Transcript Slide 1

Los Angeles County
Health Survey
Office of Health Assessment and Epidemiology
Los Angeles County
Department of Health Services
Presented By
Gigi A. Mathew DrPH, CPHQ
Mission of the Office of Health
Assessment and Epidemiology
• To ensure the availability of high quality and
comprehensive health data on the Los Angeles
County population and to facilitate its use for
public health assessment, policy development,
program planning and evaluation.
Role of Health Surveys

Population health data increasingly used to drive public
health decision-making and community health
improvement efforts.

Most local health jurisdictions lack important health data:
 chronic disease prevalence
 functional status and other measures of health-related
quality of life
 health behaviors
 access to health services

To address gaps in local health data, LA County
Department of Health Services inaugurated the Los
Angeles County Health Survey in 1997.
Key Analysis Objectives

To obtain reliable population estimates for
selected health indicators by various
demographics including sex, race/ethnicity (the 4
largest groups), and Service Planning Area (8
regions in the county).

To identify disparities across population subgroups.

To track temporal trends.

To compare with state and national data and with
national health objectives.
Methodology
• Population-based, random-digit-dialed telephone
survey of Los Angeles County residents
• Representative of Adults and Children in Los
Angeles County
• Conducted in 1997; 1999-2000; 2002-2003;
and 2005
Components and Sample Size
1997
1999-2000
2002-2003
2005
Adult
(n=8,004)
Adult
(n=8,354)
Adult
(n=8,167)
Adult
(n= 8,648)
Child
(n=2,363)
Child
(n=6,016)
Child
(n=5,995)
Child
(n=6,032)
Tobacco
Policy
(n=519)
Tobacco
Policy
(n=481)
Elder health
(n=1160)
Low-income
Survey
(n=1898)
8 Sub-samples
(n~1,000 each)
8 Sub-samples
(n~1,000 each)
Bio-terrorism (2)
Tobacco Policy (2)
Health Dept./ Antibiotic Use
Food-borne Illness
Young Children & Families
Alcohol Policy
Bio-terrorism (2)
Tobacco Policy (2)
Health Dept./ Antibiotic
Use
Food-borne Illness
Young Children &
Families
Alcohol Policy
Adult Component Content


Demographic Characteristics
Chronic Disease Prevalence
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Arthritis
Cardiovascular Disease
Diabetes
Asthma / Chronic Respiratory Condition
Functional Status and Other Measures of
Health-Related Quality of Life


Health Status
Mental Health
Adult Component Content

Health Behaviors
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Access to Health Services
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Tobacco Use
Alcohol Use
Physical Activity
Sexual Practices and HIV Testing
Health Insurance
Ease of obtaining medical care
Regular Source of Care
Barriers to Accessing Health Care
Food Insecurity and Public Aid Assistance
Medical Examinations and Vaccinations
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

