearsversus35.3years),29.9percentofthecommunityis45yearsofageorgreater.Asthepopulationages,thecommunitywilllikelycontinuetoexperienceanincreaseddemandforservicessuchasinternalmedicine,cardiovascularservices,endocrinology,gastroenterology,neurosciences,oncology,orthopedics,ophthalmology,physicalmedicineandrehabilitation,pulmonarymedicine,rheumatology,andurology,andwilllikelyhavegreaterneedsforchronicdiseasemanagement.

• Theagecohort15to44yearsoverallrepresents46.4%oftheservicearea’soverallpopulation.Thistrendimpliesthatthedemandforelectivesub-specialtycareandobstetricsandgynecologywillcontinueinMLKCH’sservicearea.

• Thepopulationagecohort0to14yearsrepresents23.7%ofthetotalserviceareapopulation,therebyimplyingthatdemandforpediatricswillcontinuetoexistinthecommunity.

Ethnicity Overall,MLKCH’sserviceareaisprimarilyHispanic/Latino(68.8%);23.9%isAfricanAmerican;2.9%oftheresidentsareAsian;2.7%areWhite;andNativeHawaiian/PacificIslander,AmericanIndian/AlaskanNative,andotherraceormultiplerace/ethnicitycombinedrepresent1.7%oftheserviceareapopulation.

EthnicCohort MLKCHServiceArea LosAngelesCounty

Hispanic/Latino 68.8% 48.1%

AfricanAmerican 23.9% 8.0%

Asian 2.9% 13.8%

White 2.7% 27.2%

Other/Multiple 1.4% 2.4%

NativeHawaiian/PacificIslander 0.2% 0.2%

AmericanIndian/AlaskaNative 0.1% 0.2%Source:U.S.CensusBureau,AmericanCommunitySurvey,2010-2014,DP05.http://factfinder.census.gov


DespitethefactthattheHispanic/Latinopopulationrepresentstheservicearea’slargestethniccohort,researchpublishedbyUSCDornsifeCenterfortheStudyofImmigrantIntegrationindicatesthatthispopulationtendstoresideontheeasternportionofMLKCH’sservicearea.Conversely,theAfricanAmericanpopulationtendstoresideonthewesternportionofthisgeographicregion.Basedonthisresearch,ahigherdensityofAfricanAmericanresideincommunitiesthatdirectlysurroundMLKCH,versusHispanics/Latinoswhotendtoliveontheeasternportionofourservicearea.

Source:Pastor,ManuelandPamelaStephens.Roots|Raíces:SharedFuturesinSouthLosAngeles.USCDornsifeCenterfortheStudyofImmigrantIntegration.April6,2017.

TheeasternportionofourserviceareaoverlapswithSt.FrancisMedicalCenter,areligiousnon-profithospitalthathastraditionallyservedlow-incomeresidents,whileCentinelaHospitalMedicalCenter,afor-profitfacility,servesmostlycommerciallyinsuredpatientsresidinginthewesternportionofthisarea.

LanguageAccessandutilizationofhealthcareserviceshavebeenshowntobeaffectedbyaperson’sprimarylanguage.Thoseunabletocommunicatewithphysiciansorhealthcareprovidersintheirlanguageofchoicearelesslikelytoseekprimarypreventativecare,havefollowupvisits,andadheretohealthcaretreatmentplans.Withinourservicearea,nearlyhalfofthecommunityhasidentifiedSpanishastheirprimarylanguage.

“OurresidentshavelowEnglishproficiencyandlowhealthliteracy.”

—CommunityMember


Language Used Most Often at Home

LanguageCohort SPA6 LosAngelesCounty

PercentofAdultsWhoMostlySpeakEnglishatHome 49.7% 62.9%

PercentofAdultsWhoMostlySpeakSpanishatHome 48.8% 26.6%

PercentofAdultsWhoMostlySpeakanAsianLanguageatHome 1.2% 8.5%

PercentofAdultsWhoMostlySpeakSomeOtherLanguageatHome - 2.0%

Source:“KeyIndicatorsofHealthbyServicePlanningArea.”LosAngelesCountyDepartmentofPublicHealth.January2017.

Basedonthisdata,itisimportantthatourhealthcareprovidersofferwrittenmedicalinformationindifferentlanguages,includingSpanish,toensurethatpatientscanreadandunderstandhealthcareinformationthatiscentraltoimprovingtheirhealth(e.g.,dischargeinstructions,treatmentplans).


SocialDeterminantsofHealth

OverviewTheWorldHealthOrganizationdefinesthesocialdeterminantsofhealthas“theconditionsinwhichpeopleareborn,grow,work,live,andage,andthewidersetofforcesandsystemsshapingtheconditionsofdailylife.”GiventhediversityandcomplexchallengesfacedbyresidentsofSPA6,itiscriticalthatweobtainadeepunderstandingoftheconditionsandcircumstancesthataffectthementalandphysicalhealthofourcommunity.BasedupontheCountyHealthRankings2017Report,LosAngelesCountywasranked30thof57countiesacrosstheStatebaseduponthefollowingsocialandeconomicfactors:

• Communitysafety

• Education

• Employment

• Familyandsocialsupport

• Income

Socialandeconomicfactorsarethelargestsinglepredictorofhealthoutcomes,andalsostronglyinfluencehealthybehaviors.Thelowerthesocialandeconomicpositionofapopulationorcommunity,themorecommonareunhealthybehaviorsandthemoredifficultitistopracticehealthyones.Assuch,theindicatorsdescribedonthefollowingpagesdescribethechallengesourcommunityfacesonadailybasis,andtheimpactthesefactorshaveonhealthstatus.Thiswillhelpusdetermineappropriateinterventionsforelevatingthehealthstatusofourcommunitiesandpopulation.

Income,Poverty,andUnemploymentWithinourservicearea,themedianandaveragehouseholdincomesarelowerthanthatoftheCounty.Additionally,ourcommunityhasahigherrateofpovertywhencomparedtoLosAngelesandtheStateoverall,withalmostathird(30.3%)ofthepopulationatorbelow100%ofthefederalpovertylevel(18.4%and16.4%forLosAngelesCountyandCalifornia,respectively).Further,eachofthecitiesthatcompriseourserviceareahaveunemploymentratesthatexceedthatfortheCountyandStateoverall.Thesetrendsareindicativeofapopulationthatmaybeuninsuredorunderinsured,maynotalwaysreceiveadequatepreventativehealthcare,aswellashigherratesofemergencydepartment(“ED”)utilization.


“Peopleinourcommunityarejusttryingtosurvive.Peoplearelivinginpovertyandtryingtokeeparoofovertheirheadandfoodonthetable,somaintaininggoodhealthmaynotalwaysbeapriority.Sometimes,theylackthewillandenergytogetupandseekthehelptheyneed.”

—CommunityMember

HouseholdIncome

Indicator MLKCHServiceArea LosAngelesCounty

MedianHouseholdIncome $36,777 $55,870

AverageHouseholdIncome $48,260 $82,109Source:U.S.CensusBureau,AmericanCommunitySurvey,2010-2014,DP03.http://factfinder.census.gov

PovertyLevel

Indicator MLKCHServiceArea LosAngelesCounty California

<100%FPL 30.3% 18.4% 16.4%

<200%FPL 61.5% 40.9% 36.4%Source:U.S.CensusBureau,AmericanCommunitySurvey,2010-2014,S1701.http://factfinder.census.gov

UnemploymentRate,2015Average

Source:CaliforniaEmploymentDevelopmentDepartment,LaborMarketInformation,2015;Unemploymentdataisnottrackedinallserviceareacities.www.labormarketinfo.edd.ca.gov/data/labor-force-and-unemployment-for-cities-and-census-areas.html

GeographicArea Percent

Carson 8.6%

Compton 10.4%

Gardena 6.7%

HuntingtonPark 8.8%

LosAngeles 7.1%

Lynwood 8.3%

Paramount 7.9%

SouthGate 8.8%

LosAngelesCounty 6.7%

California 6.2%


“Povertyandaccesstojobsarehugeissuesbecauseanythingthatincreasesstresslevelsonanalreadystressedcommunitymakesahugeimpact.”

—CommunityMember

MLKCHhashadapositiveimpactonourcommunity’ssocioeconomicstatus.SinceMLKCHopened,theHospitalhascreatedover1,200jobsdirectly,ofwhichmanyarefilledbyourownlocalresidents.Additionally,aneconomicimpactstudyestimatedthatalmost600morenewjobswereaddedinthecommunity(externaltoMLKCH)asadirectresultoftheHospitalopening.Thesepositionsincludevendors,suppliers,andotherprofessionalservicesthatarenecessarytoassureefficient,highqualitycareatourHospital.

PublicProgramParticipationAhighproportionoftheSPA6communityqualifiesforpublicassistanceprogramsandincomeassistancewhencomparedtoLosAngelesCountyandtheStateoverall.Thesetrendsaredirectlyrelatedtothedisproportionatelyhigherunemploymentandpovertyrates,andlowerhouseholdincomes,foundinourcommunity.Specifically:

• 46.1%ofSPA6residentswithincomesbelow200%oftheFPLindicatedthattheycouldnotaffordfood,and26.6%utilizefoodstamps

• 67.1%ofchildrenwhoresideinSPA6receiveWomen,InfantsandChildren(“WIC”)benefits

• 8.2%ofadultsarecurrentlyreceivingSupplementalSecurityIncome(“SSI”),and16%areTANF/CalWorksrecipients

PublicProgramParticipation

Indicator SPA6 LosAngelesCounty California

NotAbletoAffordFood(<200%FPL) 46.1% 39.5% 41.7%

FoodStampRecipients(<300%FPL) 26.6% 18.7% 18.1%WIC(Women,InfantsandChildren)UsageAmongChildren,6Years&Under 67.1% 50.8% 44.6%

CurrentlyreceivingSupplementalSecurityIncome(SSI) 8.2% 7.0% 6.1%

TANF/CalWorksRecipients 16.0% 7.4% 7.1%Source:CaliforniaHealthInterviewSurvey,2012-2015.http://ask.chis.ucla.edu/


FreeorReducedPriceMealsWithineachofthefourpublicschooldistrictsthatservemostofourservicearea,overthree-quartersofthestudentpopulationiseligibleforthefreeorreducedpricemealprogram,indicatingahighleveloflow-incomefamilies.TheseratesarefarhigherthanthosereportedforLosAngelesCountyandCaliforniaoverall.

FreeorReducedPriceMealsEligibility

SchoolDistrict PercentEligibleStudents

ComptonUnifiedSchoolDistrict 75.1%

LosAngelesUnifiedSchoolDistrict 75.6%

LynwoodUnifiedSchoolDistrict 96.3%

ParamountUnifiedSchoolDistrict 92.9%


California 58.6%Source:CaliforniaDepartmentofEducation,2014-2015.http://data1.cde.ca.gov/dataquest/

EducationalAttainmentEducationisanimportantdeterminantofhealthstatusbecauseitinfluencesaperson’sabilitytoaccessandunderstandhealthinformation.42.2%ofourcommunity’sresidentsage25yearsorolderdonothaveahighschooldiploma,comparedto23.2%forLosAngelesCountyoverall.Further,only7.2%ofarearesidentshaveearnedabachelor’sdegree.Thesetrendsareindicativeofapopulationwithhigherratesofilliteracywhomaynotbehelpedbywrittenmaterialstypicallyprovidedbyhealthcareprofessionals.CombinedwiththefactthatnearlyhalfofourcommunityspeaksSpanishonly,itiscriticalthatweidentifyalternativewaystocommunicatewithourpatientstoensuretheyunderstandtheirhealthcareissuesandtreatmentplans,andassurebetterhealthoutcomes.


EducationalAttainmentofAdults,25YearsandOlder

DegreeofEducation MLKCHServiceArea LosAngelesCounty

Lessthan9thGrade 26.0% 13.6%

SomeHighSchool,NoDiploma 16.2% 9.6%

HighSchoolGraduate 24.5% 20.5%

SomeCollege,NoDegree 18.1% 19.5%

AssociateDegree 4.9% 6.8%

BachelorDegree 7.2% 19.5%

GraduateorProfessionalDegree 3.0% 10.4%Source:U.S.CensusBureau,AmericanCommunitySurvey,2010-2014,DP02.http://factfinder.census.gov

PublicTransportation15.4%ofourcommunity’shouseholdslackamotorvehicle,andnearly12%ofourresidentsage16yearsandolderrelyonpublictransportationtocommutetowork.ThisisalmostdoubletheaverageforLosAngelesCountyoverall,andfarexceedsstateandnationaltrends.Thisimpliesthatourcommunity,withlimitedtransportation,doesnotalwayshavetheresourcesavailabletoseekimmediatemedicalcarewhennecessary,andourresidentslikelyrelyonmultipletransportationresourceswhentheydoreceivetreatment.

“Transportationinthecommunityisquiteachallenge.IfIhadtothinkabouthowIgettoahospitalandhowtousepublictransportationandthetraffic,itisachallenge.”

—CommunityMember

GeographicAreaPercentofPopulationUsing

PublicTransitforCommutetoWork

PercentageofHouseholdswithNoMotorVehicle

MLKCHServiceArea 11.8% 15.4%

LosAngelesCounty 6.8% 9.7%

California 5.2% 7.8%

UnitedStates 5.1% 9.1%Sources:USCensusBureau,AmericanCommunitySurvey.2011-2015;CommunityCommons,www.communitycommons.org.


