LOS ANGELES COUNTY

JUNE 2018

CITY AND COMMUNITY HEALTH PROFILES

CITY OF LOS ANGELES

 DIRECTOR’S MESSAGE

Los Angeles County is a vast and enormously diverse region of over

10 million residents. The county includes some of the richest and
poorest cities and communities in the nation, in some cases situated
side by side. The striking differences seen across the county in wealth,
opportunity, and environments are mirrored by stark inequalities in
health. For example, residents of some cities and communities in
the county on average live as many as 10 years less than residents of
other cities and communities. Residents in some places have rates of
heart disease, diabetes, and cancer that are more than double the rates
among residents in other places. Equally distressing is evidence that
Black, Native Hawaiian/Other Pacific Islander, and American Indian/
Alaska Native residents, regardless of where they live in the county,
experience a disproportionate burden of disease and death when
compared with White or Asian residents.
These differences are particularly tragic because they are preventable.
They arise to a large degree from the inequitable distribution of
resources and opportunities that people need in order to be healthy.
The illnesses produced by this profound inequity overwhelm our
hospitals, emergency departments, and clinics. Nationally, they
contribute to the highest healthcare spending in the world while
leaving residents in our country in poorer health than those in most
other industrialized nations. Most importantly, these differences result
in early death and disability for so many of our residents, robbing
families and communities of essential workers, leaders, and loved
ones.
City and county governments play a vital role in reducing these health
inequities and ensuring the equitable distribution of opportunities
and resources needed for optimal health and well-being. For example,
investments can be made in all communities to build public spaces
that promote physical activity and create incentives for healthy
food retail. Regulations can be adopted that discourage tobacco use
and excessive alcohol use and restrict the number of outlets that
sell tobacco and alcohol products. Government agencies can work
together to create safe spaces that reduce violence and unintended
injuries. In collaboration with residents, they can support efforts that
provide environmental protections from local sources of pollution.
Policies can be enacted that expand access to safe and affordable
housing, increase employment and training opportunities, and reduce
exposures to environmental hazards.

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 DIRECTOR’S MESSAGE

Through partnerships with the business community, faith-based

organizations, and local leaders, there can be increased commitments
for improvements in educational opportunities for children and
young adults. Working together, we can foster a culture of health by
promoting civic engagement and offering community programs that
support healthy lifestyles and reduce social isolation, which is a major
contributor to ill health. However, for these measures to eliminate
the gaps in health outcomes that disproportionately burden people of
color, low income residents, and other marginalized communities, we
need to anchor our work in efforts that promote racial, economic and
social justice.
On behalf of the Los Angeles County Department of Public Health, I
am very pleased to share the City and Community Health Profiles series.
Although these profiles do not address every aspect of health, I hope
they will help spur action and support city and community efforts to
ensure all residents achieve optimal health.
I urge you to make this report meaningful to your work and your
experience by adding additional information that helps describe
your city or community. Our staff are ready to help ensure that
the experiences of the people who live in your neighborhoods are
reflected in our future reports. For additional information or to see
how your city or community compares to others across Los Angeles
County, please visit our website at [Link] You
can also contact us at (213) 288 – 7785 or via email at
cchp@[Link].

Barbara Ferrer PhD, MPH, MEd

Director, Los Angeles County Department of Public Health

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 CITY AND COMMUNITY HEALTH PROFILES

CITY OF LOS ANGELES

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TABLE OF CONTENTS

I. Community at a Glance 1
II. Life Expectancy & Social Determinants of Health 3
III. Physical Activity & Nutrition 7
IV. Tobacco Use 11
V. Housing & Health 13
VI. Community Safety 15
VII. Environmental Justice 17
VIII. Reproductive Health 19
IX. Mental Health 21
X. Sexually Transmitted Infections 22
XI. Access to Healthcare 23
XII. California Healthy Places Index 25
XIII. Building on This Report 26
XIV. Technical Notes 27

This report is part of the City and Community Health Profiles

series developed by the Los Angeles County Department
of Public Health to provide local level data to cities and
unincorporated communities within Los Angeles County.
Profiles were created for cities and unincorporated Census
designated places (communities) with total population sizes
of at least 24,000 based on 2016 population estimates. In
addition, separate profiles for each of the 15 Council Districts
for the City of Los Angeles were produced. Due to challenges
with generating accurate and reliable data for regions with
population sizes below 24,000, we were unable to create
reports for all cities and communities in the county. In total,
86 unique geographic places in Los Angeles County have been
profiled in this series.

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 COMMUNITY AT A GLANCE

CITY OF LOS ANGELES

CITY OF LOS ANGELES

LOS ANGELES COUNTY

4,032,993 66%
86Fig 1

65%
TOTAL POPULATION 1

22% 23%
12% 13%

0-17 years 18-64 years 65 years & older

POPULATION BY AGE1, 2
86Fig 2

50.04% 48.76%

28.88% 28.04%

9.12% 11.68% 14.31%

8.46%
0.17% 0.19% 0.11% 0.24%
Black Latino White Asian American Indian/Alaska Native Hawaiian/Other
Native Pacific Islander

POPULATION BY RACE/ETHNICITY1, 2 2
Note: Due to rounding,
categories may not sum to
Hedderson Demographic Services, Population Estimates, 2016
1
100%.

1 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 COMMUNITY AT A GLANCE

CITY OF LOS ANGELES

LOS ANGELES COUNTY

86Fig 3

86Fig 4

42%
38%

20% 17% 38%

Below 100% FPL Below 200% FPL

PERCENTAGE OF RESIDENTS LIVING PERCENTAGE OF

BELOW 100% AND 200% OF THE FOREIGN-BORN RESIDENTS2
FEDERAL POVERTY LEVEL (FPL)1

86Fig 6

16%

PERCENTAGE OF HOUSEHOLDS WITH

LIMITED ENGLISH PROFICIENCY2

1
Hedderson Demographic Services, Poverty Estimates, 2016
2
US Census Bureau, American Community Survey, 2011 - 2015

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 2

 LIFE EXPECTANCY & SOCIAL
DETERMINANTS OF HEALTH

The average life expectancy of a population is one of the most basic

and important measures of the health of a community. Substantial
variation in average life expectancy is seen across Los Angeles County.
Significant determinants of this variation are the levels of education,
income, and employment in the population. Also important are the
degrees to which residents are socially connected and supported
and the adverse health impacts of the long legacy of racism and
discrimination in our society that disadvantages communities of color
and other marginalized groups. These factors are collectively referred
to as the social determinants of health. In addition to impacting the
average life expectancy in communities, these social determinants of
health are the fundamental drivers for nearly all health outcomes.

86Fig 8
87.5
82.5 82.3

LIFE EXPECTANCY AT BIRTH (YEARS)

Los Angeles County Department of Public Health, Los Angeles County Linked Death Data, 2016;
Hedderson Demographic Services, Population Estimates, 2016

CITY OF LOS ANGELES BEST PERFORMING CITY LOS ANGELES COUNTY

OR COMMUNITY

3 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 LIFE EXPECTANCY & SOCIAL
DETERMINANTS OF HEALTH

Access to early childhood education (i.e., education before the age of

five years) is associated with numerous health benefits later in life. For CITY OF LOS ANGELES
instance, young children who are enrolled in high quality preschool
programs are more likely to graduate from high school, have higher
BEST PERFORMING CITY
paying jobs, own homes, have improved cognitive function, and OR COMMUNITY
have reduced risk for adolescent pregnancy than those who are
not enrolled. All these additional advantages increase average life LOS ANGELES COUNTY
expectancy.
86Fig 9

56%

PERCENTAGE OF CHILDREN (AGES 3 AND 4 YEARS)

ENROLLED IN PRESCHOOL
US Census Bureau, American Community Survey, 2011 - 2015

For many elementary school children, third grade represents a key

transition point for reading proficiency and literacy as they are
expected to make the shift from learning-to-read to reading-to-
learn. Children found to have low reading skills in the third grade
are at increased risk for poor academic outcomes, including failing
grades and dropping out of high school. This can have profound
consequences for future health and longevity.