Mammogram
Colorectal Screening
Flu
Child Component Content
• Demographics (child & parent)
• Child Health
• SHCNs, asthma, ETS, parent-perceived health status
• Child Health Insurance & Access to Care
• Status/type, gaps in coverage, difficulty accessing care, RSC, ER
use, LAC-DHS use
• Child Routines
• TV viewing, read to child*, tells stories to child*, play music/sing
songs with child*, bed times*, meal times*
*asked of parents with children aged 0-5 yrs.
Child Component Content
Prenatal to Postpartum*
• HIV testing; breastfeeding, hospital practices post partum; infant
sleep position
Parent Behaviors/Risks/Perceptions
• Parental aggravation/stress*, ease of finding someone to talk to
about raising child*, safe park/playground accessible,
neighborhood belonging, cigarette use, mental health risk
Childcare*
• Type(s), difficulty obtaining child care, reasons why no child care
used
*asked of parents with children aged 0-5 yrs.
Languages of Interviews
Language
• English
• Spanish
• Cantonese
• Mandarin
• Korean
• Vietnamese
• Armenian
Adult
6455 (72%)
1802 (23%)
64 (1%)
82 (1%)
189 (3%)
40 (<1%)
16 (<1%)
Child
3521 (59%)
2246 (37%)
48 (<1%)
34 (<1%)
132 (<2%)
41 (<1%)
10 (<1%)
Service Planning Areas and
Health Districts
SPA 1
An telop e V alle y
Sa n Fe rn an do
Ea st V alle y
SPA 2
Foot hill
Glen da le
W est Va lley
SPA 3
Pas a de na
N orthH olly w oo d/
eas t
W il s hir e Cen tral
SPA 5
W est
Alha mb ra
SPA 4
So uth west
Service Planning Areas (SPA)
Ea st LA
Sou theas t
Sou th
Inglew ood
Po mo na
El M ont e
San
Anto nio
SPA 7
W hitt ie r
SPA 6
C om pto n
Be llflowe r
S pa s 2 0 02 .s h p
SPA 1 - Antelope Valley
Torrance
SPA 8
SPA 2 - San Fernando
SPA 3 - San Gabriel
SPA 4 - Metro
SPA 5 - W es t
SPA 6 - South
SPA 7 - Eas t
SPA 8 - South Bay
Lon g B ea ch
Harbo r
Data Examples
Adult Health
1) Chronic Disease
•
Diabetes
•
Obesity
2) Health Behavior
•
Smoking
Diabetes Trends by Age Groups,
1997-2005
1997
30%
1999
2002
2005
19% 18%
20%
14%
14%
12% 12%
12%
11%
10%
7%
6%
7%
8%
5%
6% 6%
18%
17%
14%
7%
3% 3% 2% 3%
0%
Overall 18+
30-39
40-49
50-59
60-64
65+
18%
Prevalence† of Diabetes Among Adults in
Los Angeles County, by Race/Ethnicity, 2005
25%
20%
15%
5.6%
12.2%
10%
7.1%
11.9%
5%
0%
Latino
† Age-adjusted
to 2000 US population
White
African-American
Asian/Pacific
Islander
Prevalence of Diabetes by Body Mass Index‡, 2005
25%
20%
15.6%
15%
10%
7.9%
4.1%
5%
0%
Obese
Overweight
‡Weight status is based on Body Mass Index (BMI) calculated from self-reported weight and
height. According to NHLBI clinical guidelines, a BMI < 18.5 is underweight, a BMI > 18.5
and < 25 is normal weight, a BMI > 25 and < 30 is overweight, and a BMI > 30 is obese. [
Normal
Prevalence of Obesity Among
Adults (>18 years old) by Race/Ethnicity,
Los Angeles County, 1997-2005
1997
50%
1999
2002
2005
40%
30%
28%
24%
29%
25%
30%
20%
20%
12%
15% 17% 17%
22%
17%
10%
4%
7% 5% 6%
0%
White
Latino
African American
Asian/Pacific
Islander
Prevalence of Obesity Among Adults by
Service Planning Area, Los Angeles County, 2005
40%
30.0%
30%
27.3%
24.4%
20.0%
20%
LA County
20.9%
21.0%
19.1%
17.0%
14.1%
10%
0%
Antelope
Valley
San
Fernando
San Gabriel
Metro
West
South
East
South Bay
Prevalence of Cigarette Smoking Among
Adults (>18 years old), Los Angeles County,
1997-2005
30%
22.2%
20%
18.2%
22.1%
18.1%
19.7%
15.2%
14.3%
18.0% Male
14.6%
14.2%
10%
11.1%
11.4%
0%
1997
1999
2002
2005
County
Female
Percent of Male Cigarette Smokers by Race/Ethnicity,
1997-2005
40%
1997
1999
30%
20%
2002
2005
27%
22% 22%
19%
17%
23% 23%
22% 22% 21%
18%
23% 22%23%
20%
17%
10%
0%
Latino
White
African American
Asian/Pacific Islander
Percent of Female Cigarette Smokers by
Race/Ethnicity, 1997-2005
40%
1997
1999
2002
2005
30%
20%
18% 19%
20%
15%
10%
10%
9%
21%
23%
20%
14%
9%
7% 7%
9%
7%
8%
0%
Latina
White
African American
Asian/Pacific
Islander
Data Examples
Child Health
1) Childhood Asthma
2) Children with Special Health Care Needs