HomelessnessThehomelesspopulationoftenreliesonemergencyrooms,clinics,andhospitalswhentheyareabletoobtainhealthcareservices.Homelessindividualsaremoresusceptibletocertaindiseases,havegreaterdifficultygettinghealthcare,andarehardertotreat–allbecausetheydon’thaveastableplacetolive.AccordingtotheLosAngelesHomelessServicesAuthority(“LAHSA”),thenumberofhomelessindividualswhowereidentifiedinourserviceareaincreasedby6.6%betweencalendaryears2013and2015,with76.1%ofthispopulationunsheltered.Further,thenumberofhomelessindividualswithphysicaldisabilitiesand/ordomesticviolenceencountersincreasedduringthistimeperiod.Thesetrendsareindicativeofindividualswhodonotreceivemedicalcarewhenneededorareseverelyundertreated,anddonothaveasafeplacetogotoupondischargewhentheydoreceivemedicaltreatment,therebymakingitverydifficulttostabilizetheirmedicalproblemsandimprovetheirhealth.

“Povertyisahugeissue.Wehavemanypeoplelivinginpovertyandhighnumbersofhomeless.”

—CommunityMember

HomelessPopulation,2013-2015HomelessCountComparison

HomelessCohortSPA6 LosAngelesCounty

2013 2015 2013 2015

TotalHomeless 7,045 7,513 39,463 44,359

Sheltered 33.9% 23.9% 36.3% 30.1%

Unsheltered 66.1% 76.1% 63.7% 69.9%

IndividualAdults 77.4% 77.5% 78.9% 81.1%

FamilyMembers 21.5% 21.2% 18.8% 18.2%

UnaccompaniedMinors(<18) 1.1% 1.3% 2.3% <1%Source:LosAngelesHomelessServiceAuthority,2013&2015GreaterLosAngelesHomelessCount.www.lahsa.org/homeless-count/results


HomelessnessSubpopulations

HomelessSubpopulationSPA6 LosAngelesCounty

2013 2015 2013 2015

ChronicallyHomeless 25.9% 29.3% 24.5% 34.4%

SubstanceAbuse 30.6% 17.1% 31.2% 25.2%

MentalIllness 26.9% 25.2% 28.0% 29.8%

Veterans 10.7% 6.3% 11.3% 9.8%

DomesticViolenceExperience 8.4% 16.6% 1.0% 21.4%

PhysicalDisability 16.8% 17.9% 8.9% 19.8%

PersonswithHIV/AIDS 0.9% 1.3% 0.6% 0.2%Source:LosAngelesHomelessServiceAuthority,2013&2015GreaterLosAngelesHomelessCount.www.lahsa.org/homelesscount_results

CrimeandViolence

“Therehavebeenalotofgangshereformultiplegenerationssothereisalotofviolentcrimeanddrive-byshootings.Residentsliveinastateofconstantstress,PTSD,manypeoplehaveexperiencedthemurderofalovedone.”

—CommunityMember

WithinSPA6,only40.3%ofadultsperceivetheirneighborhoodstobesafe,thelowestperceivedneighborhoodsafetyofallServicePlanningAreasinLosAngelesCounty(84.0%forLosAngelesCountyoverall).Additionally,portionsoftheserviceareaalsohavehigherratesofpropertyandviolentcrimerateswhencomparedtotheCountyandStateoverall.Highratesofpropertyandviolentcrimesinacommunitycompromiseindividuals’physicalsafety,aredetrimentaltooverallmentalhealth,anddeterresidentsfrompursuinghealthybehaviors(e.g.,walkingoutdoors)fromfearofharm.

“Violenceinacommunityisasymptomofdeeperproblemsofpoverty,discrimination,andalackofaccesstoservices.”

—CommunityMember


ViolentCrimesRatesandPropertyCrimeRates,per100,000Persons,2012

GeographicArea PropertyCrimeRates ViolentCrimeRates

Carson 2,905.6 557.7

ComptonP.D. 2,446.5 1,242.1

GardenaP.D. 2,209.0 479.9

HuntingtonParkP.D. 3,244.8 631.4

LosAngelesP.D. 2,269.1 481.1

Lynwood 1,936.3 763.0

Paramount 2,792.9 443.7

SouthGateP.D. 2,652.0 576.2

LosAngelesCounty* 2,327.1 446.4

California 2,758.7 423.1Source:U.SDepartmentofJustice,FBI,UniformCrimeReportingStatistics,2012.www.bjs.gov/ucrdata/index.cfm=www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2012/crime-in-the-u.s.-2012/tables/6tabledatadecpdfNotes:Propertycrimesincludeburglary,larceny-theft,andmotorvehicletheft.Violentcrimesincludehomicide,rape,robbery,andassault.


OurPhysicalEnvironment

OverviewLanduseandtheurbanenvironmentplayakeyroleinourhealthandwell-being.Whereourcommunitylivesdetermineshowtheylive,andaccesstohealthyfood,greenspace,andactivityresourcesoftendetermineourlong-termhealth.Ourcommunityhastwoofthemostbasicandentrenchedbarrierstohealth:extremelylimitedaccesstofresh,healthyfoodsandunsafe,polluted,vacantcitylandinsteadofgreenspace.SPA6islocatedbetweentheHarborFreewayandInterstate10,whicharemajorfreightroutesheavilytraffickedbysmogproducingtruckstravelingbetweentheLosAngelesPorttothesouthandindustrialdistributioncenterstothenorth,causingmajorenvironmentalproblemsinourcommunity.Residentsbecomevictimstoairpollutantsthatresultinrespiratorydiseasessuchaschronicobstructivelungdiseaseandlungcancer.Withover3,000segmentsofalleysinSouthLosAngelesandanoverwhelminglackofsafeandaccessiblegreenspace,ouryouthusethesecontaminatedspacestoplaybecauseparkaccessissolimited.Further,thehighconcentrationofcornerstores,liquorstores,andfastfoodchainsthatofferlimitedfoodoptionsmakeitdifficultforresidentstomakehealthychoices.Thesefactorsalonemakeitdifficultforourresidentstoleadhealthylifestylesandhaveoverallgoodhealth.

AccesstoGreenSpace–LowParkAccessThedegreetowhichparksareavailableinourcommunityisdirectlyassociatedwithincreasedparkusage,physicalactivity,andbetteroverallhealth.Improvingaccesstoparkscanincreasetheamountoftimeourcommunityengagesinexercise,decreasesriskofchronicdiseases,andimprovesoverallhealthforadultsandchildrenalike.AccordingtotheHealthAtlasfortheCityofLosAngeles,parklevelofserviceisdefinedastheacresofparklandper1,000residents;aminimumof3acresofparklandper1,000residentsisoftenusedtodetermineparklevelofservice.SPA6isconsideredapark-poorneighborhood,withjust4acresofparkspaceper100,000residents.Ourcommunityissaturatedwithunderutilizedvacantlotsandalleysthatdonotoffersafeplacesforourchildrentoplay.AccordingtoLAOpenAcres’,aprojectofCommunityHealthCouncils,thereareover100vacantlotslocatedinLosAngelesZIPCode900113,thegeographicareawherethelargestportionofourcommunityresides.

3LAOpenAcres.www.laopenacres.org.WebsiteaccessedonMay26,2017.


OverviewofParkLocationsinSouthLosAngeles

Source:Pastor,ManuelandPamelaStephens.Roots|Raíces:SharedFuturesinSouthLosAngeles.USCDornsifeCenterfortheStudyofImmigrantIntegration.April6,2017.

FoodEnvironmentTheWorldFoodProgrammedefinesfoodsecurityas“havingavailabilityandadequateaccessatalltimestosufficient,safe,nutritiousfoodtomaintainahealthyandactivelife.”4Foodinsecuritycanleadtoundernourishmentandmalnutrition,whichcoincidewithfatigue,stuntedchilddevelopment,andotherhealthissues.Undernourishedpregnantwomenaremorelikelytobearbabieswithlowbirthweight,andthebabiesarethenmorelikelytoexperiencedevelopmentaldelaysthatcanleadtolearningproblems.Hungerandfoodinsecuritycanalsoacceleratethedevelopmentofdiseaseorworsenexistingdiseases.Further,foodinsecurityandobesityco-existinsomehouseholdswherepeopleeatfoodsthatareinexpensivewhilehighinfatandsugar,butlowinnutritionalquality.Householdsthatlack“foodsecurity”aretypicallylow-incomehouseholdsandthesehouseholdscanobtainsupplementalassistancefromgovernmentprograms,suchastheCalFreshprogramand

4WorldFoodProgramme.www.wfp.org


theWICprogram.In2012,approximately7%ofhouseholdsinLosAngeleswereCalFreshrecipients,comparedtoanestimated16%inSouthLosAngeles.5

OurresidentsdonothavewidespreadopportunitiestomakehealthyfoodchoicescomparedtootherareasoftheCounty,andthishasanadverseeffectonourcommunity’soverallhealth.Portionsofourcommunityarecharacterizedas“fooddeserts,”meaningthatopportunitiestoprocurefresh,affordable,healthyfoodsarelimitedandresidentshaverelativelyeasieraccesstounhealthyfood.WhencomparedtootherserviceplanningareasandLosAngelesCountyoverall,ourcommunityhadthelowestpercentofadultswhoconsumefiveormoreservingsoffruitandvegetablesaday(9.6%versus14.7%,respectively),andthehighestpercentageofadults(41.9%)andchildren(51.6%)whodrinkatleastonesodaorsweeteneddrinkperday.6Further,only60.2%ofouradultsreportedthatthey“alwaysorusuallyfindaffordablefreshproduceintheirneighborhood,”comparedto75.7%foradultsinLosAngelesCounty,and78.2%inCaliforniaoverall.7

OverviewofFoodDesertsLocatedinServicePlanningArea6

Sources:USDepartmentofAgriculture,EconomicResearchService,USDA-FoodAccessResearchAtlas.2015;CommunityCommons,www.communitycommons.org.

Additionally,ourcommunityhasgreateraccesstofastfoodrestaurantsandliquorstores,withinincreasinglylimitedaccesstogrocerystores,whencomparedtostateandnationaltrends.

5HealthAtlasfortheCityofLosAngeles.June2013.http://planning.lacity.org/cwd/framwk/healthwellness/text/HealthAtlas.pdf

6“KeyIndicatorsofHealthbyServicePlanningArea.”LosAngelesCountyDepartmentofPublicHealth.January2017.7CaliforniaHealthInterviewSurvey,2015.http://ask.chis.ucla.edu/


GeographicArea GroceryStores FastFoodRestaurants LiquorStores

MLKCHServiceArea 20.9 82.5 11.8

LosAngelesCounty 20.9 82.6 11.9

California 21.8 78.7 10.6

UnitedStates 21.2 74.6 10.8Sources:USCensusBureau,CountyBusinessPatterns.2015;CommunityCommons,www.communitycommons.org.Note:Metricsreflectsrateper100,000population.

PollutionSouthLosAngelesisdisproportionatelyburdenedbymultiplesourcesofpollution.Fordecades,ourcommunityhasbeenplaguedwithhighexposuretopoorairanddrinkingwaterquality,largeconcentrationsofdieselemissions,pesticideuse,hazardouswaste,frequentgroundwaterthreatsandimpairedwaterbodies,andhightrafficdensity.TheCaliforniaOfficeofEnvironmentalHealthHazardAssessment(“OEHHA”)conductsariskassessmenttoevaluatethedegreetowhichenvironmentalpollutantsandothertoxinsexistincommunitiesthroughoutthestate.BasedupontheOEHHA’sCalEnviroScreen3.0findings,ourcommunitydisplayedthehighestrisksforpollutantswhencomparedtootherportionsofLosAngelesCounty.

“Wehavetoxicdumpsandlandfillsanddumpinganddrillingthatiscausinghealthconsequencesthatarenotbeingadequatelyaddressed.”

—CommunityMember


CalEnviroScreenOverview

Source:OEHHA.CalEnviroScreen3.0ResultsforSouthLosAngeles.AccessedonMay26,2017.Additionally,almostallofSouthLosAngeleshasbeendesignatedasa“SB535DisadvantagedCommunity,”whichmeansthatourcommunitywasrankedinthehighestscoring25%ofcensustracts(higherscoresareworse)basedupontheOEHHA’sCalEnviroScreenassessment.

SB535DisadvantagesCommunitiesasofFebruary,2017

Source:OEHHA.SB535DisadvantagedCommunities.AccessedonMay26,2017.


AccesstoHealthcareinOurCommunity

OverviewLosAngelesCountyishometothe“ultra-rich,”aswellassomeofthepoorestresidentsinournation.Itisnotuncommontoseelargedisparitieswhereareasofenormouswealthandfirst-classhealthcareprovidersarelocatednexttoneighborhoodswherelow-incomeresidentssufferfrompreventableconditionsandlackbasisaccesstohealthcare.The“KeyIndicatorsofHealthbyServicePlanningArea(2017)”reportpublishedbytheLosAngelesCountyDepartmentofPublicHealthfoundthatresidentsofSPA6arevastlyunderserved,andexperiencegreaterchallengestryingtoaccesshealthcareserviceswhencomparedtootherpartsoftheCounty.Majordisparitiesandhealthcareinequityexistacrossthecarecontinuuminourcommunitytoday,makingitnearlyimpossibleforourlocalhealthcareproviderstocollectivelyachievetheobjectivesoftheInstituteforHealthcareImprovementsTripleAim™Initiativeofbetterhealthoutcomes,improvedpatientexperiences,andlowercostsofhealthcare.Thehealthcaredisparitiesfacedbyourcommunityaresubstantialandinclude:

• Anoveralllackofcomprehensivehealthcareservicesavailableinthecommunityacrossthecarecontinuum

• Largeshortageofphysiciansacrossalmostallspecialties,resultinginlittletonoaccesstocriticalpreventive,primary,andspecialtycareservices

• Limitednumberofhealthcareprovidersthat:1)acceptMedi-Cal;and2)areculturallycompetentandmatchtherichdiversitythatexistsinourcommunitytoday

• Inadequatelevelsofhealthinsurancecoverageamongourresidents.Forthosethatareinsured,manyreportincomesbelowthefederalpovertylevelanddonothavethefinancialresourcesrequiredforco-paymentsorco-insuranceforhigh-deductiblehealthplans

• Absenceofcomprehensive,multi-disciplinaryhealthcare,treatmentplanning,andcarecoordination

“Wewantinvestmentforthepeoplewhoareherenow.”