86Fig 12

38%

PERCENTAGE OF PUBLIC SCHOOL THIRD GRADERS WHO

ARE MEETING OR EXCEEDING CALIFORNIA STANDARDS FOR
ENGLISH LANGUAGE ARTS & LITERACY
California Department of Education, California Assessment of Student Performance and Progress System, 2017

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 4

 LIFE EXPECTANCY & SOCIAL
DETERMINANTS OF HEALTH

86Fig 15

CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY

LOS ANGELES COUNTY

32% 30%
25% 26%
23% 24%
20% 21%

Note: Due to rounding,

1

categories may not sum to

100%. Less than High School High School Graduate Some College Bachelor Degree or Higher

HIGHEST LEVEL OF EDUCATION ATTAINED

AMONG ADULTS (AGES 25 YEARS AND OLDER)1
US Census Bureau, American Community Survey, 2011 - 2015

86Fig 16

$50,205

$143,527

$56,196

MEDIAN HOUSEHOLD INCOME

US Census Bureau, American Community Survey, 2011 - 2015

Public libraries are vital community assets. They can support

the health and well-being of local residents through the variety
of programs and services they offer. These can include literacy
programs for children and adults, after-school programs, free
access to computers and the internet, and skills-development
classes. Libraries also play a critical role in supporting academic
achievement, which has significant implications for health. In

72
Number of public addition, libraries can serve as key hubs for linking residents
libraries in City of Los to other important community resources and services, such as
Angeles: healthcare services and food assistance programs.
California Public Library Directory, 2017

5 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 LIFE EXPECTANCY & SOCIAL
DETERMINANTS OF HEALTH

86Fig 17

91%
The labor force consists of
1

the civilian population that

is employed or unemployed
but actively looking for
PERCENTAGE OF EMPLOYED ADULTS (AGES 25 TO 64 work.
YEARS) IN THE LABOR FORCE1
US Census Bureau, American Community Survey, 2011 - 2015
86Fig 20

65%

PERCENTAGE OF ADULTS (AGES 18 YEARS AND OLDER) WHO REPORT

RECEIVING THE SOCIAL AND EMOTIONAL SUPPORT THEY NEED
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015

Voter turn-out is a measure of civic engagement. Communities

that are civically engaged have more power to advocate for health-
promoting policies. In addition, civically engaged communities create
opportunities for residents to be socially connected, thereby reducing
the adverse health effects of social isolation.
86Fig 23
78%

62% 64%

CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY
PERCENTAGE OF REGISTERED VOTERS WHO VOTED
LOS ANGELES COUNTY
IN THE 2016 GENERAL ELECTION
University of California, Berkeley, Statewide Database, 2016

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 6

 PHYSICAL ACTIVITY &
NUTRITION

Increasing physical activity and improving diets are two important

ways to improve the health of community residents. Physical
inactivity and poor diet have contributed to our current obesity
epidemic and are major risk factors for heart disease, diabetes, cancer,
and many other chronic health conditions. Being physically active
and eating healthy are often considered lifestyle choices that are under
the control of individuals, but these “choices” are strongly influenced
by community environments. For example, it is difficult for people
to be physically active if their communities do not have available and
safe places for recreation. Likewise, it is very challenging for people
to have a healthy diet if they have limited access to nutritious and
affordable food options. Cities and communities can organize to
create environments that promote active living and healthy eating. For
example, they can make streets more accommodating for walking and
biking, and they can create incentives for healthy food retail.

AVAILABLE RECREATIONAL SPACE

(ACRES PER 1,000 POPULATION)

CITY OF LOS ANGELES 4.72

BEST PERFORMING CITY
OR COMMUNITY 53.32
LOS ANGELES COUNTY 8.10
Los Angeles County Geographic Information Systems Data Portal, Los Angeles County Land Types, 2015;
Hedderson Demographic Services, Population Estimates, 2015

7 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 PHYSICAL ACTIVITY &
NUTRITION
1
Defined according to
86Fig 24
the Physical Activity
Guidelines Advisory
Committee Report,
2008 published by the
36% US Department of Health
and Human Services.
Respondents reported
meeting guidelines for
aerobic activities (i.e.,
PERCENTAGE OF ADULTS (AGES 18 YEARS AND OLDER) MEETING vigorous activity for at
RECOMMENDED GUIDELINES FOR PHYSICAL ACTIVITY1 least 75 minutes a week,
moderate activity for at
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015
least 150 minutes a week,
or a combination of vigorous
and moderate activity for at
86Fig 27
least 150 minutes a week)
AND muscle-strengthening
activities on two or more
days a week that work all
68% major muscle groups (legs,
hips, back, abdomen, chest,
shoulders, and arms).

2
Close proximity defined as
PERCENTAGE OF THE POPULATION LIVING IN CLOSE living within a half mile
for urban populations and
PROXIMITY TO A SUPERMARKET OR GROCERY STORE2 within one mile for rural
US Department of Agriculture, Food Access Research Atlas, 2015 populations.

CITY OF LOS ANGELES

People who have long commute times have less free time to be physically active and BEST PERFORMING CITY
may also experience considerable stress associated with traffic. Research studies have OR COMMUNITY
shown that individuals who spend long periods of time commuting to and from LOS ANGELES COUNTY
work are at increased risk for obesity.
86Fig 30

12%

PERCENTAGE OF WORKING POPULATION (AGES 16 YEARS AND OLDER)

WITH ONE-WAY COMMUTE TO WORK OF 60 MINUTES OR LONGER
US Census Bureau, American Community Survey, 2011 - 2015

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 8

 PHYSICAL ACTIVITY &
NUTRITION

58
Farmers’ markets are a valuable community resource that can
Number of farmers’ markets
in City of Los Angeles: promote healthy eating by making fresh and in-season fruits and
vegetables readily available to residents. Many farmers’ markets are
also able to process payments through the Electronic Benefit Transfer

52
Number of farmers’ markets
(EBT) system or accept checks from food assistance programs. This
in City of Los Angeles that
accept EBT or WIC: ensures that low income residents participating in programs such as
the Supplemental Nutrition Assistance Program (SNAP, also known
Ecology Center, Farmers’ Market Finder, 2017 as CalFresh in California) or the Special Supplemental Nutrition
Program for Women, Infants, and Children (WIC) can also access the
fresh, high quality produce that is sold at these markets.

Food insecurity, or the inability to reliably afford or access sufficient

quantities of healthy foods, affects hundreds of thousands of low
income households in Los Angeles County. Fortunately, food
assistance is available in most communities through the CalFresh and
WIC programs. In addition, children from households at high risk
for food insecurity and who attend public schools are also eligible to
participate in California’s Free or Reduced Price Meal program.

86Fig 33

CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY 22%
LOS ANGELES COUNTY

PREVALENCE OF FOOD INSECURITY AMONG HOUSEHOLDS

WITH INCOMES BELOW 300% OF THE FEDERAL POVERTY LEVEL
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015

Estimated number of eligible Estimated participation

people in City of rate in City of
CALFRESH1 Los Angeles: Los Angeles:

884,921 56%
FREE OR REDUCED
PRICE MEAL2
Estimated percentage of eligible public school
students in City of Los Angeles: 77%
1
California Department of Social Services, Research Services Branch, CalFresh Geocoding Data, 2015
2
California Department of Education, Free or Reduced Price Meal Data, 2016 - 2017

9 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 PHYSICAL ACTIVITY &
NUTRITION
86Fig 36

24%
22%

10% 10%
6%
4%

PERCENTAGEObesity
OF ADULTS (AGES PERCENTAGE OF ADULTS (AGES
Diabetes
18 YEARS AND OLDER) WHO 18 YEARS AND OLDER) WITH
ARE OBESE DIAGNOSED DIABETES
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015

CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY

Research indicates that being physically Obesity can increase an LOS ANGELES COUNTY
active and eating a diet that is rich in individual’s lifetime risk
fruits, vegetables, lean meats, and fiber of breast cancer.
can reduce the risk of colon cancer.
86Fig 37

136.1 140.5

68.9

37.0 37.9
28.2

Colon
NEWLY Cancer Cases
DIAGNOSED COLON NEWLYBreast
DIAGNOSED BREAST
Cancer Cases
CANCER CASES (PER 100,000 CANCER CASES AMONG FEMALES
POPULATION) (PER 100,000 FEMALE POPULATION)

University of Southern California, Cancer Surveillance Program, 2011 - 2015;

Hedderson Demographic Services, Population Estimates, 2011 - 2015

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 10

 TOBACCO USE

Despite great progress in reducing tobacco use over the past

generation, over one million adults and adolescents in Los Angeles
County continue to smoke. Tobacco use is a leading preventable cause
of premature death and disability. Some communities and populations
in the county have much higher rates of tobacco use than others,
fueled in part by the marketing tactics of the tobacco industry that
target certain communities, including communities of color and the
lesbian, gay, bisexual, transgender, and queer communities. Cities and
communities can play a vital role in supporting public health efforts
to reduce the toll of smoking and other forms of tobacco use. Many
cities and all unincorporated communities in Los Angeles County
already prohibit smoking in public spaces, such as parks, beaches,
and outdoor dining areas. In addition, many cities prohibit smoking
in multi-unit housing complexes, such as apartment buildings, to
reduce exposure to second-hand smoke. Cities and communities can
take additional action to reduce youth access to tobacco products by
promoting zoning and licensing restrictions to regulate the location
and density of tobacco retailers and vape shops, particularly in youth-
sensitive areas and vulnerable neighborhoods.