3) Breastfeeding
Prevalence of Asthma by Child’s Race/Ethnicity
(17 years old), Los Angeles County, 2005
25%
18.3%
20%
15%
10%
8.8%
7.3%
8.3%
Latino
White
8.3%
5%
0%
LA County
AfricanAmerican
Asian/Pacific
Islander
Activity Limitation and Emergency Room
Visits by Income, Children with Asthma
(17 years old), 2005
60%
50% 53%
< 100% FPL
50%
40%
30%
100-199% FPL
34%
26%
28%
19%
20%
10%
0%
Activity Limitation
ER Use
>200% FPL
Percent of Children (17 years old) with
Special Health Care Needs (SHCNs) by
Race/Ethnicity, 2005
22.5%
25.0%
19.3%
15.8%
14.3%
9.6%
0.0%
L.A. County
Latino
White
African
American
Asian/Pacific
Islander
Percent of Children (17 years old) with
Special Health Care Needs (SHCNs) by
Age Group, 2005
25.0%
19.3%
15.8%
14.3%
0.0%
0-5 Years
6-11 Years
12-17 Years
Prevalence of Breastfeeding Initiation
by Child Race/Ethnicity, 1994-2005
1994-1999
100%
80%
90%
82%
79%
82%
1998-2003
92%
91%
90%
83%
84%
2001-2005
92%
79%
63%
60%
60%
78%
68%
40%
20%
0%
LA County
Latina
White
AfricanAmerican
Asian/Pacific
Islander
Prevalence of Breastfeeding 6 Months or
Longer by Child Race/Ethnicity, 1994-2005
1994-1999
100%
1998-2003
2001-2005
80%
60%
57%
50%
40%
59%
51%
42%
62% 61%
50%
49%
41%
40%
27%
23%
36%
25%
20%
0%
LA County
Latina
White
AfricanAmerican
Asian/Pacific
Islander
Prevalence of Breastfeeding
12 Months or Longer by Child
Race/Ethnicity,1994-2005
1994-1999
1998-2003
2001-2005
50%
40%
30%
20%
33%
29%
17%
35%
30%
19%
36%35%
29%
20%
19%
14%
*11%
10%
18%
*6%
0%
LA County
Latina
* Estimate based on small sample size
White
AfricanAmerican
Asian/PacificIslander
Percent of Latina Mothers Who Initiated Breastfeeding
and Breastfed at Least 6 Months by Birthplace,
2001-2005
Initiated breastfeeding
100.0%
90.0%
Breastfed at least 6 months
92.5%
84.1%
80.0%
63.3%
70.0%
60.0%
50.0%
42.4%
40.0%
30.0%
20.0%
10.0%
0.0%
U.S. born Latinas
Non-U.S. born Latinas
Limitations of Survey
• Self-reported data
• Non-telephone households not included in
the sampling frame
• Questionnaire content limited by time
constraints
• Does not represent those living in group
quarters (e.g. nursing homes and college
dormitories)
Users of the Data,
Los Angeles County Health Survey
•
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•
•
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•
•
•
LAC Department of Health Services
Governmental organizations (local, county, & state)
Non-profit health foundations
Community-based organizations (health centers,
hospitals, human services, providers, healthinterested organizations)
Policymakers (advocacy groups)
Researchers
Private health care organizations
Academic health and health policy professionals
Uses of the Data
• LAC-DHS Evaluation and Program Planning
– Ambulatory care planning
– Medi-Cal and Healthy Families outreach and enrollment
targets
– Public health emergency response preparedness
– HIV counseling and testing
• Health services planning (e.g., Kaiser Kids)
• Community Health Assessment (e.g., SB 697)
• School Readiness Indicators
• Public Education
• Advocacy (e.g., food security)
• Funding proposals/grant applications
Dissemination of Results
• Health Briefs and Fact Sheets (L.A. Health)
• Comprehensive Reports for county as a whole
(e.g., Health Trends) and 8 Service Planning Areas
(e.g., Key Health Indicators)
• Custom data requests and reports
• On the Web (www.lapublichealth.org/ha)
• Press Releases and Press Conferences
• Presentations
Dissemination of Results
• DHS Newsletters (e.g., The Public’s Health mailed
to 30,000 LA Co. Physicians)
• Reports produced by other organizations
(e.g., Children’s Planning Council, United Way, First
5 LA)
• Newsletters disseminated by other organizations
(e.g., advocacy groups)
• Peer-reviewed journal publications
For additional information, call the
Office of Health Assessment and Epidemiology
at (213) 240-7785
or
Go to our website:
www.lapublichealth.org/ha