—CommunityMember

PatientAccessPointsAreNeededAcrosstheCareContinuum


Keyfactorsthatsupportthesefindings,andimpactourcommunity’sabilitytoaccessneededhealthcareservices,aredescribedbelowandonthefollowingpages.

HealthInsuranceCoverageHealthinsurancecoverageisakeycomponenttoaccessinghealthcareincludingprimarycare,specialtycare,andotherhealthservicesthatcontributetoone’shealthstatus.ThePatientProtectionandAffordableCareAct(“ACA”)hasbeenveryimportanttoourcommunity.In2015,88.0%ofourresidentshadsomeformofhealthinsurance–upfrom73.6%in2009,theyearbeforetheACAwassignedintolaw.Despitethispositivetrend,healthinsurancealonedoesnotguaranteeaccesstohighquality,affordablehealthcareservices,andourcommunityisstillchallengedwithasignificantshortageofhealthcareproviders.Additionally,theHealthyPeople2020Objectiveisfor100%ofthepopulationtohaveinsurancecoverage,andourcommunityisbelowthistarget,aswellasratesfortheCounty(89.6%)andStateoverall(91.6%).8

OfthosewithinsurancecoverageinSPA6,56.3%haveMedi-Calcoverage,and24.3%haveemployment-basedinsurance.WheninsurancecoverageforSPA6isexaminedbyagegroups,adults,ages18-64,hadthehighestrateofuninsured.CoverageforchildrenwasprimarilythroughMedi-Cal(76.8%).SeniorshavehighratesofMedi-Cal/Medicare(e.g.,dual-eligible)coverage(45.4%).9

SourcesofCareInpatientHospitalBedsandEmergencyDepartmentStationsAccordingtotheOfficeofStatewideHealthPlanningandDevelopment(“OSHPD”),thereareapproximately123hospitalsinLosAngelesCounty,andonlyfourarelocatedinSPA6:MLKCH,St.FrancisMedicalCenter,CommunityHospitalofHuntingtonPark,andMemorialHospitalofGardena.In2012,SPA6hadthelowestnumberoflicensedhospitalbedsper100,000populationinalloftheCounty,comparedtoSPA3(SanGabrielValley),withnearlydoublethepopulationandover12timesmorelicensedbeds.EvenafterMLKCHopenedin2015,OHPSDrecordsshowthatalmost84%ofourservicearea’spatientshadtoleavethecommunityforinpatientcare–largelybecauseourcommunitydoesnothavetheinpatientcapacityandresourcestoadequatelyprovidemanyofthespecialtycareprogramsthatarecriticallyneededbyourpatients.Thesespecialtyservicesinclude:

• InterventionalCardiology:Cardiaccatheterizations,pacemakers,andelectrophysiologyprocedures

• Gastroenterology:Endoscopicretrogradecholangiopancreatography(“ERCP”),andoutpatientcolonoscopiesandendoscopies

8CaliforniaHealthInterviewSurvey,2015.http://ask.chis.ucla.edu/9CaliforniaHealthInterviewSurvey,2015.http://ask.chis.ucla.edu/


• InterventionalRadiology:Uterinearteryembolization,peripheralvasculardisease,permanentdialysisaccess,andabscessdrainage

• Urologyanduro-gynecologyprocedures

• Outpatientsurgicalservices

Inadditiontoinpatientlicensedbeds,SPA6alsohasthelowestnumberofemergencydepartmenttreatmentstationsper100,000population,andhigherutilizationrateswhencomparedtotheCountyandStateoverall.

• Specifically,24.3%ofresidentsinSPA6visitedanERwithina12-monthtimeperiod,whichwashigherthanthestateandcountylevels(18%)

UseofEmergencyRoom

Characteristic SPA6 LosAngelesCounty California

VisitedERinLast12Months 24.3% 18.0% 18.0%

0-17YearsOld 16.8% 21.4% 19.5%

18-64YearsOld 28.5% 16.6% 17.3%

65andOlder 20.5% 18.5% 18.9%

<100%ofPovertyLevel 20.5% 19.2% 21.7%

<200%ofPovertyLevel 22.0% 18.9% 20.0%Source:CaliforniaHealthInterviewSurvey,2013-2014.http://ask.chis.ucla.edu/

Thesetrendsareduetothefactthatthereisashortageofhealthcareprovidersinourcommunity,accesstoprimarycareisfrequentlysoughtonanepisodicoremergentbasis,emergencydepartmentsareoftenovercrowded,andpatientsexperiencelongwaittimesbeforetheyareabletobetreated.Duringourfirstyearofoperations,MLKCH’sEDtreatednearly50percentmorepatientsperEDstation(2,800visitsperstation)whencomparedtoindustryperformancestandards(1,800–2,000visitsperstation),andweknowtherearepatientsthatarestillnotreceivingthecaretheyneedanddeserve.


“ThereisstillapopulationinSouthLAthatlacksaccesstocare(specialtycareandprimarycare).Weneedtoshiftthecultureofhealthreformfromapursuitofhealthcareasepisodictooneofbeingproactiveandobtaininghealtheducationandpreventativeservices.”

—CommunityMember


Ourcommunityhasadisproportionateshareofcrimeandviolence.St.FrancisMedicalCenteristheonlytraumacenterlocatedinSPA6,servingalargeportionofourcommunity’spatientsrequiringthislevelofcare..However,whentheoldKing-DrewMedicalCenterclosed,anewtraumacenterwasopenedatCaliforniaHospitalMedicalCentertohelpaddressourcommunity’sneeds,andthetraumacatchmentareaswerere-drawntomaintainshorttraveltimesforresidents.AdditionaltraumacenterslocatedadjacenttoourSPAincludeCaliforniaHospitalMedicalCenter,Harbor-UCLAMedicalCenter,LongBeachMemorialMedicalCenter,andLosAngelesCounty-USCMedicalCenter.OurlocalEmergencyMedicalServicesteamsworkcloselywiththesefacilitiestoensuretimelytransportofourtraumapatients,andMLKCHmaintainstransferagreementswitheachofthesehospitals.

HealthProfessionalShortageAreasandMedicallyUnderservedAreasTheFederalGovernmentdefinesaHealthProfessionalShortageArea(“HPSA”)asanarea,facility,orpopulationgroupwithashortageofprimarycarephysiciansasdefinedbyapopulation-to-primarycarephysicianratiogreaterthan3,500:1.ForpurposesofthisCHNA,theFederalGovernmentdefinesprimarycareasthefollowingspecialties:familypractice,geriatrics,internalmedicine,pediatrics,andpsychiatry.Otherfactorstakenintoconsiderationincludethepovertyrate,infantmortalityrate,fertilityrate,andindicatorsofinsufficientcapacitytomeetareaneed.

AMedicallyUnderservedArea(“MUA”)isdefinedasanarea,facility,orpopulationgroupwithanIndexofMedicalUnderservice(“IMU”)lessthanorequalto62outof100.TheIMUiscalculatedbytakingintoconsiderationtheratioofprimarymedicalcarephysiciansper1,000population,infantmortalityrate,percentageofthepopulationwithanincomebelowthepovertylevel,andthepercentageofpeopleage65orolder.ThesefactorsareconvertedtoweightedvaluesandthensummedtoobtainanIMUscoreforaparticulararea.

SectionsofourserviceareaaredesignatedaseitheraHPSA,MUA,orboth,indicatinganinsufficientnumberofprimarycareprovidersinthearea.Mapsillustratingthisfactcanbefoundbelowandonthefollowingpage.


HealthProfessionalShortageArea


MedicallyUnderservedArea

ServiceAreaPhysiciansWhenMLK-Harborclosedin2007,anexodusofprimaryandspecialtycareprovidersfollowed.MLKCHrecentlyconductedastudytoidentifyphysicianneedinSPA6andsubstantiateaninvestmentinphysicianworkforcerecruitmentacrossmultiplespecialties.Notsurprisingly,thisanalysisrevealedasevereshortageinalmostallspecialtiesstudied.In2017,thestudyshowedashortageofover1,200full-timeequivalent(“FTE”)physicianstrainedinprimary,andmedicalandsurgicalspecialties,combined.Findingsfromthisanalysisareprovidedbelow.


PrimaryCarePhysicianSupplyandNeed,2017

Specialty TotalExistingFTESupply

EstimatedAreaPhysicianNeed

EstimatedNet(Need)/Supply

FamilyPractice 172.7 374.7 (202.0)

InternalMedicine 132.6 428.2 (295.6)

ObstetricsandGynecology 63.1 137.3 (74.3)

Pediatrics 95.0 215.8 (120.8)Source:Premier,Inc.,AMIPhysicianDatabase,Claritas,Inc.,2017

MedicalSpecialtyCarePhysicianSupplyandNeed,2017




AllergyandImmunology 1.0 11.5 (10.5)

Cardiology 10.2 47.0 (36.8)

Dermatology 6.7 39.6 (32.9)

Endocrinology 3.8 12.0 (8.3)

Gastroenterology 9.0 38.5 (29.5)

HematologyandOncology 39.0 50.9 (11.9)

InfectiousDisease 7.8 12.8 (5.1)

Neonatology 2.0 7.4 (5.4)

Nephrology 19.6 15.6 4.0

Neurology 9.0 32.5 (23.5)PhysicalMedicineandRehab 3.0 22.9 (19.9)

PulmonaryDisease 10.3 21.3 (11.0)

RadiationOncology 8.0 15.2 (7.2)

Rheumatology 2.8 9.7 (7.0)Source:Premier,Inc.,AMIPhysicianDatabase,Claritas,Inc.,2017


SurgicalSpecialtyCarePhysicianSupplyandNeed,2017




CardiovascularSurgery 6.0 12.0 (6.0)

GeneralSurgery 36.0 137.3 (101.3)

Neurosurgery 4.0 14.0 (10.0)

Ophthalmology 18.3 65.4 (47.1)

Orthopedics 15.9 89.4 (73.5)

Otolaryngology 13.5 45.8 (32.3)OralandMaxillofacialSurgery 0.0 15.3 (15.3)

PlasticSurgery 0.0 15.3 (15.3)

Urology 11.2 47.9 (36.7)Source:Premier,Inc.,AMIPhysicianDatabase,Claritas,Inc.,2017

GiventhefactthatLosAngelesCounty’soverallprimaryandspecialtyphysiciansupplyiswithintheCouncilofGraduateEducation’srecommendedguidelines,itisclearthatthereiswidemaldistributionofphysicians,andaccesstotheseprovidersisnotequitableinourservicearea.

MedicalHomeHavingamedicalhomeandausualsourceofcareisanimportantcontributortohealthandwell-being,sincetheseresourcescanenhanceaccesstoprimarypreventativecare,alleviatehealthissuesduringamedicalevent,andimproveoverallcontinuityofcare.SpecifictoSPA6,

• 19.2%ofadultsage18-64yearsreportednoregularsourceofcare,eitherforpreventiveprimarycare,ortoaddressmedicalconcernsduringaspecificeventand/orperiodoftime

• ThepercentageofpeoplewhoreportedaccesstoausualsourceofcareinSPA6waslowerthanLosAngelesCountyoverall,anddidnotmeettheHealthyPeople2020Objectiveforchildren,adults,andseniors(95.0%foreachagecohort).


AccesstoaUsualSourceofCare

Ages0-17 Ages18-64 Ages65+

SPA6 LosAngelesCounty SPA6 LosAngeles

County SPA6Los

AngelesCounty

UsualSourceofCare 93.8% 90.6% 80.8% 80.6% 87.4% 94.7%

Source:CaliforniaHealthInterviewSurvey,2014.http://ask.chis.ucla.edu/

Whenaccessthroughausualsourceofcareisexaminedbyrace/ethnicity,AfricanAmericansaretheleastlikelytohaveausualsourceofcare,followedbyAsians,thenHispanics;Whitesarethemost-likelytohaveausualsourceofcare.Thisisakeyfactor,asahigherdensityofAfricanAmericansresideincommunitiesthatdirectlysurroundMLKCH,versusHispanics/Latinoswhotendtoliveontheeasternportionofourservicearea.

“Wefindthatpatientscomeforservicesandhaveaprimarycareproviderthatthey’veneverseenorcommunicatedwith,andtheydon’tevenknowtheyhaveinsurance.”

—CommunityHealthcareProvider

AccesstoaUsualSourceofCarebyRace/Ethnicity

EthnicCohort SPA6 LosAngelesCounty California

AfricanAmerican 81.1% 85.6% 86.2%

Asian* 83.2% 81.8% 85.0%

Latino 84.1% 80.8% 81.7%

White* 99.9% 90.7% 91.0%Source:CaliforniaHealthInterviewSurvey,2012-2014.http://ask.chis.ucla.edu/*=statisticallyunstableduetosmallsamplesize

SourcesofCareInSPA6,communityorgovernmentclinicsorhospitalswerethemostfrequentlyidentifiedsourceofcare(41.5%).Further,thereisstillasizableportionofresidentswhodon’thaveausualsourceofcareinourcommunityatall.