86Fig 38

12%

PERCENTAGE OF ADULTS (AGES 18 YEARS AND

OLDER) WHO SMOKE CIGARETTES
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015

CITY OF LOS ANGELES BEST PERFORMING CITY LOS ANGELES COUNTY

OR COMMUNITY

11 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TOBACCO USE

86Fig 41

27.9
27.1
25.8
23.7

14.3
13.1

LUNGLung
CANCER DEATHS
Cancer Deaths(PER
1
CHRONIC OBSTRUCTIVE
COPD DeathsPULMONARY
100,000 POPULATION) DISEASE DEATHS1 (PER 100,000
POPULATION)
Los Angeles County Department of Public Health, Los Angeles County Linked Death Data, 2012 - 2016;
Hedderson Demographic Services, Population Estimates, 2012 - 2016

In addition to lung cancer and chronic obstructive pulmonary disease,

smoking is a major risk factor for cardiovascular disease. Cardiovascular
disease-related deaths include deaths due to heart disease and stroke.

86Fig 42

205.1 204.8

127.5

Death rate has been age-adjusted.

1

CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY
CARDIOVASCULAR DISEASE DEATHS1 (PER
100,000 POPULATION) LOS ANGELES COUNTY
Los Angeles County Department of Public Health, Los Angeles County Linked Death Data, 2012 - 2016;
Hedderson Demographic Services, Population Estimates, 2012 - 2016

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 12

 HOUSING & HEALTH

Housing affordability is a major concern for many Los Angeles County

residents. Housing constitutes the single largest monthly expense for
most people, and among homeowners, their homes are often their largest
financial assets. Given the high cost of housing in Los Angeles County,
many residents spend a sizable portion of their incomes on housing every
month and are susceptible to significant housing burden, which is defined
as housing expenses totaling 30% or more of monthly income. Housing
burden disproportionately affects low income individuals, renters, and
communities of color, many of whom in fact experience severe housing
burden, meaning that their housing costs total 50% or more of their
monthly incomes. Housing burden can negatively impact health by causing
significant stress and limiting the amount of money people have available to
spend on other life necessities, such as food or healthcare. Housing burden
can increase the risk for homelessness as well. The high cost of housing
can also affect health by prohibiting access to high quality housing, which
can often be too expensive. Living in poor quality housing can increase
exposure to environmental hazards, such as lead, molds, and cockroaches.
Lead exposure during childhood is a particular concern as it can adversely
impact brain development. Exposure to molds and cockroaches can worsen
underlying respiratory conditions, such as asthma in children.
86Fig 43

53%
49%

33%
29%
25%

Housing burden is defined

1
13%
as spending 30% or more
of household income on
housing.

Severe housing burden is

2 PERCENTAGE OF PERCENTAGE OF HOUSEHOLDS
Housing burden Severe housing burden
defined as spending 50% or HOUSEHOLDS EXPERIENCING EXPERIENCING SEVERE
more of household income on HOUSING BURDEN1 HOUSING BURDEN2
housing. US Census Bureau, American Community Survey, 2011 - 2015

CITY OF LOS ANGELES BEST PERFORMING CITY LOS ANGELES COUNTY

OR COMMUNITY

13 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 HOUSING & HEALTH

PERCENTAGE OF PERCENTAGE OF
HOUSEHOLDS THAT HOUSEHOLDS THAT
OWN THEIR HOMES RENT1
1
Note: Due to rounding,
CITY OF LOS
ANGELES 37% 63% categories may not sum to
100%.

LA COUNTY 46% 54%

US Census Bureau, American Community Survey, 2011 - 2015

Estimated number of homeless

individuals in City of Los Angeles: 28,464
Los Angeles Homeless Services Authority, Greater Los Angeles Homeless Count by City/Community, 2016

86Fig 44

6%

CITY OF LOS ANGELES

PERCENTAGE OF CHILDREN (AGES 17 YEARS AND
YOUNGER) WITH DIAGNOSED ASTHMA BEST PERFORMING CITY
OR COMMUNITY
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015
LOS ANGELES COUNTY

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 14

 COMMUNITY SAFETY

Neighborhood violence and crime can have a harmful impact on all

members of a community. Living in communities with high rates of
violence and crime not only exposes residents to a greater personal
risk of injury or death, it can also render individuals more susceptible
to many adverse health outcomes. People who are regularly exposed
to violence and crime are more likely to suffer from chronic stress,
depression, anxiety, and other mental health conditions. They are
also less likely to be able to use their parks and neighborhoods for
recreation and physical activity. In Los Angeles County, communities
of color and low income neighborhoods are disproportionately
affected by neighborhood violence and crime.

Serious crimes consist of Part 1 offenses as

1 SERIOUS CRIMES1 (PER 100,000 POPULATION)
defined by the US Department of Justice’s

620.0
Uniform Reporting Statistics. These include
murders, nonnegligent homicides, rapes CITY OF LOS ANGELES
(legacy and revised), robberies, aggravated
assaults, burglaries, motor vehicle thefts, BEST PERFORMING CITY
larceny-thefts, and arsons.
OR COMMUNITY 62.0
LOS ANGELES COUNTY 551.0
California Attorney General, Crimes and Clearances, 2016;
Los Angeles Police Department, Crime Data from 2010 to Present, 2016;
Los Angeles County Sheriff’s Department, Historical Crime Data, 2016;
Hedderson Demographic Services, Population Estimates, 2016
86Fig 47

6.2 5.7

1.2

Death rate has been age-adjusted.

2
HOMICIDES2 (PER 100,000 POPULATION)
Los Angeles County Department of Public Health, Los Angeles County Linked Death Data, 2012 - 2016;
Hedderson Demographic Services, Population Estimates, 2012 - 2016

CITY OF LOS ANGELES BEST PERFORMING CITY LOS ANGELES COUNTY

OR COMMUNITY

15 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 COMMUNITY SAFETY

One important community characteristic that is associated with

community safety is alcohol outlet density. Alcohol outlet density
refers to the number of retail outlets in a community that sell alcohol
relative to the number of residents living in that community. In
general, consumption of alcohol tends to be higher in communities
where the alcohol outlet density is also high. This has important
implications for health as excessive consumption of alcohol is a
leading cause of premature death in Los Angeles County. In addition
to elevated crime rates, communities with high alcohol outlet
densities also experience more deaths from alcohol-related motor
vehicle crashes.

