Community Health Assessment for Los Angeles County California
The Selected Community
The state of California is geographically divided into three coastal regions. Southern California is bounded by Mexico in the South and the central valley to the North. Los Angeles county is in the middle portion of the region and it has features that also define its boundaries. The county is situated in a large valley that resides along the Pacific coast and is surrounded by mountain ranges. Though a relatively small area geographically, it contains a large and diverse population.
The people of Los Angeles county are among the most culturally and ethnically diverse groups in the country and their healthcare and safety needs reflect this. Nearly 10 million people live in the area which equates to almost 2,500 people per square mile. Of course, this is an urban area, which presents specific problems, and it is a densely populated urban area with many different types of neighborhoods that must all be addressed. This means that there are some areas of the county that are populated with extremely disadvantaged people financially who will have more difficulty obtaining quality healthcare. Whereas some areas of the county house extremely wealthy individuals who have better access to superior healthcare facilities, but may suffer other deficiencies that have to be addressed. The county is also subject to possible disasters due to its position relative to the Pacific Ocean and the San Andreas fault line.
The people that occupy the county are largely Caucasian (74.1%) followed by Asian/Pacific Islander (13.5%), Black (9.4%), and American Indian (1.0%). Intermingled with these classifications, 47.3% of the population also identifies as of Hispanic origin in some way (HHS, 2009). The Census Bureau (2011) indicates that the median per capita income was $27,344, and that the household income was $55,476. In the county, 15.7% of people were deemed to be below the poverty line which was 2% greater than the number below that line in the rest of the state and the nation as a while (Census Bureau, 2011). The disparity of income in the county is also one of the largest in the nation because there are some areas of the county that house people who are extremely wealthy whereas Los Angeles county also has one of the largest homeless populations in the nation with figures suggesting that "an estimated 254,000 men, women and children experience homelessness in Los Angeles County during some part of the year and approximately 82,000 people are homeless on any given night" (Los Angeles Almanac, 2011).
Due to the wide variation in peoples and financial means, there is also a great diversity with regard to culture in the county in question. The largest single population, by group, in the county is Hispanic. These people come from any of a number of Central and South American cultures although the vast majority of the population traces its ancestry to Mexico. Although the cultures of the peoples that identify themselves as Hispanic may seem to correlate highly, there are differences that must be acknowledged by healthcare professionals. Another large group, Asian/Pacific Islanders, is also one in which many different cultures are often mistakenly grouped together. The cultural identity of all of these peoples can be very different due to the length of time the family has been in the United States and how prevalent cultural teaching is in the family.
Another outcome of a widely diverse population, in terms of both culture and socioeconomic status, is the access the individual has to health insurance of some kind. While the wealthiest people in the population may be able to fund their own healthcare needs out-of-pocket, this is not an option for most people living in Low Angeles county. According to HHS figures slightly more than 2 million people are uninsured. While this does not mean that they have no access to health care, it does place a large burden on the available clinics and hospital choices for those without insurance. It is recognized that the area has a sufficient number of healthcare facilities and it is not regarded as an area with a health professional shortage (HHS, 2009).
Besides the health care needs of the community are those for safety and disaster preparedness. The western expanse of the county runs along the Pacific Ocean which is always a potential tsunami danger zone due to the frequent earthquakes which occur in the Pacific rim. The San Andreas fault runs through the county and produces a large amount of minor tremors and has been responsible for a few major earthquakes. The county runs disaster preparedness drills on a frequent basis due to these dangers, and healthcare professionals are trained how to deal with the possibility of a major event.
The statistics show that Los Angeles county does have some areas in which it differs from what the HHS survey calls "peer counties," but, in general, these variances are either very small or in other ways negligible. The measures given by HHS are all per 100,000 people. The report gives birth, death and pother health statistics.
Birth rates are in line with those across the population as a whole. Infant mortality is at 5.0, and is lowest among Caucasians (4.0) and highest among Blacks (10.7) (HHS, 2009). Although there is a wide disparity in these rates, they are lower than the country at large. As a matter of fact, the difference between the white and black populations in Los Angeles county is actually lower than it is in the rest of the country. The same can be said for other ethnic populations with Hispanic infant mortality rates being significantly lower than in the rest of the country.
At the other end of the spectrum are the death figures. Of course, everyone dies, so these calculations are based on how many people die from a specific cause. The markers that the HHS (2009) survey used were (in chronological order from the Los Angeles county data) coronary heart disease, stroke, lung cancer, breast cancer, colon cancer, unintentional injury, homicide, motor vehicle injury and suicide. Heart disease is by far the most deadly problem faced in any part of the country, but it seems to be an even larger issue in Los Angeles county. The national number is 154 deaths per 100,000 people, but there are 190 deaths in the county under consideration. This disparity can be caused by a number of different factors, but there is not enough data to suggest the reason in the HHS study. Both breast cancer and colon cancer death rates were almost identical between the national and county scales, but the national rate for lung cancer (52.6) was much higher than the county rate (37.7). This could be due to the lower number of smokers in the Los Angeles county region (HHS, 2009), or to a variety of other factors that can be seen as significant causes of lung cancer. It is interest8ing to note that deaths from medical causes far outweigh those from any type of injury. For example it may be expected that there would be a large number of traffic fatalities due to the amount of miles driven and the fast moving, close traffic in the county. However, Los Angeles county has fewer traffic related fatalities (9.9) than the national average (14.6).
Population Economic Status
Most Los Angeles county figures have already been given, those not provided above will be elucidated now. Unemployment in LA county was at 11.9% in 2011 but it was trending down from other recent figures (LA County Unemployment, 2012). A large portion of the population uses preventive care facilities except in the case of vaccines for pneumonia (58.7%) and influenza (66.1%) (HHS, 2009).
The population has a large white majority, but more than half of those also claim Hispanic heritage. The predominant religious preference is Christian with most of that population being Catholic. The health services that are available are known to a large majority of the population. Drug and alcohol use has remained relatively stable over the past decade.
Many different types of health services organizations exist in the county with those helping the poor being especially prominent. Air quality has always been an issue in the region due to the bowl created by the ocean and the mountains. There is very little problem with wildlife, but bears and panthers are being repopulated in the area. Due to the ocean, some danger of drowning or injury from sea creatures does exist. Since the area has a lot of industry, there is a possible problem with toxic chemical and fumes release. One of the greatest natural dangers in the region comes from perennial forest fires. Floods and mudslides from drenching winter rains are often a problem in some areas of the county.
Disaster Assistance and Planning
The county has a comprehensive emergency preparedness plan that covers biological, chemical and radiological hazards and natural disaster (Public Health, 2012). The county carries out drills for…