SourcesofCare

SourceofCare SPA6 LosAngelesCounty California

Dr.Office/HMO/Kaiser 38.9% 57.6% 60.7%CommunityClinic/GovernmentClinic/CommunityHospital 41.5% 23.6% 23.0%

ER/UrgentCare 6.2% 1.7% 1.4%

Other N/A 0.9% 0.7%

NoSourceofCare 13.5% 16.2% 14.2%Source:CaliforniaHealthInterviewSurvey,2014.http://ask.chis.ucla.edu/

AccesstoCommunityHealthCentersDespitethefactthattherearenumerouscommunityhealthcentersthatincludeFederallyQualifiedHealthCenters(“FQHCs”)andFQHCLook-Alikesinourservicearea,therearestillalargenumberoflow-incomeresidentswhodonotseekcareatthesefacilities.BasedupondatareportedbytheUniformDataSystem(“UDS”),FQHCsandLook-Alikestreated217,482patientsintheservicearea,whichequatesto27.3%penetrationamonglow-incomepatientsand16.5%penetrationamongthetotalpopulation.From2012-2014theclinicprovidersadded28,517patients;a15.1%increaseinpatientsservedbyCommunityHealthCenters.However,thereremain578,597low-incomeresidents,approximately72.7%ofthepopulationatorbelow200%FPL,thatarenotservedbyaCommunityHealthCenter.Additionally,theCommunityAssociationofLosAngeles(“CCALAC”)publishedastudythatfoundthatSPA6hadthelowesthealthcenterpenetrationinLosAngelesCounty,andthehighestnumberoflow-incomeresidentsunservedbyaFQHC.10

Low-IncomePatientsServedandNotServedbyFQHCsandLook-Alikes

Low-IncomePopulation

PatientsservedbySection330GranteesInServiceArea

PenetrationamongLow-

IncomePatients

PenetrationofTotal

Population

Low-IncomeNotServed

Number Percent

796,079 217,482 27.3% 16.5% 578,597 72.7%Source:UDSMapper,2014.http://www.udsmapper.org

Thesecommunityhealthcentersaretypicallystaffedbyalimitednumberofprimarycarephysicians,advancedpracticeclinicians,andalliedhealthprofessions.Thesefacilitiesrarelyofferaccesstospecialtycare,anddonothaveresourcestomanagechronicconditions.

10UncharteredTerritory:MappingtheUnmetNeedsofLA’sUnderserved.CommunityClinicAssociationofLosAngeles.

March2012.


Post-AcuteCareProvidersAccessinghighquality,post-acutecareservices,includingskillednursing,homehealth,rehabilitationservices,andsub-acutecareservices,isachallengeinourcommunity.Medicareistheprimarypayerforthefourtraditionalpost-acutecaresettings:long-termacute-carehospitals,inpatientrehabilitationfacilities,skillednursingfacilities(“SNFs”),andhomehealthagencies.ThispayercohortalsorepresentsasmallerportionofourcommunityandthepatientstreatedatMLKCH–approximately25%oftheHospital’spatientsarecoveredbyMedicare,withamuchlargerportioncoveredbyMedi-Cal.Consequently,Medi-Cal,thepayerwiththelargestnumberofenrolleesinourcommunity,payssomeofthelowestratesforpost-acutecareservices.Asaresult,

• LowMed-Calreimbursementratesforshort-andlong-termSNFcareandsub-acutecarelimitskillednursingoptionsforourMedi-Calbeneficiaries

• Higherreimbursementforshort-termMedicarepatientshasshiftedSNFpracticetowardshort-termpatientswithMedicare,furtherlimitingthenumberofplacementoptionsforMedi-Calpatients

• Patientswithbehavioraldifficulties(e.g.,mentalillness,traumaticbraininjuries,dementia,substanceusers)areoftencoveredbyMedi-Cal,andareverydifficulttoplaceandmanageinaSNF11

Asaresult,ourpatientsoftenreturntotheirhomewithlittletonopost-acutecare,andrelyontheirsocialandfamilialsupportsystemsforassistance.

CareCoordinationOurcommunityhealthprovidersnotedtheabsenceofformalcarecoordinationactivitiesamonghealthcareprovidersinSouthLosAngeles(e.g.,communityhealthcenters,hospitals)thatcouldcircumventtheinappropriateutilizationofhospital-basedcare,andbettermanagechronicconditions.Muchofthetime,primarycareprovidersinourcommunityareunawareofpatientvisitstotheemergencydepartmentorhospitaladmissions,andonlylearnofthemwhenapatientreturnsforavisitandinformstheirprovider.Additionally,primarycareprovidersrarelyreceivedanycommunicationabouttheoutcomeofapatient’svisittoahospitalsuchasinstructionsforfollow-upcare,newmedicationsorchangestoprescriptions,treatmentprovided,orlabanddiagnostictestresults,allfactorsthatarecriticalasweseektoensurequality,coordinatedcare.

11“FramingSanFrancisco’sPost-AcuteCareChallenge.”2016.https://www.sfdph.org/dph/files/hc/

HCAgen/HCAgen2016/Feb%2016/Post-Acute%20Care%20Project%20Report_02.10.16.pdf


BarrierstoCareComparedtotheCounty,agreaterpercentageofadultsinSPA6reportedbarriersinaccessingdentalcare,medicalcare,mentalhealthcare,andprescriptionmedicationsduetocost.Additionally,32.5%ofadultsinSPA6reporteddifficultyaccessingmedicalcarewhenneeded.Thesetrendsareindicativeofthesocioeconomicchallengesfacedbyourcommunity–loweraverageincomes,andhigherratesofpovertyandunemployment.

BarrierstoAccess

Barrier SPA6 LosAngelesCounty

AdultsUnabletoAffordDentalCareinthePastYear 35.0% 30.3%

AdultsUnabletoAffordMedicalCareinthePastYear 18.7% 16.0%

AdultsUnabletoAffordMentalHealthCareinthePastYear 6.8% 6.1%

AdultsUnabletoAffordPrescriptionMedicationinPastYear 18.8% 15.4%

AdultsWhoReportedDifficultyAccessingMedicalCare* 32.5% 23.6%Source:LosAngelesCountyDepartmentofPublicHealth,OfficeofHealthAssessmentandEpidemiology,LosAngelesCountyHealthSurvey2011.http://www.publichealth.lacounty.gov/ha/LACHSDataTopics2011.htm*=http://www.publichealth.lacounty.gov/ha/LACHSDataTopics2015.htm

Additionalresearchindicatesthatinmedicallyunderservedcommunities,enhancedpatienteducationandastrongerhealthservicedeliveryinfrastructurearenecessarytoensurethatservicesareavailableandpatientsunderstandhowtoutilizethem.12

“Peoplearen’teducatedabouttheimportanceofprimaryhealthcareandseekingoutadoctorandgettinganannualphysical.Theyaren’tgettingthateducationintheschools.Ithasn’tbecomeacommunitynormtoautomaticallygotothePrimaryCareProviderandknowtheirhealthstatus.Thereneedstobemoreeducationatelementaryandsecondaryschoolssonormsandvaluesaroundmaintaininggoodhealthcanbeincorporatedintothecurriculum.”

—CommunityMember

12Molina,MelanieF.andMedellBriggs-Malonson,MD.“ThePatientPerspective:ReceivingCareinthePost–ACAEra”.”JournalofHealthDisparitiesResearchandPractice.Volume10,Issue1,Spring2017,p.238-249.


DelayedCareOverhalfofSPA6residents(55.5%)delayedmedicalcarewhenneededduetocostorlackofinsurance.ThisratefarexceedstheHealthyPeople2020Objectiveofreducingtheproportionofpeoplewhowereunabletoobtainordelayedmedicalcareto4.2%,andthosewhowereunableordelayedobtainingnecessaryprescriptionmedicinesto2.8%.

DelayedCare

Trend SPA6Los

AngelesCounty

California

DelayedorDidn’tGetMedicalCareInPast12Months 10.7% 11.7% 11.3%

DelayedCareDuetoCostorLackofInsurance 55.5% 44.8% 51.3%

Delayed/Didn’tGetPrescriptionMedsInPast12Months 8.8% 7.9% 8.7%

Source:CaliforniaHealthInterviewSurvey,2014.http://ask.chis.ucla.edu/


OurCommunity’sHealthStatusandHealthyBehaviors

Givenourcommunity’sethniccompositionandalongstandinghistoryofbeingunderserved,withlimitedaccesstohealthcareprovidersandwidespreadsocialandenvironmentalchallenges,itisnotsurprisingthatgreatopportunityexiststobuildhealthequityandimprovetheoverallhealthstatusofourcommunity.IncomparisontoCounty,State,andnationaltrends,ourcommunity’shealth,andthedegreetowhichourresidentsengageinhealthybehaviors,isratedfarworseforalmostallkeymetrics.Evenourcommunityrecognizestheirownhealthchallenges-21.6%ofourresidentsthemselveshaveratedtheirhealthaseitherfairorpoor.13Ourmissiontoimprovethehealthofourcommunitycombinedwithourdesiretocollaboratewithcommunitypartnerswillallowustoaddressthehealthcaredisparitiesexperiencedbyourcommunity,andimproveoverallhealthoutcomes.

“ThereisstillapopulationinSouthLosAngelesthatlacksaccesstocare.Weneedtoshiftthecultureofhealthfromapursuitofhealthcareasepisodictooneofbeingproactiveandobtaininghealtheducationandpreventiveservices.”

—CommunityMember

HealthStatusandHealthOutcomesChronicDiseaseChronicdiseasesaretheleadingcauseofdeathanddisabilityintheUnitedStates.TheCenterforDiseaseControlandPrevention(“CDC”)estimatesthatalmost50%oftheUnitedStatespopulationhasatleastonechronicdisease.Theseconditionscanbedisablingandreduceaperson’squalityoflife,especiallyifleftundiagnosedoruntreated.Further,manychronicdiseasescanbeprevented,delayed,oralleviatedthroughsimplelifestylechanges.TheCDCestimatesthateliminatingthreeriskfactors–poordiet,inactivity,andsmoking–wouldprevent:

• 80%ofheartdiseaseandstroke;

• 80%oftype2diabetes;and

• 40%ofcancer

Additionally,researchcompletedbytheCDC’sRacialandEthnicApproachestoCommunityHealth(“REACH”)hasconcludedthefollowing:

• Chronicdiseasesandtheirriskfactorscanbemorecommonandsevereforracialandethnicminoritygroupsthanfornon-Hispanicwhites.Thesehealthdisparitiesarecausedbycomplexfactorssuchasdifferencesinincome,education,communityconditions,andaccesstohealthcare

13Source:CaliforniaHealthInterviewSurvey,2015.http://ask.chis.ucla.edu/


• Specifictochronicconditions:

§ Non-HispanicAfricanAmericansare40%morelikelythannon-Hispanicwhitestohavehighbloodpressure,andtheyarelesslikelytohavethisconditionundercontrol

§ Therateofdiagnoseddiabetesis77%higheramongnon-HispanicAfricanAmericans,66%higheramongHispanics,and18%higheramongAsiansthanamongnon-Hispanicwhites

§ Hispanicsaremorelikelytodevelopasthma,cervicalcancer,end-stagerenaldisease,HIV,liverdisease,andtuberculosiswhencomparedtonon-Hispanicwhites.Additionally,whencomparedtonon-Hispanicwhitechildren,Latinochildrenaremorelikelytosufferfrominfantmortality,asthma,obesity,anddepression14

§ AmericanIndiansandAlaskaNativesare60%morelikelytobeobesethannon-Hispanicwhites

§ Lifeexpectancyfornon-HispanicAfricanAmericansis75.1years,comparedto78.9yearsfornon-Hispanicwhites

Racialandethnicminoritypopulationsoftenreceivepoorerqualityofcareandfacemorebarriersinseekingcare,includingpreventivecareandchronicdiseasemanagement,thandonon-Hispanicwhites.Thesedisparitiescanleadtopoorhealthoutcomesandhigherhealthcarecosts.Ourcommunityconsistentlyhashigherprevalenceofchronicdiseases,asdescribedinthetableprovidedbelow.Thesetrendsarelargelydrivenbyenvironmentalandbehavioralfactorsprevalentinourcommunity–includingexposuretoenvironmentaltoxins,lackofhealthyfoodoptions,anabsenceofgreenspaceforphysicalactivity,andanabundanceofopportunitiestoconsumeunhealthyfoodandalcohol.

Metric SPA6 LosAngelesCounty California

PercentDiagnosedwithAsthma,TotalPopulation 11.3% 12.1% 14.1%

PercentofAdultsDiagnosedwithDiabetes 14.7% 10.0% 8.9%

PercentofAdultsDiagnosedwithHeartDisease 5.3% 5.3% 5.9%

PercentofAdultsDiagnosedwithHighCholesterol 22.2% 25.2%

PercentofAdultsDiagnosedwithHighBloodPressure 35.7% 27.3% 28.5%Source:CaliforniaHealthInterviewSurvey,2012-2014.http://ask.chis.ucla.edu/;“KeyIndicatorsofHealthbyServicePlanningArea.”LosAngelesCountyDepartmentofPublicHealth.January2017.

14LatinoHealthDisparitiesComparedtoNon-HispanicWhites.FamiliesUSA.July2014.http://familiesusa.org/product/latino-health-disparities-compared-non-hispanic-whites


MortalityandLeadingCausesofDeathSPA6hasthesecondhighestage-adjustedmortalityrateacrosstheeightserviceplanningareasinLosAngelesCounty,with726.6deathsper100,000residents.Thisrateis22.4%higherthantheaverageforLosAngelesCounty(593.5),and50.3%higherthanWestLosAngeles(SPA5),whichhadthelowestreportedmortalityrateoftheeightSPAs(483.3).15Additionally,ourserviceareahashighermortalityratesforalmostallleadingcausesofdeathwhencomparedtoLosAngelesCountyandCaliforniaoverall,demonstratingourcommunity’sneedforaccesstohighqualitypreventativeandspecialtyhealthcareservices.