86Fig 48

14.9 15.1

5.2

ALCOHOL OUTLETS (PER 10,000 POPULATION)

State of California Alcoholic Beverage Control, 2013;
Hedderson Demographic Services, Population Estimates, 2013

CITY OF LOS ANGELES BEST PERFORMING CITY LOS ANGELES COUNTY

OR COMMUNITY

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 16

 ENVIRONMENTAL JUSTICE

Environmental justice describes a movement that recognizes that

many low income communities and communities of color across
the United States are disproportionately and unfairly exposed to
a wide array of environmental pollutants and toxins. This is an
important issue in Los Angeles County, which is home to some
of the most polluted communities in the state. Residents living
in or near neighborhoods with high levels of pollution are at an
increased risk for developing respiratory diseases, such as asthma,
and cardiovascular diseases, such as stroke. Pregnant women
living in highly polluted neighborhoods are also at an increased
risk for experiencing poor birth outcomes, such as preterm birth.
Environmental justice seeks to address these inequities by raising
awareness of hazardous exposures among residents living in polluted
communities and by fostering collaboration between communities
and policy makers to increase the focus of regulatory decision-making
on health protection.
The California Healthy Places Index (HPI) Clean Environment
Score is a composite measure of pollution that was developed by
the Public Health Alliance of Southern California. It is based on the
average levels of four common environmental pollutants used in
the California Environmental Protection Agency’s CalEnviroScreen
3.0 tool. The four pollutants considered in the Clean Environment
Score are fine particles in the air (PM2.5), ground-level ozone (PM
ozone), diesel particulate matter in the air (DPM), and groundwater
contamination. PM2.5, PM ozone, and DPM are emitted from motor
vehicles, industrial facilities, oil and gas wells, electric utilities,
gasoline vapors, and chemical solvents. Groundwater can become
contaminated by gasoline, oil, road salts, and other chemicals.

CALIFORNIA HPI
CLEAN ENVIRONMENT SCORE
0 TO 25TH 26TH TO 50TH 51TH TO 75TH 76TH TO 100TH
PERCENTILE PERCENTILE PERCENTILE PERCENTILE

Higher pollution burden Lower pollution burden

CITY OF LOS ANGELES: 21ST percentile

California Environmental Protection Agency, CalEnviroScreen 3.0, 2005 – 2015

17 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 ENVIRONMENTAL JUSTICE

Many communities throughout Los Angeles County are situated close

to heavy industry, including oil and gas wells. As a result, nearby
residents may be at risk for exposure to numerous toxic chemicals.

Number of oil and gas wells

in City of Los Angeles: 5,192
California Department of Conservation, Division of Oil, Gas, and Geothermal Resources, 2017

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 18

 REPRODUCTIVE HEALTH

Reproductive health outcomes, including teen births, low birth

weight births, and infant deaths, are among the most important
measures of the health of a community. Adolescent girls who give
birth are at a much greater risk of not completing their education,
which significantly impacts their life opportunities and future health.
Babies born at a low birth weight are at markedly increased risk for
a range of medical complications that can impair their development
and reduce their prospects for a long and healthy life. Infant deaths
are among the most tragic health events in a community, and sadly,
they occur at a much greater frequency in some communities than
in others. For example, Black babies in Los Angeles County die at
three times the rate of White or Asian babies. This racial inequity
is not entirely explained by differences in access to prenatal care or
levels of education and income. Research suggests that chronic stress
associated with both historical and ongoing racism are important
contributing factors. Cities and communities can play an important
role in addressing these inequities in reproductive health outcomes
by examining their policies and practices with a racial equity lens,
ensuring that all groups have the opportunities and resources needed
to achieve optimal health.
86Fig 49

29.2

15.1

8.5
6.2

Birth rate
TEEN among
BIRTHS 15- 17BIRTHS
(LIVE year oldsPER Birth rate
TEEN among
BIRTHS 18-19BIRTHS
(LIVE year oldsPER
1,000 WOMEN AGES 15 TO 17 1,000 WOMEN AGES 18 TO 19
YEARS) YEARS)
Los Angeles County Department of Public Health, Los Angeles County Linked Birth Data, 2014 - 2016;
Hedderson Demographic Services, Population Estimates, 2014 - 2016

CITY OF LOS ANGELES

LOS ANGELES COUNTY

19 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 REPRODUCTIVE HEALTH

86Fig 50

7%

PERCENTAGE OF LOW BIRTH WEIGHT BIRTHS1 Low birth weight birth refers to
1

babies who are born weighing less

Los Angeles County Department of Public Health, Los Angeles County Linked Birth Data, 2016
than 2,500 grams (5 pounds, 8
ounces).

86Fig 53

4.4
4.2

INFANT DEATHS2 (PER 1,000 LIVE BIRTHS) Infant death is defined as death
2

Los Angeles County Department of Public Health, Los Angeles County Linked Death Data, 2012 - 2016; occurring within the first year of life.
Los Angeles County Department of Public Health, Los Angeles County Linked Birth Data, 2012 - 2016

86Fig 54

85%
CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY
PERCENTAGE OF BIRTHS TO WOMEN INITIATING
PRENATAL CARE IN THE FIRST TRIMESTER LOS ANGELES COUNTY

Los Angeles County Department of Public Health, Los Angeles County Linked Birth Data, 2016

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 20

 MENTAL HEALTH

There is growing recognition that mental health is as essential to

overall well-being as is physical health. When people feel emotionally,
psychologically, and socially secure, they are able to thrive and reach
their full potentials. Individuals who are exposed to chronic stress from
financial worry, work and family demands, job insecurity, unsafe living
environments, social isolation, or discrimination are at a greater risk
for developing mental health conditions, such as depression, anxiety,
or post-traumatic stress disorder. Having a mental health condition in
turn increases the risk for other adverse outcomes such as substance
abuse or death from suicide or drug overdose. While ensuring access
to timely and affordable mental health interventions and services is
important for effectively treating mental health conditions, promoting
well-being at the community level may help prevent these conditions
from developing. Cities and communities can take an active role in
fostering mental health by ensuring community safety, promoting
employment opportunities and economic security, expanding
affordable housing, creating varied opportunities for residents to
engage in community issues, reducing the stigma associated with
mental health, and providing support services, particularly for seniors
and other vulnerable community members.
86Fig 57

9%

PERCENTAGE OF ADULTS (AGES 18 YEARS AND

OLDER) WITH DIAGNOSED DEPRESSION
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015
86Fig 60
7.9 7.6 7.4
6.6

CITY OF LOS ANGELES

3.2
2.6

BEST PERFORMING CITY

OR COMMUNITY

LOS ANGELES COUNTY Deaths

1 from Suicide DEATHS FROM
Deaths from UNINTENTIONAL
Accidental Drug Overdose
SUICIDES (PER 100,000
DRUG OVERDOSE1 (PER 100,000
POPULATION)
POPULATION)
Death rate has been age-adjusted.
1 Los Angeles County Department of Public Health, Los Angeles County Linked Death Data, 2012 - 2016;
Hedderson Demographic Services, Population Estimates, 2012 - 2016

21 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 SEXUALLY TRANSMITTED INFECTIONS

In recent years, Los Angeles County has experienced a steady increase

in the rates of sexually transmitted infections (STIs), including
syphilis, gonorrhea, and chlamydia, a trend that has also been seen
nationally. In addition, HIV infection remains a significant public
health concern, with more than 50,000 county residents estimated
to be currently living with HIV. The rates of STIs, including HIV, are
much higher in some communities than in others, with low income
communities, communities of color, and gay, bisexual, and transgender
communities most severely impacted. Cities, community organizations,
faith-based institutions, and businesses can play an important role in
supporting efforts to prevent these infections. For example, they can
help promote sexual health education campaigns, support condom
distribution programs, and foster efforts to reduce stigmatization of
and discrimination against groups most at risk of these infections.
In addition, the local community providers can help by assisting at-
risk groups in accessing prevention programs, testing, and treatment
services, including partner notification and treatment.

CITY OF LOS ANGELES

LOS ANGELES COUNTY

SYPHILIS CASES1 Primary, secondary,

1

(PER 100,000 POPULATION) 44.8 33.3 and early latent

syphilis cases have been
Los Angeles County Department of Public Health, Sexually Transmitted Disease Surveillance System, 2014 - 2016
included.

GONORRHEA CASES
(PER 100,000 POPULATION) 230.2 179.5
Los Angeles County Department of Public Health, Sexually Transmitted Disease Surveillance System, 2014 - 2016

PERSONS LIVING WITH HIV

(PER 100,000 POPULATION) 702.8 491.7
Los Angeles County Department of Public Health, HIV Surveillance System, 2016

CITY OF LOS ANGELES

LOS ANGELES COUNTY

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 22

 ACCESS TO HEALTHCARE

The vast majority of adults and children in Los Angeles County

have health insurance, in large part due to outreach efforts and local
insurance availability for children and the expansion of insurance
coverage following the passage of the federal Affordable Care Act in
2012. Despite this progress, rates of uninsured remain high in some
communities, particularly among low income Latinos. Even among
people who have health insurance, many continue to experience
difficulty accessing needed healthcare. In addition, many children
do not have access to essential dental services. Cities and community
organizations can play an important role in advocating for needed
services and in providing information on free or low-cost services in
their communities. Hospitals can also provide medical and dental
services through their community benefit programs and other
community services. 86Fig 61

29%
25%

8% 7%
4%
2%

PERCENTAGE OF UNINSURED
Uninsured children Uninsured
PERCENTAGE OF adults
UNINSURED
CHILDREN (AGES 17 YEARS AND ADULTS (AGES 18 TO 64 YEARS)
YOUNGER)
US Census Bureau, American Community Survey, 2011 - 2015

CITY OF LOS ANGELES BEST PERFORMING CITY LOS ANGELES COUNTY

OR COMMUNITY

23 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 ACCESS TO HEALTHCARE

86Fig 62

13%

PERCENTAGE OF CHILDREN (AGES 2 TO 17 YEARS) WHO

WERE UNABLE TO AFFORD NEEDED DENTAL CARE IN THE
PAST 12 MONTHS
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015

86Fig 65

22%

PERCENTAGE OF ADULTS (AGES 18 YEARS AND OLDER)

REPORTING DIFFICULTY ACCESSING HEALTHCARE
Los Angeles County Department of Public Health, Los Angeles County Health Survey, 2015

CITY OF LOS ANGELES

BEST PERFORMING CITY

OR COMMUNITY

LOS ANGELES COUNTY

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 24

 CALIFORNIA HEALTHY PLACES INDEX

As highlighted in this report, the health of a community is shaped by

many factors, the most important of which are the social, economic,
and environmental conditions in the community and the policies
that impact these conditions. Given the complexity of factors that
influence health and the many ways in which health is measured, it is
often difficult to compare overall health across different communities.
To address this challenge and to identify opportunities for improving
health and reducing health inequities, the Public Health Alliance of
Southern California collaborated with national, state, and local public
health experts to develop a single composite measure that summarizes
the health of a community, referred to as the California Healthy Places
Index (HPI). The index is calibrated to correlate with life expectancy.
In addition to environmental factors, it takes into account the diverse
non-medical economic, social, and political factors that influence
physical and mental function, behavior and disease. In total, the
index combines 25 community characteristics into a single composite
score. HPI scores have been calculated for almost all census tracts
in California. In addition, the Public Health Alliance of Southern
California has made data available for numerous indicators that are
not part of the HPI but can still be used as decision support tools
to inform public health and policy efforts. The HPI website also
features an interactive mapping tool that allows users to visualize the
HPI data at different levels and various geographical units. For more
information, please visit [Link]

For the City and Community Health Profiles series, the HPI score was
recalculated for incorporated cities, the 15 Los Angeles City Council
Districts, and unincorporated communities by aggregating census
tracts to these geographical locations. The recalculated HPI scores
were assigned a percentile rank to facilitate comparison among cities
and communities within Los Angeles County.

CALIFORNIA HEALTHY PLACES INDEX SCORE

0 TO 25TH 26TH TO 50TH 51TH TO 75TH 76TH TO 100TH
PERCENTILE PERCENTILE PERCENTILE PERCENTILE

Fewer healthy community conditions More healthy community conditions

CITY OF LOS ANGELES: 29TH percentile

Public Health Alliance of Southern California, California Healthy Places Index, 2018

25 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 BUILDING ON THIS REPORT

While the City and Community Health Profiles series presents a broad
array of indicators known to impact health and well-being, we
recognize that the information in these profiles is limited. The reports
in this series may not do justice to the numerous community assets
that are unique to some of the places that have been profiled, nor
do they capture all the narratives that may be relevant to health in a
particular city or community. We also acknowledge that these reports
do not highlight the work that is currently being done in many cities
and communities throughout the county to improve health. In
addition, local agencies and organizations may have their own data
that they wish to add to these profiles to underscore key issues in
their cities or communities.
To better support your efforts to promote health for all, we have made
the data presented in this report accessible through our website.
In addition, results are available for every indicator in this report
to facilitate comparison across multiple cities and communities in
Los Angeles County. We encourage you to build on this report by
downloading the data for your city or community and adding your
own data. For more information, please visit [Link]
ohae/cchp. Should you have any questions, please contact our office at
(213) 288 - 7785 or via email at cchp@[Link].
We look forward to working with you to ensure that all individuals
and families in your community and across Los Angeles County have
the opportunities and resources they need to achieve optimal health.

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 26

 TECHNICAL NOTES

CITY AND COMMUNITY DEFINITIONS

For the majority of indicators presented in the City and Community
Health Profiles series, the following geographical definitions were used:
• Cities were defined using the 2015 US Census incorporated places
boundaries. These files can be accessed at [Link]
maps-data/data/cbf/cbf_place.html.
• Los Angeles City Council Districts (LACDs) were defined
using the 2012 City of Los Angeles Bureau of Engineering
boundaries. These files can be accessed at [Link]
dataportal/2012/08/07/la-city-council-districts-2012.
• Unincorporated communities were defined using 2015 US Census
designated places (CDP) boundaries. These files can be accessed
at [Link]
For American Community Survey (ACS) indicators, LACDs were
approximated by aggregating census tracts to each of the 15 LACDs.
Census tracts that crossed LACD boundaries were allocated to
specific LACDs if the centroids of those census tracts fell within the
boundaries of those LACDs.
For indicators derived from the California Department of Education
(CDE) data sources, geographical allocation was determined
based on public school addresses. If a school was located within a
community boundary, students from that school were allocated to that
community. This allocation method was used because information
about students’ residential addresses was not available through the
CDE data sources. School addresses for all Los Angeles County
schools were individually verified and corrected if needed prior to
geographical allocation.
For the indicator on the number of homeless individuals, cities,
unincorporated communities, and LACDs were defined according to
the boundaries established by Los Angeles County’s four Continuums
of Care (CoC): Los Angeles, Glendale, Long Beach, and Pasadena.
The Los Angeles Homeless Services Authority, the agency that
leads the Los Angeles CoC, collaborated with the University of
Southern California to define the geographic boundaries for cities,
unincorporated communities, and LACDs in the greater Los Angeles
area by selecting the census tracts that were included in their annual
homeless count. The CoCs for the cities of Glendale, Long Beach, and
Pasadena established their own geographic boundaries to define the
areas that would be surveyed for their respective homeless counts.
For the indicators derived from the United States Department of
Agriculture Food Access Research Atlas, the California Environmental
Protection Agency CalEnviroScreen 3.0, the University of California,

27 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TECHNICAL NOTES

Berkeley Statewide Database, and the Public Health Alliance of

Southern California Healthy Places Index, cities and unincorporated
communities were defined by aggregating census tracts to 2010
Census incorporated places and CDP boundaries. LACDs were
defined by aggregating census tracts to the 2012 City of Los Angeles
Bureau of Engineering boundaries. Census tracts that crossed
geographical boundaries were allocated to particular communities if
the centroids of those census tract fell within the boundaries of those
communities. Geographical assignments for indicators from these
four data sources were performed by the Public Health Alliance of
Southern California for the City and Community Health Profiles series.

INTERPRETING THE DATA IN THIS REPORT

For many of the indicators presented in this report, results have also
been provided for the best performing city or community and for
Los Angeles County overall. To determine whether two values are
statistically different from one another (e.g., whether the indicator
value for the city or community being profiled is statistically different
from the value for the highest performing city or community or the
value for Los Angeles County overall), the 95% confidence interval
(CI) is required. While we have not included 95% CIs or noted
statistically significant differences in this report, this information has
been provided for relevant indicators on our website.
In addition, for several of the cities and communities included in the
City and Community Health Profiles series, data were not presented for
a few of the indicators featured in the health profile reports. In these
instances, “RESULT UNAVAILABLE” was used to indicate that data
were not reported. In general, data were not reported for one of three
reasons. First, only results that were deemed to be statistically reliable
were presented. When available, the relative standard error (RSE)
was used to determine statistical stability (i.e., reliability). For most
indicators with available RSE information, estimates were presented
if their corresponding RSE was less than 30%. For indicators derived
from small area estimation of Los Angeles County Health Survey
data, estimates were presented if their corresponding RSE was less
than 35%. Second, for indicators presenting information on the rates
of specific health conditions in a given city or community (e.g., the
number of lung cancer deaths per 100,000 population), results were
not presented if very few cases occurred in that city or community.
This was done to maintain the confidentiality of those individuals.
Finally, for several indicators, data were not available to our analytic
staff at certain geographic levels.