LeadingCausesofDeath,Age-AdjustedMortalityRateper100,000Persons,2013

CauseofDeath SPA6LosAngelesCounty California

HeartDisease 209.6 159.0 151.8

Cancer 159.0 140.1 147.0

CerebrovascularDiseases 40.4 32.8 34.9

Diabetes 37.6 21.9 20.6

ChronicLowerRespiratoryDiseases 33.0 30.2 35.3

PneumoniaandFlu 31.1 22.4 16.6

Accidents 23.9 20.9 29.2

Alzheimer’sDisease 22.0 25.1 30.0

Hypertension/HypertensiveRenalDisease

13.5 11.9 11.2*

Nephritis/NephroticSyndrome/Nephrosis

15.9 9.3 7.2

Sources:CenterforDiseaseControlandPreventionNationalCenterforHealthcareStatistics.CaliforniaLeadingCausesofDeathDatabase.https://www.cdc.gov/nchs/pressroom/states/california/california.htm“KeyIndicatorsofHealthbyServicePlanningArea.”LosAngelesCountyDepartmentofPublicHealth.January2017.http://publichealth.lacounty.gov/ha/docs/2015LACHS/KeyIndicator/PH-KIH_2017-sec%20UPDATED.pdfLosAngelesCountyDepartmentofPublicHealthMortalityDataset.https://dqs.publichealth.lacounty.gov/query.aspx?d=62*Datareportedreflects2014calendaryear.2013comparabledatawasnotavailable.

15“KeyIndicatorsofHealthbyServicePlanningArea.”LosAngelesCountyDepartmentofPublicHealth.January2017.


EmergencyDepartment InpatientDischargeDiagnosis

1. Abdominalandpelvicpain 1. Primaryhypertension

2. Chestpain 2. Type2diabetesmellitus

3. Headache 3. Congestiveheartfailure

4. Biliousvomiting 4. Acidosis

5. Cervicalgia 5. ChestpainSource:MartinLutherKing,Jr.CommunityHospital

MaternalandChildHealthOurcommunity’smaternalandchildhealthstatusoutcomesareindicativeofthechallengesfacedbywomeninourservicearea.

• Giventhefactthatourpatientsexperiencelimitedaccesstoproviders,itisnotsurprisingthatalowerportionofourpregnantmothersreceivetimelyprenatalcare.Thisresultsinahigherrateofprematurebabies,ofwhichaportionwillexperiencedevelopmentaldelaysthroughoutchildhood.

• Highratesofobesityexistinourservicearea,atrendfueledbyourcommunity’ssocialandenvironmentalchallenges.Obesepregnantwomenareatahigherrisktodeveloppre-eclampsia,hypertension,andgestationaldiabetes,andtheyaremorelikelytoneedcesareansectionswithhigherratesofcomplicationsfromthesurgery,includinginfections,hernias,andinternalbleeding.Further,obesemotherstendtohavelargerbabies(e.g.,ninepoundsorgreater),andthesebabieshavehigherratesofbirthcomplications,including:

§ Neuraltubedefectssuchasspinabifida

§ Cardiovasculardefects

§ Cleftlipandcleftpalates

§ Hydrocephaly

§ Limbreductionabnormalities

§ Shoulderdystocia,whichcanleadtopermanentfetalinjuryduringbirth,neurologicaldisorders,andevendeath


Metric MLKCHServiceArea

LosAngelesCounty California

PercentofBirthstoTeenageMothers(UndertheAgeof20YearsOld) 11.6% 6.3% 6.2%

PercentofMotherswithOn-TimeEntryintoPrenatalCare 77.5% 84.9% 83.6%

PercentofBirthsResultinginLowBirthWeightBabies(<2,500g) 7.7% 7.0% 6.8%

InfantMortalityRate 6.1 4.3 4.7

BreastfeedingInitiated 88.2% 93.1% NotAvailable

BreastfeedingExclusivelyforSixMonths 44.7% 49.7% NotAvailable

BreastfeedingExclusivelyforTwelveMonths 31.7% 27.6% NotAvailableSources:CaliforniaDepartmentofPublicHealth,VitalStatisticsQuerySystem,2013http://informaticsportal.cdph.ca.gov/chsi/vsqs/;CaliforniaHealthandHumanServicesDataPortal,2013https://chhs.data.ca.gov/browse?category=Demographics;LosAngelesCountyHealthSurvey,2017.www.publichealth.lacounty.gov/ha/LACHSDataTopics2015.htm*InfantMortalityRatefortheHospitalServiceAreaisapproximate.

DisabilityAlmost40%ofouradultcommunityhasreportedatleastonedisability.Combinedwithagingofthebabyboomerpopulation,ourcommunityisfacedwithuniquechallengesrelatedtoaginganddisability.Ahigherportionofolderadultswithdisabilitiesimpliesagreaterdemandforlong-termcareservices.

PopulationwithaDisability


AdultswithaDisability 39.4% 28.6% 28.9%

DisabledPersonswithHealthInsurance 35.0% 84.6% 87.8%Source:CaliforniaHealthInterviewSurvey,2014;http://ask.chis.ucla.edu/

HIV/AIDSDespiteadecliningrateofHIV/AIDSdiagnosesinourcommunity,SPA6stillhasahigherincidenceofthesecaseswhencomparedtoLosAngelesCountyoverall.

• Ratesofnewdiagnosesarehighestamongmales,youngadultsages20to29years,andAfricanAmericans.

• 83%ofthenewcaseswerereportedlyviamale-to-malesexualcontact,10%viaheterosexualsex,and7%werecaseswhereIVdrugusewasimplicated.


HIV/AIDSDiagnoses,NumberandRateper100,000Persons,2011–2013

GeographicArea2011 2012 2013

Number Rate Number Rate Number Rate

SPA6 279 28 233 23 244 24

LosAngelesCounty 1,997 20 2,012 20 1,820 18

Source:CountyofLosAngeles,PublicHealth,2014AnnualHIV/STDSurveillanceReporthttp://publichealth.lacounty.gov/dhsp/Reports/HIV-STDsurveillanceReport2014.pdf

SexuallyTransmittedInfectionsSPA6hasthehighestrateofchlamydiaandthesecond-highestrateofgonorrheaandearlysyphilisamongallotherServicePlanningAreasinLosAngelesCounty.

• Femalesages20to24yearshavethehighestratesofchlamydia,malesages20to29yearshavethehighestratesofgonorrhea,andmalesages25to34yearshavethehighestsyphilisrates

• AfricanAmericanshavethehighestratesofthelistedsexuallytransmittedinfections

STICases,Rateper100,000Persons,2014

SexuallyTransmittedInfection SPA6 LosAngelesCounty

Chlamydia 993 551

Gonorrhea 305 154

EarlySyphilis(Primary/SecondaryorEarlyLatent) 15 26Source:CountyofLosAngeles,PublicHealth,2014AnnualHIV/STDSurveillanceReporthttp://publichealth.lacounty.gov/dhsp/Reports/HIV-STDsurveillanceReport2014.pdf

DentalCare12.7%ofchildreninSPA6werereportedashavingneverbeentoadentist.43.1%ofadultsinSPA6hadbeentothedentistinthepastyear,comparedto59.3%ofadultsintheCountywhohadbeentothedentistduringthissametimeperiod.Historically,Medi-Cal,whichcoversthelargestportionofourpopulation,hasnotofferedrichbenefitsfordentalservices,andtheStatewillperiodicallylimitbenefitsandevenexcludeadultsfromthiscoverageduetobudgetlimitations.ResearchpublishedbytheMayoClinicshowsthatpoororalhealthimpactsphysicalhealthbycontributingtothefollowingdiseasesandconditions:


• Endocarditis

• Cardiovasculardisease

• Hypertension

• Prematurebirthsduringpregnancy,andlowbirthweightbabies

“Dentalcareisfragmented.Thereisalackofeducationoftheimportanceofdentalcareandtheimpactithasonphysicalcare.ThereisalackofresourcesforhowpatientscanaccessclinicsandDenti-Cal.Patientsarepresentinglateandhaveadvanceddiseaseandlimitedresources.”

—MLKCHPatientandCommunityMember

DelayofDentalCareAmongChildrenandTeens,2013-2014

Trend SPA6 LosAngelesCounty California

ChildrenNeverBeentotheDentist 12.7% 18.1% 17.7%

ChildrenBeentoDentistLessThan6Monthsto2Years 86.9% 80.9% 81.2%

TeensNeverBeentotheDentist 0.0% 2.6% 2.1%

TeensBeentoDentistLessThan6Monthsto2Years 98.4% 94.9% 94.8%Source:CaliforniaHealthInterviewSurvey,2013-2014.http://ask.chis.ucla.edu/*=statisticallyunstableduetosamplesize

AdultDentalCare

Trend SPA6 LosAngelesCounty

AdultsWhoHaveDentalInsurancethatPaysforSomeorAllofTheirRoutineDentalCare

37.1% 48.2%

AdultsUnabletoObtainDentalCareBecauseTheyCouldNotAffordIt

44.5% 30.3%

AdultsWhoReportedTheirLastVisittoaDentistWasLessThan12MonthsAgo*

43.1% 59.3%

Source:LosAngelesCountyDepartmentofPublicHealth,LosAngelesCountyHealthSurvey2011and*2015.www.publichealth.lacounty.gov/ha/LACHSDataTopics2011.htm


PreventivePracticesFluandPneumoniaVaccineGiventhechallengesourcommunityexperiencesaccessingmuchneededmedicalanddentalcare,itisnotsurprisingthatmanyofourresidentsgowithoutprimarypreventivecare.Specifically,ourcommunityhaslowerratesofreceivingfluandpneumoniavaccinationswhencomparedtoLosAngelesCountyandCalifornia.Forsome,ourratesarelessthanhalfoftheHealthyPeople2020Target.Thisresultsinhigherratesofinpatienthospitalizations,pneumococcalinfections,andevendeathifinfectionsareuntreatedorifmedicalcareisdelayed.

Characteristic SPA6 LosAngelesCounty California HealthyPeople

2020TargetReceivedFluVaccine,65+YearsOld 58.5% 69.7% 72.7% 90.0%

ReceivedFluVaccine,18-64 34.5% 32.5% 37.4% 70.0%ReceivedFluVaccine,6Months-17YearsOld 57.4% 47.8% 53.7% 70.0%

Adults65+,HadaPneumoniaVaccine 51.1% 62.0% NotReported 90.0%

Source:CaliforniaHealthInterviewSurvey,2014.http://ask.chis.ucla.edu/LosAngelesCountyHealthSurvey,2015.http://www.publichealth.lacounty.gov/ha/LACHSDataTopics2015.htm

ImmunizationofChildrenFourschooldistrictssupportourcommunity–ComptonUnifiedSchoolDistrict,LosAngelesUnifiedSchoolDistrict,LynwoodUnifiedSchoolDistrict,andParamountUnifiedSchoolDistrict.Ofthefour,theLosAngelesUnifiedSchoolDistricthadtheloweststudentimmunizationcomplianceat85.6%ofchildrenenteringkindergarten;thisrateisbelowbothCountyandStateaverages.TheComptonschooldistrictstandsoutasahighperformer.


Up-to-DateImmunizationRatesofChildrenEnteringKindergarten,2015-2016

SchoolDistrict ImmunizationPercent

ComptonUnifiedSchoolDistrict 95.3%

LosAngelesUnifiedSchoolDistrict 85.6%

LynwoodUnifiedSchoolDistrict 92.8%

ParamountUnifiedSchoolDistrict 91.2%


California 92.9%Source:CaliforniaDepartmentofPublicHealth,ImmunizationBranch,2015-2016.https://www.cdph.ca.gov/programs/immunize/Pages/ImmunizationLevels.aspx

MammogramsandPapSmearsWhencomparedtotheHealthPeople2020Targets,notnearlyenoughwomeninourcommunityareseekingpreventativehealthcareservicesbaseduponrecommendedclinicalguidelines,specificallyformammogramsandpapsmears.

PercentageofWomenReceivingMammogramsandPapSmears

Metric SPA6 LosAngelesCounty HealthyPeople2020Target

Women50-74Years,HadaMammograminPastTwoYears

77.6% 77.3% 81.1%

Women21-65;PapSmearinPastThreeYears

84.2% 84.4% 93.0%

Source:LosAngelesCountyHealthSurvey,2015.http://www.publichealth.lacounty.gov/ha/LACHSDataTopics2015.htm

Factorsthatcontributetothistrendinourcommunityinclude:

• Lowincome,orworryaboutcost

• Lackofaccesstocare(orlackofalocal(oreasytogetto)mammographycenterorlackoftransportationtosuchacenter

• Lackofawarenessofbreastorcervicalcancerrisksandscreeningmethods

• Lackofchildcare

• Lackofsickleaveorinabilitytomisswork

• Culturalandlanguagedifferences


AccordingtoresearchconductedbytheAmericanCancerSociety,Hispanic/Latinawomenage40yearsandolderaretheleastlikelytohavehadamammograminthepasttwoyears.16

HealthyBehaviorsTheCDCfoundthatmorethanone-thirdofournation’sadultsareobese,andtheassociatedmedicalcostsforthemareroughly$1,429higherthanforthosewhoareatwhatisconsideredahealthyweight.WhilemillionsofAmericansstrugglewithweightissues,theyarealsoatriskfor-orarealreadysufferingfrom-associatedchronicdiseasessuchastype2diabetes,heartdisease,cancerorstroke.17Socioeconomicissuesaretiedtoobesityandhealthybehaviors.Studieshavefoundthatcommunitieswiththehighestobesityratesandunhealthybehaviorsarethosethataresocioeconomicallydisadvantaged,oftenlackinginbasicresourcessuchasaccesstohealthyfood,safeplacestoexercise,andtheoverallstandardofcarethattheyneedtogethealthy.ResearchhasalsoproventhatobesityandchronicdiseaseisespeciallywidespreadamongAmericanswiththelowlevelsofeducationandthosewiththehighestpovertyrates–allchallengesthatwehavefoundtoexistonalargescalethroughoutourcommunity.BasedupontheCountyHealthRankings2017Report,LosAngelesCountywasranked21stof57countiesacrosstheStatebaseduponfourmajorhealthindicators:adultsmoking,obesityandphysicalinactivity,excessivedrinking,andsexuallytransmittedinfections.Forsomemetrics,wearefarbelowCountyandStateaverages,withgreatopportunitytopositivelyaffectchangeintheoverallhealthofourcommunityandthewaytheyliveeachday.