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 28

 TECHNICAL NOTES

DATA SOURCES
Hedderson Demographic Hedderson Demographic Services produces population estimates
Services, Population Estimates on an annual basis for the Los Angeles County Internal Services
Department and Information Technology Service Division. Their
population estimation methods include applying mortality and
migration rates to the 2010 Census estimates and adhering closely
to the State’s official city and county estimates from the California
Department of Finance, Demographic Research Unit. For the City and
Community Health Profiles series, the July 1 population estimates from
2016 were used for the indicators on total population, population
by age, and population by race/ethnicity. July 1 population estimates
from 2011 – 2016 were used as the denominators in the rate
calculations that were derived for many of the other indicators in this
report. For more information, please contact our office at (213) 288 –
7785, or email us at cchp@[Link].

Hedderson Demographic Hedderson Demographic Services produces poverty estimates on an

Services, Poverty Estimates annual basis for the Los Angeles County Internal Services Department
and Information Technology Service Division. Poverty estimation
methods include using 2015 American Community Survey (ACS)
5-Year Public Use Microdata Sample (PUMS) data and extrapolating
to county level projections using 2016 ACS 1-Year PUMS data. The
July 1, 2016 poverty estimates were used for the indicator on the
percentage of residents living below 100% and 200% of the Federal
Poverty Level. For more information, please contact our office at
(213) 288 – 7785, or email us at cchp@[Link].

US Census Bureau, American ACS is a nationwide continuous survey conducted by the US Census
Community Survey (ACS) Bureau. The 2015 five year estimates (2011 – 2015) were used for
the following indicators in this report: percentage of foreign-born
residents, percentage of residents with limited English proficiency,
preschool enrollment, adult educational attainment, median
household income, employment, travel time commuting to work,
percentage of households that own or rent their homes, percentage
of households experiencing housing burden and severe housing
burden, and percentage of uninsured adults and children. Data can be
accessed at [Link]

Los Angeles County The California Department of Public Health’s Death Statistical Master
Department of Public Health, File and California Comprehensive Death File for Los Angeles County
Los Angeles County Linked contain information reported on death certificates. These files were
Death Data geocoded by the Los Angeles County Department of Public Health,
Office of Health Assessment and Epidemiology to create the Los
Angeles County Linked Death Data file. Death data from 2012 – 2016
were included in this file and were used to calculate the indicators
for life expectancy and death rates from lung cancer, chronic

29 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TECHNICAL NOTES

obstructive pulmonary disease, cardiovascular disease, homicide,

suicide, unintentional drug overdose, and infant mortality. For the life
expectancy and mortality indicators (except for infant mortality rate),
Hedderson Demographic Services Population Estimates for relevant
years were used to generate the life table and the denominators for
the life expectancy and mortality rate calculations, respectively. For
the infant mortality rate indicator, the total number of live births
from 2012 – 2016 was used as the denominator; these data were
derived from the Los Angeles County Department of Public Health’s
Los Angeles County Linked Birth Data file. For more information,
please contact our office at (213) 288 – 7785, or email us at cchp@
[Link].

The Smarter Balanced assessments are new computer-based tests that California Department
measure student knowledge of California’s English language arts/ of Education, California
literacy and mathematics standards and are administered to public Assessment of Student
school students in the third through eighth grades and the eleventh Performance and Progress
grade. These assessments are part of CAASPP, which replaced the System (CAASPP)
Standardized Testing and Reporting Program in 2015. Data from
2017 were used to estimate the percentage of third graders meeting
or exceeding California’s content standards for English language arts/
literacy. Community level estimates were based on the summation of
student scores for all traditional public elementary schools (including
charters) located within community boundaries (which were often
different than school district boundaries). Additional information can
be accessed at [Link]

The count of public libraries in Los Angeles County cities, California Public Library
Los Angeles City Council Districts, and unincorporated communities Directory
was compiled by the County of Los Angeles Public Library from the
California Public Library Directory. Data reflect the count of public
libraries as of November 2017. More information is available at http://
[Link]/services/to-libraries/library-directory/.

LACHS is a periodic, random-digit-dial telephone survey of Los Angeles County

approximately 8,000 adults and 6,000 children in Los Angeles Department of Public Health,
County. The data presented in this report are from the 2015 wave Los Angeles County Health
of the LACHS and include the following indicators: percentage of Survey (LACHS)
adults who report receiving the social and emotional support they
need; percentage of adults meeting physical activity guidelines;
prevalence of food insecurity among households with incomes below
300% of the federal poverty level; percentage of adults who are
obese; percentage of adults with diagnosed diabetes; percentage of
adults who currently smoke cigarettes; percentage of children with
diagnosed asthma; percentage of adults with diagnosed depression;

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 30

 TECHNICAL NOTES

percentage of children who were unable to afford needed dental care;

and percentage of adults reporting difficulty accessing healthcare. All
information is self-reported. Community level estimates for indicators
were prepared by Abt Associates using small area estimation of
2015 LACHS data. Estimates were derived based on individual level
characteristics, including age, gender, race/ethnicity, education,
marital status, and household size, as well as community level
characteristics. For more information, please contact our office at
(213) 288 – 7785, or email us at cchp@[Link].

University of California, The UCB Statewide Database houses data on voters in the state
Berkeley (UCB), Statewide of California. These data were used to generate the indicator on
Database voter participation in the 2016 general election. This indicator was
prepared for the City and Community Health Profiles series by the
Public Health Alliance of Southern California. More information is
available at [Link]

Los Angeles County Data from the 2015 Los Angeles County Land Types digital database
Geographic Information were used for the indicator on available recreational space per
Systems Data Portal, Los 1,000 population. Available recreational space was approximated by
Angeles County Land Types selecting for beaches and marinas, recreational centers, and regional
parks and gardens. Only recreational areas located within community
boundaries were included. Natural areas and wildlife sanctuaries
(including the Santa Monica and San Gabriel mountain recreational
areas) and historical parks were excluded. Hedderson Demographic
Services Population Estimates for 2015 were used as the denominator
to calculate available recreational space acres per 1,000 population.
The Los Angeles County Land Types database can be accessed at
[Link]

US Department of Agriculture The USDA Food Access Research Atlas presents data on various food
(USDA), Food Access Research access indicators for census tracts in the US. Data for the indicator
Atlas on the percentage of the population living in close proximity to a
supermarket or grocery store were derived from the 2015 counts
of individuals living within a half mile of a supermarket or grocery
store in urban areas and within one mile of a supermarket or
grocery store in rural areas. Counts from the 2010 US Census were
used for denominators. This indicator was prepared for the City
and Community Health Profiles series by the Public Health Alliance
of Southern California. More information is available at http://
[Link]/.

Ecology Center, Farmers’ The Farmers’ Market Finder is maintained by the Ecology Center,
Market Finder a non-profit eco-education center. Information from the Farmers’
Market Finder was used for the indicator on the number of farmers’
markets. The information presented in this report is current as of

31 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TECHNICAL NOTES

December 2017. More information is available at [Link]

org/fmfinder/.

CDSS provides CalFresh Geocoding data to all counties in California. California Department of
The CalFresh Geocoding data for Los Angeles County includes Social Services (CDSS),
estimates for the number of eligible individuals as well as the Research Services Branch,
Program Reach Index (i.e., participation rate) by incorporated CalFresh Geocoding Data
city or zip code. Data are unavailable by Los Angeles City Council
District or unincorporated Census designated place. To generate
the CalFresh Geocoding Data, CDSS Research Services Branch used
the 2015 US Census Topologically Integrated Geographic Encoding
and Referencing boundaries as well as data from the American
Community Survey five-year estimates, CDSS Supplemental Security
Income (SSI) data, and data from the Medi-Cal Eligibility Data System
(MEDS). The CalFresh Geocoding data were used for the indicators
on the number of eligible people and the participation rate for the
CalFresh program. More information is available at [Link]
inforesources/Data-Portal/Research-and-Data/CalFresh-Data-Dashboard.

CDE FRPM data for the 2016 - 2017 school year were used to California Department of
estimate the percentage of students in kindergarten through twelfth Education (CDE), Free or
grade who meet household income or categorical eligibility criteria Reduced Price Meal (FRPM)
for free or reduced price meals. Community level estimates were Data
based on the summation of eligible student counts for all traditional
K-12 public schools (including charters) located within community
boundaries (which were often different than school district
boundaries). Additional information can be found at
[Link]

The USC Cancer Surveillance Program is a population-based The University of Southern

cancer registry that collects information about newly diagnosed California (USC), Cancer
cancer cases in Los Angeles County.1 Data for indicators on Surveillance Program
newly diagnosed colorectal and female breast cancer cases were
enumerated using the International Classification of Diseases
for Oncology (ICD-O-3)-based “Recode” published by the
Surveillance, Epidemiology, and End Results (SEER) Program of
the National Cancer Institute. Data from 2011 – 2015 were used
as the numerators for these indicators. Hedderson Demographic
Services Population Estimates for 2011 – 2015 were used as the
denominators. Numerator data was prepared by the USC Cancer
Surveillance Program for the City and Community Health Profiles
series. More information is available at [Link]
siterecode/icdo3_dwhoheme/[Link].
1
The collection of cancer incidence data presented in the City and Community Health Profiles series was supported by the California Department of Public Health pursuant to California
Health and Safety Code Section 103885; Centers for Disease Control and Prevention’s National Program of Cancer Registries, under cooperative agreement 5NU58DP003862-04/
DP003862; and the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute
of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute. The ideas
and opinions expressed herein are those of the author(s) and do not necessarily reflect the opinions of the California Department of Public Health, the National Cancer Institute, or the
Centers for Disease Control and Prevention or their Contractors and Subcontractors.

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 32

 TECHNICAL NOTES

The Los Angeles Homeless LAHSA is the lead agency for the Los Angeles Continuum of Care, a
Services Authority (LAHSA), regional planning body that is supported by the US Department of
Greater Los Angeles Homeless Housing and Urban Development to coordinate housing and services
Count by City/Community for homeless families and individuals. LAHSA coordinates the annual
homeless count for the greater Los Angeles region except for the cities
of Glendale, Long Beach, and Pasadena. Data from the 2016 Greater
Los Angeles Homeless Count by City/Community dataset were used
for the indicator on the estimated number of homeless individuals
(excluding the cities of Glendale, Pasadena, and Long Beach). For
more information, please visit [Link]

City of Glendale Continuum of The City of Glendale Continuum of Care (CoC) is a local planning
Care, Homeless Count body supported by the US Department of Housing and Urban
Development to coordinate housing and services for homeless families
and individuals in the City of Glendale. The Glendale CoC also
coordinates the annual homeless count for the city. Data from the
2016 City of Glendale homeless count were used for the indicator
on the estimated number of homeless individuals in the City and
Community Health Profiles report for Glendale. Additional information
can be found at [Link]
community-services-parks/community-development-block-grant/homeless-
services.

Long Beach Department of The Long Beach Department of Health and Human Services,
Health and Human Services, Homeless Services Division leads the Long Beach Continuum of
Homeless Services Division, Care, a local planning body supported by the US Department of
Biennial Homeless Count Housing and Urban Development to coordinate housing and services
for homeless families and individuals in Long Beach. The Homeless
Services Division also coordinates the city’s biennial homeless count.
Data from the 2017 homeless count were used for the indicator
on the estimated number of homeless individuals in the City and
Community Health Profiles report for Long Beach. More information
can be accessed at [Link]
homeless-services/.

Pasadena Partnership to The Pasadena Partnership to End Homelessness is the lead agency
End Homelessness, for the Pasadena Continuum of Care, the local planning body
Homeless Count supported by the US Department of Housing and Urban Development
to coordinate housing and services for homeless families and
individuals in Pasadena. The Pasadena Partnership coordinates the
annual homeless count for the City of Pasadena. Data from the 2016
homeless count were used for the indicator on the estimated number
of homeless individuals in the City and Community Health Profiles
report for Pasadena. Additional information can be found at https://
[Link]/homeless-count/.

33 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TECHNICAL NOTES

The California Attorney General’s office collects crime data from California Attorney General,
county and local law enforcement agencies in the state. Data from Crimes and Clearances
the 2016 Crimes and Clearances file were used for the indicator on
the serious crime rate for all the incorporated cities in Los Angeles
County profiled in the City and Community Health Profiles series,
excluding the City of Los Angeles. The number of Part I offenses (i.e.,
serious crimes) reported in 2016 was used as the numerator, while
Hedderson Demographic Services Population Estimates for 2016 were
used as the denominator. Data for this indicator were prepared by the
Los Angeles County Department of Public Health Injury and Violence
Prevention Program. More information is available at [Link]
crime.

Crime data for the City of Los Angeles are made publicly available Los Angeles Police
by the Los Angeles Police Department. Data for 2016 were obtained Department, Crime Data from
from the Crime Data from 2010 to Present file and were used for 2010 to Present
the indicator on the serious crime rate for the City of Los Angeles
and the Los Angeles City Council Districts (LACDs). To generate
the numerator for the number of serious crimes, Part I offenses (i.e.,
serious crimes) were identified using the “crime code description”
variable, and crime locations were geocoded to 2012 City of
Los Angeles and LACD boundaries as defined by the City of Los
Angeles Bureau of Engineering. Hedderson Demographic Services
Population Estimates for 2016 were used as the denominator.
Data for this indicator were prepared by the Los Angeles County
Department of Public Health Injury and Violence Prevention
Program. More information is available at [Link]
browse?category=A+Safe+City.

Crime data for Los Angeles County unincorporated Census Los Angeles County Sheriff’s
designated places (CDPs) are made publicly available by the Los Department, Historical
Angeles County Sheriff’s Department. Data from the Historical Crime Crime Data
Data 2016 file were used for the indicator on the serious crime rate
for the unincorporated CDPs. To generate the numerator for the
number of serious crimes in the unincorporated CDPs, Part I offenses
(i.e., serious crimes) were identified using the “category” variable, and
crime locations were geocoded to unincorporated CDPs as defined
by the 2015 Board Approved Statistical Boundaries for Los Angeles
County. Hedderson Demographic Services Population Estimates for
2016 were used as the denominator. Data for this indicator were
prepared by the Los Angeles County Department of Public Health
Injury and Violence Prevention Program. More information is
available at [Link]

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 34

 TECHNICAL NOTES

State of California Alcoholic The California ABC maintains a record of all licensed alcohol retailers
Beverage Control (ABC) in the State of California. Retailers are classified as on-premise (i.e.,
alcohol is sold for consumption at the retail site) and off-premise
(i.e., alcohol is sold for consumption off site). Information about
on-premise and off-premise alcohol outlets in 2013 was obtained
from ABC, and alcohol outlet density for Los Angeles County cities
and unincorporated communities as well as the 15 Los Angeles City
Council Districts was calculated using Hedderson Demographic
Services Population Estimates for 2013 as the denominator. These
data were obtained from the Los Angeles County Department of
Public Health, Substance Abuse and Prevention Program’s report
Alcohol Outlet Density and Alcohol-Related Consequences by City and
Community in Los Angeles County, 2013. The report is accessible at
[Link]

California Environmental CalEPA’s CalEnviroScreen 3.0 is a tool that was developed to identify
Protection Agency (CalEPA), communities that may be disproportionately burdened by multiple
CalEnviroScreen 3.0 sources of pollution while also taking into account characteristics of
those communities that may render them especially susceptible to
the ill effects of hazardous exposures. The CalEnviroScreen 3.0 uses
environmental, health, and socioeconomic data to calculate a score
for census tracts in California. The Public Health Alliance of Southern
California developed the Clean Environment Score for use in their
Healthy Places Index by drawing data from CalEnviroScreen 3.0 on
average levels of the following four pollutants: fine particles (PM2.5),
ground-level ozone (ozone), diesel particulate matter (DPM), and
groundwater contamination. The most recently available data for
average levels of PM 2.5 and ozone are from 2012 – 2014. The most
recently available data for average levels of DMP are from 2012.
The most recently available data for average levels of groundwater
contamination are from 2005 – 2013. The Clean Environment Score
was calculated for the incorporated cities, Los Angeles City Council
Districts, and unincorporated Census designated communities that
have been included in the City and Community Health Profiles series.
In this report, we have presented the percentile rank of the Clean
Environment Score. This indicator was prepared by the Public Health
Alliance of Southern California. More information is available at
[Link]