“Aseriousprobleminourcommunitystemsfromlackofqualityfood,andqualityatanaffordableprice,systemicproblemsoflackinggoodjobsandeconomicempowerment.Ifyoudon’tmakealotofmoney,yourdefinitionofaqualitymealisRamenNoodlesorCup-a-Souporalow-qualitypieceofmeatandbreadandpasta.Wearemoreofareactivecommunitythanapreventativecommunity.Wefindoutwehavediabetes,thenthesolutionistotakediabetesmedicineeverydayandnotcreateahealthierlifestyle.”

—CommunityMember

16AmericanCancerSociety.CancerPrevention&EarlyDetectionFacts&Figures,2015-2016.17CentersforDiseaseControlandPrevention.DataandStatistics,2015.https://www.cdc.gov/obesity/data/index.html


OverweightandObesityPrevalenceHighratesofoverweightandobesityexistinourcommunity.Further,SPA6isnotmeetingtheHealthyPeople2020Targetforobesity–30.5%foradultsage20yearsandolder,and16.1%forteens.

OverweightandObesity

PopulationCohort SPA6 LosAngelesCounty California

Overweight:

Adult(18+Years) 37.6% 35.2% 35.4%

Teen(Ages12-17) 14.3% 19.2% 17.2%

Child(Under12) 16.8% 12.7% 12.5%

Obesity:

Adult(Ages20+Years) 38.7% 25.9% 25.8%

Teen(Ages12-17Years) 19.7% 14.9% 14.9%Source:CaliforniaHealthInterviewSurvey,2011-2014.http://ask.chis.ucla.edu/

AfricanAmericansandHispanics/Latinos,whichrepresent93%ofourserviceareapopulation,havethehighestratesofoverweightandobeseadults.

Adults,20+YearsofAge,OverweightandObesitybyRace/Ethnicity

EthnicCohort SPA6 LosAngelesCounty California

AfricanAmerican 79.1% 75.8% 74.2%

Asian 43.1% 39.3% 40.6%

Hispanic/Latino 76.6% 72.0% 73.5%

White 55.6% 55.2% 58.1%Source:CaliforniaHealthInterviewSurvey,2011-2014.http://ask.chis.ucla.edu/


PhysicalFitnessThephysicalfitnesstest(PFT)forstudentsinCaliforniaschoolsistheFitnessGram®,ofwhichbodycompositionisoneofthecomponentsmeasured.Childrenwhodonotmeetthe“HealthyFitnessZone”criteriaforbodycompositionarecategorizedasneedingimprovementorathealthrisk(overweight/obese).

• InComptonUnifiedSchoolDistrict,overhalfofall5th(55.8%)and9thgraders(51.6%)testedasneedingimprovementorathealthrisk.

• InLAUSDandLynwoodUnifiedSchoolDistrict,almosthalfofthe5thgraders(49.8%and49.5%respectively)testedasneedingimprovementorathealthrisk.Among9thgraderstherateswereimprovedbutshowedahigherrateofunhealthybodycompositionthanCountyandStaterates.

5thand9thGraders,BodyComposition,NeedsImprovement+HealthRisk

SchoolDistrict FifthGrade NinthGrade

ComptonUnifiedSchoolDistrict 55.8% 51.6%

LosAngelesUnifiedSchoolDistrict 49.8% 45.6%

LynwoodUnifiedSchoolDistrict 49.5% 41.3%

ParamountUnifiedSchoolDistrict N/A 38.9%

LosAngelesCounty 44.0% 39.0%

California 40.3% 36.0%Source:CaliforniaDepartmentofEducation,FitnessgramPhysicalFitnessTestingResults,2014-2015.http://data1.cde.ca.gov/dataquest/page2.asp?Level=District&submit1=Submit&Subject=FitTest

PhysicalActivityAsmentionedearlierinthisreport,SPA6hasfewerparksandgreenspaceavailablewhencomparedtoLosAngelesCounty.Giventhistrend,ourcommunityactuallyperformsslightlybetterforcombinedchildandteensedentaryrateswhencomparedtotheCountyandState.However,whenevaluatingteensexclusively,thisagegroupdemonstratedhighersedentaryratesandlesstimespentinparksandotheropenspaces.

PhysicalActivity


5+HoursSpentonSedentaryActivitiesAfterSchoolOnaTypicalWeekday-ChildrenandTeens 9.9% 11.2% 11.4%

8+HoursSpentonSedentaryActivitiesOnaTypicalWeekendDay-ChildrenandTeens 11.3% 25.2% 22.8%


TeensNoPhysicalActivityinaTypicalWeek 14.5% 9.4% 8.6%

TeensVisitedPark/Playground/OpenSpaceinPastMonth 65.9% 69.9% 71.9%

Source:CaliforniaHealthInterviewSurvey,2013-2014;http://ask.chis.ucla.edu/

Further,only39.4%ofouradultsindicatedthattheyusecommunitywalkingpaths,parks,andplaygrounds.Thistrendisalsoattributedtothelimitedgreenspaceavailableinourcommunity,aswellasthefactthatonly40%ofouradultsperceivetheirneighborhoodstobesafe.

AdultsUseofWalkingPaths,PlaygroundsorSportsFieldsinTheirNeighborhoods

Characteristic SPA6 LosAngelesCounty

Yes,UseWalkingPath,ParksandPlaygrounds 39.4% 47.5%

No,DoNotUse 38.9% 37.2%

NeighborhoodDoesNotHave 21.7% 15.2%Source:LosAngelesCountyHealthSurvey,2015.http://www.publichealth.lacounty.gov/ha/LACHSDataTopics2015.htm

EatingHabitsSPA6hashigherratesoffastfoodandsodaconsumptionamongadultsandchildrenwhencomparedtotheCountyandState.Thistrendisdirectlyrelatedtothefactthatportionsofourcommunityareidentifiedasfooddeserts,withlimitedaccesstohealthy,fresh,andaffordablefoodandanoverabundanceoffastfoodavailablethroughoutourservicearea,resultinginhighratesofoverweightandobesityacrossourpopulation.

“Alargeportionofourpopulationisobeseoroverweightsoit’sahugeproblembecauseprevalenceissohigh.Alackoffreshfruitsandvegetablesandexercise,it’sjustsopartofourculture.”

—CommunityMember


EatingHabits


Adult,Aged18-64,FastFoodConsumption 30.7% 26.8% 23.9%ChildrenandYouth,0-17YearsofAge,FastFoodConsumption

20.6% 16.4% 14.9%

AdultSodaConsumption 16.8% 10.2% 10.1%Drank1orMoreGlassesofSodathePreviousDay,ChildrenAges0–11Years

18.6% 15.6% 15.4%

Drank1orMoreGlassesofSodathePreviousDay,Teens,Ages12–17Years

49.0% 37.6% 34.5%

ConsumptionofFruit,2orMoreServingsaDay,ChildrenAges0–11Years

76.6% 67.6% 69.8%

ConsumptionofFruit,2orMoreServingsaDay,TeensAges12–17Years

47.9% 54.9% 56.0%

Source:CaliforniaHealthInterviewSurvey,2011-2014;http://ask.chis.ucla.edu/

MentalHealthandSubstanceAbuseArecentreportfromtheCDCrevealedtheurgentstateofmentalhealthacrossournation:from1999to2014,theage-adjustedsuiciderateintheU.S.jumpedby24percent.Suicidesroseforbothmenandwomenacrossallages10to74yearsold.18Ourcountryasawholeisfacingseriouschallengesaddressingmentalhealth,andthesechallengesarefurthercompoundedinunderservedcommunitieswhereindividualsarefacedwithsocial,emotional,environmental,andphysicaldisparities.Unfortunately,SPA6isnotuniqueandourresidentsexperienceincreasingbarrierstomentalhealthcareaccess,including:

• Lackofaccessandasubstantialshortageofmentalhealthprofessionalsthatpracticeinourcommunity

• Costofcare

• Lowperceivedneedinwhichourresidentsfeelasthoughtheycanhandletheproblemwithouttreatment

• Afeelingofshameorsensethatmentalhealthserviceusewouldhaveanegativeeffectonrelationshipsandemployment

18CentersforDiseaseControlandPrevention.DataandStatistics,2015.https://www.cdc.gov/obesity/data/index.html19Pittalwala,Iqbal.“Studypointstohowlow-income,resource-poorcommunitiescanreducesubstanceabuse.”ScienceDaily.

April21,2016.https://www.sciencedaily.com/releases/2016/04/160421171353.htm


Withinthepastyear,almosthalfoftheadultsinSPA6(45.6%)whoneededhelpforanemotionalormentalhealthproblemdidnotreceivetreatment,andourcommunityconsistentlydemonstrateshighratesofpsychologicaldistressacrossouradultandteenpopulations.MentalHealthIndicators,Adults


AdultswhohadSeriousPsychologicalDistressDuringPastYear 8.2% 9.6% 7.7%

AdultswhoNeededHelpforEmotional-Mentaland/orAlcohol-DrugIssuesinPastYear 15.0% 18.0% 15.9%

AdultswhoSawaHealthCareProviderforEmotional/MentalHealthand/orAlcohol-DrugIssuesinPastYear

10.9% 13.0% 12.0%

HasTakenPrescriptionMedicineforEmotional/MentalHealthIssueinPastYear 8.0% 9.2% 10.1%

Sought/NeededHelpbutDidNotReceiveTreatment 45.6% 43.2% 43.4%Source:CaliforniaHealthInterviewSurvey,2014.http://ask.chis.ucla.edu/

MentalHealthIndicators,Teens


TeensWhoNeededHelpforEmotionalorMentalHealthProblemsinPastYear 13.8% 19.1% 19.8%

TeensWhoHadSeriousPsychologicalDistressDuringthePastMonth 4.8% 4.9% 4.2%

Source:CaliforniaHealthInterviewSurvey,2011-2014.http://ask.chis.ucla.edu/

AdultSocialandEmotionalSupport


AdultsWhoReportReceivingtheSocialandEmotionalSupportTheyNeed,UsuallyorAlways 55.7% 64.0%



AdultswithDepression


AtRiskforMajorDepression 16.8% 11.8%

EverDiagnosedwithDepression 11.9% 13.0%CurrentDepressionandCurrentlyBeingTreatedorHavingSymptomsofDepression

8.4% 8.6%


Tobacco/Alcohol/DrugUseOurcommunityhassimilarratesofsmokingandbingedrinkingwhencomparedtoLosAngelesCountyoverall.Additionally,almost30%ofourteensreportedillegaldruguse–aratethatisnearlydoublewhencomparedtotheCountyandStateoverall.ResearchconductedbytheUniversityofCalifornia-Riversidebetween2010and2012foundthatillegaldruguse(e.g,cocaine)amongAfricanAmericansandotherminoritypopulationshasincreasedsubstantiallyinsomeofthemostunderservedareasoftheUnitedStates1919andthoseafflicteddonothavethefinancialresourcesforformalsubstanceabuserecoveryandrehabilitationprograms.Thesepopulationsrelyheavilyonsupportfromnon-drugusingfamilyandfriends,andneedaccesstoemployment,thefaithcommunity,andeducationtoreduceandovercomesubstanceabuse.


PercentofAdultsWhoSmokeCigarettes 13.0% 13.3% 11.6%

PercentofAdultswhoReportBingeDrinkingDuringthePastYear 31.9% 31.5% 32.6%

PercentofTeenswhoReportEverHavinganAlcoholicDrink 27.9% 27.3% 26.4%

PercentofTeensWhoReportEverTryingIllegalDrugs,IncludingMarijuana,Cocaine,SniffingGlueOrOthers*

28.5% 15.2% 13.2%

PercentofTeenswhoReportUsingMarijuanainPastYear* 7.7% 10.2% 9.2%

PercentofAdultswhoReportUsingAnyFormofMarijuanainthePastYear 11.9% 11.6% NotReported

PercentofAdultsWhoReportMisusingAnyFormofPrescriptionDrugsinthePastYear 6.8% 5.5% NotReported

Sources:CaliforniaDepartmentofPublicHealth;CaliforniaHealthInterviewSurvey,2011-2014,http://ask.chis.ucla.edu;LosAngelesCountyHealthSurvey,2015.http://www.publichealth.lacounty.gov/ha/LACHSDataTopics2015.htm

19Pittalwala,Iqbal.“Studypointstohowlow-income,resource-poorcommunitiescanreducesubstanceabuse.”ScienceDaily.April21,2016.https://www.sciencedaily.com/releases/2016/04/160421171353.htm


Conclusions

Ourcommunity,whilerichindiversityandculture,representsoneofLosAngelesCounty’smostvulnerableandunderservedpopulations,withpovertyrates,unemployment,andmetricsofpoorhealthandunhealthybehaviorsexceedingotherregionsinLosAngelesCounty.Our1.3millionresidentsare93%HispanicorAfricanAmerican,and45,000aredual-eligibleforbothMedi-CalandMedicareandhavesomeofthemostcomplexandcostlyhealthcareneedsinallofourcommunity.Majordisparitiesandinequityexistinourlocalhealthcaresystemtoday–wehavethelowestrateofinpatientlicensedbedsandEDstationsinallofLosAngelesCounty,andaccesstoanyprovider–includingprimaryandspecialtyprovidersinboththeambulatoryandinpatientcaresettings,aswellaspost-acuteproviders,isverylimited.Manyofourpatientsaretransferredorreferredoutoftheareaforcarebecauseourcommunitydoesnothavethecapacityandinfrastructureforcommonspecialtycareprograms,suchasinterventionalcardiology,outpatientcolonoscopiesandendoscopies,interventionalradiologyforvasculardiseases,urologyanduro-gynecologyprocedures,andmanyambulatorysurgeryprocedures.Oncethesepatientsaretransferredout,thereislittletonocarecoordinationorfollow-upcarelocallytomanagetheseconditions.Further,educationopportunitiesandaccesstohealthy,affordablefood,qualityhousing,andgreenspaceisscarce,andourcommunityhashighratesofcrime,druguse,andfastfoodconsumption,andanoverabundanceofliquorstores.Giventhesechallenges,itisnotsurprisingthatourcommunityhashigherratesofchronicdiseases,mortality,andobesity,acultureofunhealthybehaviors,anddelayedreceiptofcriticalhealthcareservices.