California Department of The DOGGRR maintains a comprehensive database of all oil and
Conservation, Division of gas wells in the State of California. The 2017 DOGGRR data on all
Oil, Gas, and Geothermal wells were used for the indicator on the number of oil and gas wells.
Resources (DOGGR) All well types were counted in this report, including new, active
producer, active injector, dry hole, plugged, and geothermal. More
information is available at [Link]

35 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 TECHNICAL NOTES

The California Department of Public Health’s Birth Statistical Master Los Angeles County
File contains information reported on birth certificates, including Department of Public Health,
detailed demographic data for infants and parents as well as clinical Los Angeles County Linked
data about the pregnancy. This file was geocoded by the Los Angeles Birth Data
County Department of Public Health, Office of Health Assessment
and Epidemiology to produce the Los Angeles County Linked Birth
Data file. Data from 2012 – 2016 have been included in this file. The
data from this file were used for the indicators on teen birth rate,
percentage of low birth weight births, and percentage of births to
women initiating prenatal care in the first trimester. In addition, the
data from this file were also used to provide the denominator for the
infant mortality indicator. For more information, please contact our
office at (213) 288 – 7785, or email us at cchp@[Link].

The Los Angeles County Department of Public Health STD Los Angeles County
Surveillance system obtains data on cases of gonorrhea, chlamydia, Department of Public Health
and syphilis infections through passive surveillance. Passive (DPH), Sexually Transmitted
surveillance relies on reports submitted to DPH by physicians, Disease (STD) Surveillance
laboratories, and other healthcare providers via Confidential System
Morbidity Reports. The DPH STD Surveillance system excludes
the cities of Long Beach and Pasadena; STD surveillance data for
these cities are captured through the California Reportable Disease
Information Exchange system. Data from the Los Angeles County
DPH STD Surveillance system were used for the indicators on
syphilis and gonorrhea rates. Numerator data were generated from
the number of syphilis and gonorrhea cases reported in 2014 – 2016
while Hedderson Demographic Services Population Estimates for
2014 – 2016 were used as the denominator. These indicators were
prepared by the Los Angeles County DPH Division of HIV and STD
Programs. For more information, please contact our office at (213)
288 – 7785, or email us at cchp@[Link].

CalREDIE is a state-wide secure system for electronic disease reporting California Reportable Disease
and surveillance administered by the California Department of Information Exchange
Public Health. Healthcare providers and laboratories are mandated (CalREDIE)
by State law to report specified diseases and conditions to public
health authorities. These includes sexually transmitted diseases (STD)
such as syphilis and gonorrhea. The Long Beach Health and Human
Services Department and the Pasadena Health Department granted
permission to the Los Angeles County Department of Public Health
(DPH) Division of HIV and STD Programs (DHSP) to obtain syphilis
and gonorrhea case data from the jurisdictions of Long Beach and
Pasadena for use in the City and Community Health Profiles reports

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 36

 TECHNICAL NOTES

for Long Beach and Pasadena for the indicators on syphilis and
gonorrhea rates. Numerator data were generated from the number
of syphilis and gonorrhea cases reported in 2014 – 2016 while
Hedderson Demographic Services Population Estimates for 2014 –
2016 were used as the denominator. These indicators were prepared
by the Los Angeles County DPH DHSP. For more information,
please contact our office at (213) 288 – 7785, or email us at
cchp@[Link].

Los Angeles County The Los Angeles County DPH HIV Surveillance system uses active
Department of Public Health and passive surveillance to compile information on HIV infections
(DPH), HIV Surveillance System (including AIDS) in Los Angeles County. Data are collected on cases
of HIV diagnosed at hospitals, clinics, physician offices, laboratories,
community-based organizations, and hospices. In addition, DPH staff
routinely contact and visit sites to facilitate completion of HIV case
reports as part of the active surveillance protocol. The Enhanced HIV/
AIDS Reporting System is used for the collection and management
of HIV surveillance data in Los Angeles County. Data from the DPH
HIV Surveillance system were used for the indicator on the prevalence
of persons living with HIV. The numerator represents the number of
individuals living with HIV in Los Angeles County as of December
31, 2016. Hedderson Demographic Services Population Estimates for
2016 were used as the denominator. This indicator was prepared by
the Los Angeles County DPH Division of HIV and STD Programs. For
more information, please contact our office at (213) 288 – 7785, or
email us at cchp@[Link].

Public Health Alliance of The HPI is a composite measure developed by the Public Health
Southern California, California Alliance of Southern California to summarize the health of the
Healthy Places Index (HPI) community based on the cumulative impact of the social determinants
of health. The index combines 25 community characteristics into a
single score and has been organized around the following eight policy
domains: economic, social, education, transportation, neighborhood,
housing, clean environment, and health care. The HPI score was
calculated for the incorporated cities, Los Angeles City Council
Districts, and unincorporated Census designated communities that
have been included in the City and Community Health Profiles series.
In this report, we have presented the percentile rank of the HPI score.
This indicator was prepared by the Public Health Alliance of Southern
California. More information is available at [Link]
org/.

37 CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES

 ACKNOWLEDGMENTS

We would like to thank the following individuals for their contributions to the
City and Community Health Profiles series:

Frank Alvarez, Aida Angelescu, Patty Banuilos, Susan Blackwell, Jerome Blake, Catherine Branson, Jason
Brinkley, Katherine Butler, David Cardenas, Janice Casil, Michelle Chan, Jennifer Cloud, Myles Cockburn,
Charlene Contreras, Yolanda Cordero, Janet Cuanas, Yan Cui, Bryant Dao, Deborah Davenport, Tracy Delaney,
Christine De Rosa, Helen Dowling, Yajun Du, Andrew Evans, Leila Family, Jennifer Florez, Tonya Gallow,
Wendy Garland, Avi Goldenberg, Elycia Mulholland Graves, Gayle Haberman, Heena Hameed, Ann Hamilton,
Frank Harris, Alex Ho, Shelly Hsu, Natalie Jimenez, Grace Kim, Tina Kim, Jan King, Stas Kolenikov, Tony Kuo,
Alice Kwan, Ming H Lee, Sun Lee, Amy S Lightstone, Hong Ling, Neil Maizlish, Amy Mellies, Zahra Mobasher,
Cristin Mondy, Douglas Morales, Karen Noyes, Rangell Oruga, Chitra Pannirselvam, Skye Patrick, Carlos
Portillo, Silvia Prieto, Yeira Rodriguez, Louise Rollin-Alamillo, Marci Schalk, Dipa Shah, Megha D Shah, Paul
Simon, Lisa V Smith, Justin Stein, Isabelle Sternfeld, Carrie Tayour, Rachel Tyree, Jesse Walker-Lanz, Mark
Weber, Andrea Welsing, Brenda Booth West
We extend a special thank you to Amy Truong and Alan Albert for their significant contributions to the report
design and layout.
We also thank the members of the Community Prevention and Population Health Task Force for their helpful
input during the development of these reports.
In addition, we thank Kaiser Permanente Southern California Community Health for their generous support.

CITY AND COMMUNITY HEALTH PROFILES | CITY OF LOS ANGELES 38

CITY AND COMMUNITY
HEALTH PROFILES CITY OF LOS ANGELES

Los Angeles County Department of Public Health

Office of Health Assessment and Epidemiology
313 N Figueroa St, Room 127
Los Angeles, CA 90012
(213) 288 - 7785
cchp@[Link]

LOS ANGELES COUNTY BOARD OF SUPERVISORS

HILDA L SOLIS
First District
MARK RIDLEY-THOMAS
Second District
SHEILA KUEHL
Third District
JANICE HAHN
Fourth District
KATHRYN BARGER
Fifth District

LOS ANGELES COUNTY DEPARTMENT OF PUBLIC HEALTH

BARBARA FERRER, PhD, MPH, MEd
Director
JEFFREY D GUNZENHAUSER, MD, MPH
Interim Health Officer
CYNTHIA A HARDING, MPH
Chief Deputy Director

Suggested Citation: Los Angeles County Department of Public Health. City and Community Health Profiles:
City of Los Angeles. June 2018.