Recognizingthateconomicopportunities,environmentalfactors,healthcareinfrastructure,andsocialnetworksarekeydeterminantsofhealth,MLKCHisfocusedonreachingbeyondthewallsoftheHospitaltoaddressthesehealthcaredisparitiesandbuildhealthequityinourcommunity.Throughthisprocess,wehaveanalyzeddataandobtainedinputfromourcommunitystakeholderstoidentifysignificanthealthneedsinourcommunity.


SignificantHealthNeedsinOurCommunity

Aswemoveforward,thesepriorityareaswillbeusedtoguidethedevelopmentofaCommunityBenefitPlan,withinitiativesdesignedtoaddresstheseissues,suchas:

• Expandingaccesstoprimaryandspecialtyoutpatientcareservicestopromoteprevention(immunizationsandscreenings),andmanagechronicconditions

• Offeringmorewomen’shealthcareservicestoaddresstheneedforprenatalcare,otherreproductivehealthcare,andaccesstopreventativescreeningservicessuchasmammogramsandpapsmears

• Providingmorehealtheducationandsupportsothatresidentsunderstandthehealthcareservicesthatareavailabletothemlocally,aswellastoprovidethemwiththerightinformation,inlanguagetheyunderstand,sotheycanlivehealthierlifestylesandbettermanagetheirownchronicconditions

• Addressingtheneedformoreresourcesto:1)helppeoplestrugglingwithmentalhealthconditionsandsubstanceabuse;and2)houseandstabilizepeoplewhoarehomelessoratriskofbecominghomeless

• Collaboratingwithourcommunitypartnerstopromoteanenvironmentandlifestyleofhealthandwellnessthatincludes:accesstohealthy,fresh,affordablefoodthroughfarmersmarkets,grocerystores,andhealthierrestaurants;expansionofsafe,greenspacethroughoutourneighborhoods;andareductioninthenumberofliquorstoresdispersedthroughoutourcommunity.

Buildingahealthycommunityrequiresmultiplestakeholdersworkingtogetherwithacommonpurpose.WelookforwardtousingthisCHNAasourfoundationtocollaboratewithourpartnersasweseektofulfillourmissionof“improvingthehealthofourcommunity”andbuildinghealthyequityinanareathathasbeendeservingforsolong.

PrimaryandPreventativeCare

Access

SpecialtyCareAccess CareCoordination ChronicDisease

Management

DentalCareLocalHealthcareInfrastructureand

Capacity

HealthyandSafeEnvironment

MaternalandInfantHealth

MentalHealth OverweightandObesity

SexuallyTransmittedInfections

SubstanceAbuse


AppendixA:CommunityStakeholderInterviewsCompleted

Communityinputwasobtainedfromacademicresearchexperts,publichealthprofessionals,representativesfromorganizationsthatrepresentmedicallyunderserved,low-income,orminoritypopulations,andcommunityresidents.

Name Title Organization

JohnBaackes ChiefExecutiveOfficer LACareHealthPlan

DannyBakewell,Jr. Editor LosAngelesSentinel

Dr.MedellBriggsSeniorMedicalDirectorofQuality

MartinLutherKing,Jr.CommunityHospital

CynthiaDavis AssistantProfessor CharlesDrewUniversity

Dr.HelenDuplessis ChiefMedicalOfficer St.John’sWellChildandFamilyCenter

Dr.JohnFisher ChiefMedicalOfficer MartinLutherKing,Jr.CommunityHospital

Dr.StanFrencher Urologist,DirectorofSurgicalOutcomesandQuality


KennethaGainesDirectorofMaternalChildHealth


Dr.MarianneGausche-Hill MedicalDirector LosAngelesCountyEmergencyMedicalServicesAgency

OzieGonzaque CommunityLeader GonzaqueVillagePublicHousing

SweetAliceHarris ParentsofWatts CommunityLeaderandOrganizer

Dr.DamienKessler Principal GeorgeWashingtonCarverElementarySchool

Dr.JanKingAreaHealthOfficer,WestandSouthLosAngeles

LosAngelesCountyDepartmentofPublicHealth

Dr.NathanaLurveyChairofWomenandChildrenServices


LouiseMcCarthy,MPPPresidentandChiefExecutiveOfficer

CommunityClinicAssociationofLosAngeles

Dr.VynetteMoore ProgramManager ShieldsforFamilies/WelcomeBaby

YeseniaMounsourPublicAffairsandBrandCommunication KaiserPermanente

CynthiaOliverChiefExecutiveOfficer,OutpatientCenter

MartinLutherKing,Jr.OutpatientCenter

GaryPainter,Ph.D. DirectorofSocialPolicy USCSolPriceCenterforSocialInnovation

ReginaldPope Reverend BethelMissionaryBaptistChurch


Name Title Organization

AlbertoRetana ChiefExecutiveOfficer CommunityCoalitionSouthLosAngeles

JanRobinson-Flint President BlackWomenforWellness

Dr.EllenRothman ChiefMedicalOfficer MartinLutherKing,Jr.OutpatientCenter

BarbaraStanton WattsTheater CommunityLeader

NinaVaccaro,MPH ChiefOperatingOfficer CommunityClinicAssociationofLosAngeles

YolandaVera SeniorDeputyHealthAdvocacyandChiefCounsel,LosAngelesCountySupervisorMarkRidley-Thomas

GloriaWalton President SCOPE/AGENDA

TimWatkins PresidentandCEO WattsLaborCommunityActionCommittee


AppendixB:HealthcareResourcesAvailableInOurCommunity

Communityresourcestopotentiallyaddresstheidentifiedsignificanthealthneedsarelistedinthetablebelow.Thisisnotacomprehensivelistofallavailableresources.ForadditionalresourcesrefertoThinkHealthLAatwww.thinkhealthla.organd211LACountyathttps://www.211la.org/.

SignificantHealthNeeds CommunityResources

Accesstocare

• BlackWomenforWellness

• CommunityCoalitionSouthLosAngeles

• CommunityHealthCenters

• HealthyWayLA

• LosAngelesCountyDepartmentofPublicHealth

• SouthLosAngelesHealthCouncils

Communitysafety

• CommunityCoalitionSouthLosAngeles

• ElevateYourG.A.M.E.

• Faithcommunity

• NeighborhoodWatch

• ParentsofWatts

• ParksafterDark

• Schoolsandschooldistricts

• SummerNightLights

• WattsLibraryProgram

Dentalcare


• HealthySmiles

• USCSchoolofDentistry,mobiledentalclinic

Diabetes

• AmericanDiabetesAssociation


• Promotoras




HeartDisease

• AmericanHeartAssociation

• ChooseHealthLA


• LosAngelesCountyOfficeofEducation

• ParksandRecreationprograms

MaternalandInfantHealth

• BestStart

• ChildCareAllianceofLosAngeles

• First5LA


• LosAngelesUnifiedSchoolDistrict

• PlannedParenthood

• SHIELDSforFamilies

• WelcomeBaby

• WIC(Women,InfantsandChildren)

Mentalhealth

• CaringConnections

• CommunityFamilyGuidanceCenter


• ExodusRecovery

• LosAngelesCountyDepartmentofMentalHealth

• NAMI


• WattsCounselingandLearningCenter

Overweightandobesity


• Farmer’sMarkets

• LosAngelesFoodPolicyCouncil



• PlayfulCityUSA

• WIC(Women,InfantsandChildren)

SexuallyTransmittedInfections

• AIDSProjectLosAngelesHealth&Wellness

• BIENESTAR

• BlackWomenforWellness



• PlannedParenthood

Substanceabuse

• AlcoholicsAnonymous

• Faithcommunity

• LACADA

• LACountySheriff’sDepartment

• NarcoticsAnonymous

• SHIELDSforFamilies

• UCLAAddictionCenter

Aninventoryofadditionalhealthprovidersandresourcesavailableinourcommunityareprovidedbelowandonthefollowingpages.

CommunityClinics

FacilityName StreetAddress City ZIPCode

AghabyComprehensiveCommunityHealthCenter 349W.ComptonBoulevard Compton 90220

AllCareOneCommunityHealthCenter 7300SantaFeAvenue HuntingtonPark 90255

AltamedMedicalGroup–HuntingtonPark 1900E.SlausonAvenue Huntington

Park 90255

AltamedPace–HuntingtonPark 1900E.SlausonAvenue,SuiteB

HuntingtonPark 90255



AltamedPaceSouthLosAngeles 1776E.CenturyBoulevard LosAngeles 90002

AltamedSeniorBuenaCareLynwood3820MartinLutherKing,Jr.Boulevard Lynwood 90262

APLADentalServices–S.MarkTaperCenter 1741E.120thStreet LosAngeles 90059

APLAHealth&WellnessCenter–BaldwinHills 3743S.LaBreaAvenue LosAngeles 90016

BAARTLynwoodClinic 11315AtlanticAvenue Lynwood 90262

BAARTSoutheastClinic 4920AvalonBoulevard LosAngeles 90011

BANJFamilyMedicalClinic3620MartinLutherKing,Jr.Boulevard Lynwood 90262

BenevolenceHealthCenter611E.ImperialHighway,Suite107 LosAngeles 90059

BenevolenceHealthCenter 920N.LongBeachBoulevard,Suite1 Compton 90221

BSNJHealthCenter,Inc. 201N.CentralAvenue Compton 90220

CentralCityCommunityHealthCenter 5970S.CentralAvenue LosAngeles 90001CentralCityCommunityHealthCenter–MobileUnit 5968S.CentralAvenue LosAngeles 90001

CentralNeighborhoodHealthFoundation 2707S.CentralAvenue LosAngeles 90007

CentralNeighborhoodHealthFoundation 2614S.GrandAvenue LosAngeles 90011

ClinicaParaLaMujer 3624MartinLutherKing,Jr.Boulevard Lynwood 90262

CommunityMedicine,Inc. 8540AlondraBoulevard,SuiteB-2 Paramount 90723

CommunityOutreachMedicalServices 4300CrenshawBoulevard LosAngeles 90008CompleteCareHealthCenter–SouthGate

5831FirestoneBoulevard,SuiteE SouthGate 90280

CrenshawCommunityClinic 3631CrenshawBoulevard,Suite109 LosAngeles 90016

CrenshawCommunityHealthCenter 3756SantaRosaliaDrive,Suite400 LosAngeles 90008

EisnerPediatric&FamilyMedicalCenteratLynwood 3680E.ImperialHighway Lynwood 90262

ElizabethHealthCenter–NECC 2822E.FlorenceAvenue HuntingtonPark 90255

EngemannStudentHealthCenter 1031W.34thStreet LosAngeles 90089

FlorenceMedicalCenter 1039W.FlorenceAvenue LosAngeles 90044

FoshayClinic 3751S.HarvardBoulevard LosAngeles 90018

FremontWellnessCenter 7821AvalonBoulevard LosAngeles 90003



HealthCareIntegratedServices2600N.CentralAvenue,SuiteB1 Compton 90222

HillStreetMedicalandMentalHealthServices 3130S.HillStreet LosAngeles 90007

HuntingtonParkFamilyHealthCenter 2680SaturnAvenue HuntingtonPark 90255

JordanWellnessCenter 10110JuniperStreet LosAngeles 90002

KedrenCommunityCareClinic 4211AvalonBoulevard,SuiteA LosAngeles 90011

LockeWellnessCenter 316E.111thStreet LosAngeles 90061

NECCGageHealthCenter 2975ZoeAvenue HuntingtonPark 90255

OrthopaedicInstituteforChildren 403W.AdamsBoulevard LosAngeles 90007PlannedParenthoodBasics,BaldwinHills/Crenshaw 3637S.LaBreaAvenue LosAngeles 90016

PlannedParenthoodLosAngeles–DorothyHechtCenter 8520S.Broadway LosAngeles 90003

PlannedParenthoodofLosAngeles–S.MarkTaperforMedicalTrainingCenter 400W.30thStreet LosAngeles 90007

PlannedParenthoodLosAngelesStollerFilerHealthCenter 11722WilmingtonAvenue LosAngeles 90059

R.O.A.D.S.CommunityCareClinic 121S.LongBeachBoulevard Compton 90221

SaludDigna 5900PacificBoulevard,Suite101

HuntingtonPark 90255

SouthBayFamilyHealthCareCenter 742W.GardenaBoulevard Gardena 90247

SouthCentralFamilyHealthCenter 4425S.CentralAvenue LosAngeles 90011

SouthGateCommunityClinic 5720ImperialHighway,SuiteN-O SouthGate 90280

St.AnthonyMedicalCenter/ImperialClinic 6368HollywoodBoulevard LosAngeles 90044

St.John’sWellChildandFamilyCenter 326W.23rdStreet LosAngeles 90007

St.John’sWellChildandFamilyCenter 1910MagnoliaAvenue LosAngeles 90007

St.John’sWellChildandFamilyCenter 5701S.HooverStreet LosAngeles 90037

St.John’sWellChildandFamilyCenter 808W.58thStreet LosAngeles 90037

St.John’sWellChildandFamilyCenter 4085S.VermontAvenue LosAngeles 90037

St.John’sWellChildandFamilyCenter 65058thAvenue LosAngeles 90043

St.John’sWellChildandFamilyCenter 1555W.110thStreet LosAngeles 90047

St.John’sWellChildCenter/Compton 2115N.WilmingtonAvenue Compton 90222

St.John’sWellChildandFamilyCenter3628E.ImperialHighway,Suite301 Lynwood 90262

T.H.EClinicatRuthTempleHealthCenter 3834S.WesternAvenue LosAngeles 90062



T.H.EHealthandWellnessCenteratLaBrea 3721S.LaBreaAvenue LosAngeles 90016

TheOasisMedicalClinic,Inc. 2635WalnutStreet HuntingtonPark 90255

UMMACommunityClinic 711W.FlorenceAvenue LosAngeles 90044

VermontCommunityClinic 5320S.VermontAvenue LosAngeles 90037

WattsHealthCenter 10300ComptonAvenue LosAngeles 90002

WesleyHealthCenter 3580E.ImperialHighway Lynwood 90262

WesleyHealthCenter 3591E.ImperialHighway Lynwood 90262WellnessCenteratJeffersonHighSchool 3410HooperAvenue LosAngeles 90011

CommunityHealthCentersandOtherOutpatientSpecialtyCareCenters


MartinLutherKing,Jr.OutpatientCenter 1670E.120thStreet LosAngeles 90059

MartinLutherKing,Jr.CenterforPublicHealth 11833S.WilmingtonAvenue LosAngeles 90059

RuthTempleHealthCenter 3834S.WesternAvenue LosAngeles 90062


DialysisCenters


AvalonDialysis 5807AvalonBlvd. LosAngeles 90011

BeachCitiesDialysis-Gardena,IDS 1045WRedondoBeachBlvd. Gardena 90247

BMACarsonCommunityDialysis 20710LeapwoodAve. Carson 90746

CAImperialCareDialysis,Davita 4345EImperialHwy. Lynwood 90262

CarsonAvalonDialysis,IDS 930EDominquezSt. Carson 90746ComptonCommunityHemodialysisCenter

801WComptonBlvd. Compton 90220

FlorenceDialysisCenter 351WFlorenceAve. LosAngeles 90003

GatewayPlaza,Davita 1580WRosecransAve. Compton 90222GreaterLAUniversityParkDialysis,Davita 3986SFigueroaSt. LosAngeles 90037

HuntingtonParkDialysis 5942RugbyAve. HuntingtonPark 90255

KennethHahnPlazaDialysisCenter 11854WilmingtonAve. LosAngeles 90059

KidneyDialysisCareUnit3600MartinLutherKingJrBlvd. Lynwood 90262

KidneyDialysisCenterOfBaldwinHills,LLC. 3705SLaBreaAve. LosAngeles 90016

LosAngelesDialysisCenter 3901SWesternAve. LosAngeles 90062LosAngelesDowntownDialysis,Davita 2021SFlowerSt. LosAngeles 90007

ParamountDialysisCenter,Davita 8319AlondraBlvd. Paramount 90723RAICareCenterComptonLosAngelesDialysisClinic 11859ComptonAve. LosAngeles 90059

SatelliteDialysisOfSouthGate 8716GarfieldAve. Southgate 90280U.S.RenalCareCarson-AvalonDialysis 930EDominguezSt. Carson 90746

U.S.RenalCareGardenaDialysis 1045WRedondoBeachBlvd. Gardena 90247U.S.RenalCarePacificGatewayDialysis 1149W190thSt. Gardena 90248

UniversityParkDialysisCenter 3986SFigueroaSt. LosAngeles 90037

VantageMedicalSupply 427N.LongBeach Compton 90221

DurableMedicalEquipment


BroadwayMedicalSupply 8512Broadway LosAngeles 90003


HomeHealthAgencies


AvalonVillaCareCenter 12029AvalonBoulevard LosAngeles 90061CaliforniaPost-AcuteCare 3615EastImperialHighway Lynwood 90262ClearViewConvalescentCenter 15823SouthWesternAvenue Gardena 90247CountryVillaEastNursingCenter 2415SouthWesternAvenue LosAngeles 90018CountryVillaUniversityPark 230EAdamsBlvd. LosAngeles 90011CrenshawNursingHome 1900SouthLongwoodAvenue LosAngeles 90016AllCareEnterprises,Inc. 1225W190thSt. Gardena 90248

ApexHomeHealthServices 3919WSlausonAve. LosAngeles 90043BrightHorizonsHomeHealthServices,Inc. 10511SWesternAve. LosAngeles 90047

CarepointeHomeHealthServices,Inc. 454ECarsonPlazaDr. Carson 90746

CaringmindsServices,Inc. 454ECarsonPlazaDr. Carson 90746

CharityHomeHealthServices 500ECarsonPlazaDr. Carson 90746ForeverCaringHomeHealthServices,Inc. 3756SantaRosaliaDr. LosAngeles 90008

GentleCare,Inc. 3701StockerSt. LosAngeles 90008IndependenceHomeHealthcare,Inc. 135WWalnutSt. Gardena 90248

LightHomeHealthAgency 23601AvalonBlvd. Carson 90745

MaximHealthcareServices,Inc. 1515W190thSt. Gardena 90248OptimumHomeHealthCareServices,Inc. 9426SWesternAve. LosAngeles 90047

RelianceHomeHealthServices 16660ParamountBlvd. Paramount 90723

SalcareHomeHealthServices 15607LakewoodBlvd. Paramount 90723

SanityHomeHealthServices,Inc. 10501SWesternAve. LosAngeles 90047

SupremeVisitingNurses,Inc. 550ECarsonPlazaDr. Carson 90746VantageHomeHealthCareServices,Inc. 20620LeapwoodAve. Carson 90746

WelcomeBabyLA-MLKJr.CommunityHospital 1680E.120ThStreet LosAngeles 90059

WisdomHealthcareServices,Inc. 16921SWesternAve. Gardena 90247

AllCareEnterprises,Inc. 1225W190thSt. Gardena 90248

ApexHomeHealthServices 3919WSlausonAve. LosAngeles 90043


Hospice


24/7AlphaHospiceandPalliativeCare 11900AvalonBlvd. LosAngeles 90061

ASpiritOfSupport,Inc. 2013W48thSt. LosAngeles 90062AllSeasonsHospice 16660ParamountBlvd. Paramount 90723AmanacerCommunityCounselingServices 1200WilshireBlvd. LosAngeles 90017

CharityHospiceCare,Inc. 500ECarsonPlazaDr. Carson 90746EvergreenHomeCare&Hospice,Inc. 3756SantaRosaliaDr. LosAngeles 90008

PsychiatricHealthFacilities


GatewaysHospitalAndMentalHealthCenter 216SLakeSt. LosAngeles 90057

JosephHRodd,M.D.,Inc. 20710LeapwoodAve.B Carson 90746

KedrenCommunityHealthCenter,Inc. 4211AvalonBlvd. LosAngeles 90011SouthernCaliforniaHealth&RehabilitationProgram 2610IndustryWay Lynwood 90262

TheRoadsFoundation,Inc. 121SLongBeachBlvd. Compton 90221

PhysicalTherapyServices


CommunityPhysicalTherapyCenter,Inc. 725SLongBeachBlvd. Compton 90221

GardenaPhysicalTherapy 1045WRedondoBeachBlvd. Gardena 90247

MaumWellnessPhysicalTherapy,Inc. 1607WRedondoBeachBlvd. Gardena 90247

PodiatryServices


AlfredGlover,DPM 1910SMagnoliaAve. LosAngeles 90007AllenB.PragerDPM,PC 3771SWesternAve. LosAngeles 90018ArnoldG.RoxasDPM,Inc. 1000EDominguezSt. Carson 90746

EastWestBaruchMedicalGroup,Inc. 7024SevilleAve.DHuntingtonPark

90255



KennethWilkins,DPM 3756SantaRosaliaDr.,#220 LosAngeles 90008LawrenceI.Rubin,DPMInc. 1045WRedondoBeachBlvd. Gardena 90247NathanJavari,DPM 231WVernonAve. LosAngeles 90037OliverFoster,DPM 3756SantaRosaliaDr.,Ste302 LosAngeles 90008OlufunmilayoOlanipekun,DPM 3756SantaRosaliaDr.,Ste302 LosAngeles 90008RabinBeralDPM,APodiatryCorporation

1141WRedondoBeachBlvd. Gardena 90247

RichardJ.Sarte,DPM 3984SFigueroaSt. LosAngeles 90037SalisShrestha,DPM 874WMartinLutherKingJrBlvd. LosAngeles 90037

PsychologyClinics


1736FamilyCrisisCenterLosAngeles 2116ArlingtonAve. LosAngeles 90018

AugustusHawkinsMentalHealthCenter 1720E120thSt. LosAngeles 90059

ExodusRecoveryInc 8401SVermontAve. LosAngeles 90044

HOPICS 5715S.Broadway LosAngeles 90037

KedrenCommunityHealthCenter 4211S.AvalonBlvd. LosAngeles 90011

MatrixInstitute 5220W.WashingtonBlvd. LosAngeles 90016

Sabath&Associates 1225W190thSt. Gardena 90248

ShieldsForFamilies 11705DeputyYamamotoPl. Lynwood 90262


SkilledNursingFacilities


AvalonVillaCareCenter 12029AvalonBoulevard LosAngeles 90061CaliforniaPost-AcuteCare 3615EastImperialHighway Lynwood 90262ClearViewConvalescentCenter 15823SouthWesternAvenue Gardena 90247CountryVillaEastNursingCenter 2415SouthWesternAvenue LosAngeles 90018CountryVillaUniversityPark 230EAdamsBlvd. LosAngeles 90011CrenshawNursingHome 1900SouthLongwoodAvenue LosAngeles 90016DesirableCongregateLivingHome-ViewPark

3654W.60thStreet LosAngeles 90043

GardenaConvalescentCenter 14819SouthVermontAvenue Gardena 90247GreenfieldCareCenterOfGardena 16530SouthBroadway Gardena 90248GreenfieldCareCenterOfSouthGate

8455StateStreet SouthGate 90280

HancockParkNursing 505N.LaBreaAvenue LosAngeles 90036HuntingtonParkNursingCenter 6425MilesAvenue HuntingtonPark 90255HydeParkConvalescentHospital 6520WestBoulevard LosAngeles 90043KEI-AISouthBayHealthcareCenter 15115SouthVermontAvenue Gardena 90247LaPazGeropsychiatricCenter 8835VansSt. Paramount 90723LighthouseHealthcareCenter 2222SantaAnaBlvd. LosAngeles 90059

LongwoodManorConvalescentHospital

4853WestWashingtonBoulevard

LosAngeles 90016

LotusCareCenter 6011WestBoulevard LosAngeles 90043LynwoodHealthcareCenter 3611EImperialHighway Lynwood 90262ManchesterManorConvalescentHospital

837WestManchesterAvenue LosAngeles 90044

MapleHealthcareCenter 2526MapleAvenue LosAngeles 90011ParamountConvalescentHospital 8558RosecransAvenue Paramount 90723ParamountMeadowsNursingCenter

7039AlondraBoulevard Paramount 90723

RosecransCareCenter 1140W.RosecransAvenue Gardena 90247RoyalOaksCareCenter 3565EastImperialHighway Lynwood 90262SantaFeHeightsHealthcareCenter 2309NorthSantaFeAvenue Compton 90222

St.AndrewsHealthcare2300WestWashingtonBoulevard

LosAngeles 90018

St.JohnOfGodRetirementAndCareCenter

2468S.StAndrewsPlace LosAngeles 90018



SunnyviewCareCenter2000WestWashingtonBoulevard

LosAngeles 90018

UniversityParkHealthcareCenter 230EastAdamsBlvd. LosAngeles 90011VernonHealthcareCenter 1037WestVernonAvenue LosAngeles 90037ViewHeightsConvalescentHospital 12619AvalonBoulevard LosAngeles 90061ViewParkConvalescentCenter 3737DonFelipeDrive LosAngeles 90008WesternConvalescentHospital 2190WestAdamsBoulevard LosAngeles 90018

UrgentCare


DuskToDawnUrgentCare-Lynwood 3680EImperialHwy,#410 Lynwood 90262

DuskToDawnUrgentCare-Paramount 15745ParamountBlvd. Paramount 90723

JSEEmergencyMedicalGroup 2623ESlausonAve. HuntingtonPark 90255

RedondoEmergencyPhysicians,Inc. 1145WRedondoBeachBlvd. Gardena 90247

VEPMLKEmergencyMedicalGroup 1680E120thSt. LosAngeles 90059

WoundCare


DynamicMedicalSystems 2811EAnaSt. Compton 90221IntegratedSpecialtyMedicalAssociatesIPA,Inc. 1515W190thSt. Gardena 90248

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