Monitoring health in Los Angeles County

The University of California at Los Angeles School of Public Health, in collaboration with the Los Angeles County Department of Health Services, compiled data and developed a standardized format that displayed a comparison of mortality and morbidity data between Los Angeles County, the State of California, and the United States in 1960, 1970, and 1980 for 16 health topic areas. Findings noted both favorable and unfavorable health trends, as well as substantial data collection problems. In 1980, compared with the United States, the Los Angeles County rates for tuberculosis, gonorrhea, syphilis, and hepatitis B were as much as 45 to 128 percent higher, the homicide rate was more than double, and, for the population aged 65 years and over, the cirrhosis of the liver rate was more than 56 percent higher. The myocardial infarction rate was 58 percent lower in the population aged 18 to 64. Problems of inadequate data for many health indicators, lack of comparability in data, and conflicting information from different data sources were noted. These limitations with the data underscore the need to standardize data collection procedures and to extend the parameters on which information is collected. The approach represents a tool that could be used by many health departments to monitor their activities and set future goals.     

Trends in Air Pollution Outside Los Angeles County

Polyvinyl chloride polymers and formulations were pyrolyzed in a stream of air by gradually raising the temperature from ambient to approximately 600 C. The pyrolysis air stream was diluted with twice its volume of room air, and rats were exposed to it. Exposure to an air stream containing the pyrolyzed products of 1 to 2 gm of polyvinyl chloride polymer resulted in the death of 50% of the animals. Most deaths were due to carbon monoxide (CO), and carboxyhemoglobin (COHb) levels correlated well with the amount of plastic pyrolyzed. Little histological evidence of lung damage was evident. When oxygen (O₂) was added to the air stream to prevent deaths from CO, pulmonary edema and interstitial hemorrhage developed. The lungs of some animals exposed to high levels of pyrolysis products of vinyl chloride-vinyl acetate copolymer also showed focal edema and intra-alveolar hemorrhage. Polyvinyl chloride formulations, containing additives and inert materials, were in general less toxic per gram of sample pyrolyzed.     

Epidemiologic impact of water reuse in Los Angeles County

The importance of recycled wastewater in the pathogenesis of disease has been considered in an ecologic analysis of four geographic areas of Los Angeles County. Two of the areas received recycled wastewater via the groundwater since 1962, while two similar areas served as controls. Of 19 health outcomes included in the analyses, five exhibited statistically significant differences among four areas. In none of these five analyses, however, were the differences in accord with the biologic hypothesis that recycled water causes disease. For only one outcome, deaths due to cancer of the rectum, were differences noted in which the high recycled water area had more excess deaths than the low recycled water area, and both had more excess deaths than the control areas. This positive association was of a low order, however, and might well have been due to chance (P = 0.08). The results of this first stage of our investigation suggest that as of 1969–1971, there were no grossly apparent adverse health effects associated with the use of recycled water. Nonetheless, a cautious interpretation of the study findings is necessary due to the inherent limitations of this type of analysis.     

Differences in individual-level terrorism preparedness in Los Angeles County

BACKGROUND: Increasing individual preparedness for disasters, including large-scale terrorist attacks, is a significant concern of public health planners. As with natural disasters, individuals can help protect their health and safety by preparing for the emergency situation that may follow a terrorist event. Our study describes variations in preparedness among the population of Los Angeles County after the September 11, 2001 and subsequent anthrax attacks. METHODS: In 2004, the data were analyzed from the Los Angeles County Health Survey, a random-digit-dialed telephone survey of the non-institutionalized population in Los Angeles County fielded October 2002 through February 2003. RESULTS: Overall, 28.0% of respondents had emergency supplies, and 17.1% developed an emergency plan in the past year in response to the possibility of terrorism. Factors associated with having emergency supplies included African American (adjusted odds ratio [AOR] 1.8, 95% confidence interval [CI]=1.1-3.1) and Latino (AOR=1.5, 95% CI=1.0-2.4) race/ethnicity; having a household dependent aged相似文献   

Shifting from in-person to virtual home visiting in Los Angeles County: Impact on programmatic outcomes

Maternal and Child Health Journal - This paper describes the effect that the COVID-19 pandemic, and subsequent shift from in-person to virtual (video-based) home visiting, had on the Los Angeles...     

Monitoring the Impact of Heat Waves with Emergency Service Utilization Data in Los Angeles County

Objective

To assess current indicators for situational awareness during heat waves derived from electronic emergency department (ED) and 911 emergency dispatch call (EDC) center data.

Introduction

Los Angeles County’s (LAC) early event detection system captures over 60% of total ED visits, as well as 800 to 1,000 emergency dispatch calls from Los Angeles City Fire (LACF) daily. Both ED visits and EDC calls are classified into syndrome categories, and then analyzed for aberrations in count and spatial distribution. During periods of high temperatures, a heat report is generated and sent to stakeholders upon request. We describe how syndromic surveillance serves as an important near real-time, population-based instrument for measuring the impact of heat waves on emergency service utilization in LAC.

Methods

Daily electronic ED registration data, EDC calls, and high temperatures from Palmdale, California were queried from January 1, 2010 to August 26, 2012 and aggregated into Centers for Disease Control (CDC) weeks. A custom “heat exposure” category was created by searching ED chief complaints for key terms such as “Heat stroke,” “hyperthermia,” “overheat,” and relevant ICD9 diagnosis codes. Similarly, EDC calls were classified if related to “heat exposure.” Pearson correlation tests were used to determine correlation between total ED visits, heat-related ED visits, heat-related EDC calls, and daily maximum temperatures.

Results

Thus far 2012 has exceeded counts cumulative to August 26th for the past two years in the number of heat-related ED visits, heat-related EDC calls, and hot days (

Breast cancer treatment experiences of Latinas in Los Angeles County

OBJECTIVE: We examined breast cancer treatment experiences of and outcomes for Latinas in Los Angeles County. METHODS: We conducted a population-based survey of women who were diagnosed with breast cancer between December 2001 and November 2002 (n=910) to evaluate the types of treatments received, communication with clinicians, and satisfaction. RESULTS: About two thirds were non-Latina White, 18.8% were African American, and 18.9% were Latina (with 11.0% preferring English and 7.9% preferring Spanish). The rest indicated other ethnic groups. Latinas who preferred Spanish were more likely to experience a delay of 3 months or more from diagnosis to surgical treatment (36.4% vs 9.1% for non-Latina Whites, 18.6% for African Americans, and 12.7%, for other Latinas, P<.001). African Americans and Latinas who preferred Spanish had very low rates of reconstruction (13.8% and 9.2%, respectively, compared with 42.1% for Whites and 34.5% for Latinas who preferred English, P=.009). Latinas who preferred Spanish had the highest odds ratio for low satisfaction. CONCLUSION: Latinas who preferred Spanish received different treatments and perceived a different treatment experience than did other cultural groups.     

Tailoring outdoor tobacco advertising to minorities in Los Angeles County

This study provides the first longitudinal comparison of the frequency and content characteristics of tobacco ads that appeared along thoroughfares running through four types of Los Angeles ethnic neighborhoods. Tobacco ad density (tobacco billboards per mile), concentration (proportion of billboards with tobacco content), and content were compared from 1990 to 1994 across four neighborhoods at multiple time points. Compared with White neighborhood thoroughfares, African American and Hispanic neighborhoods contained greater tobacco ad density, and all minority neighborhoods contained greater tobacco ad concentration along the roadsides. Initial differences in tobacco ad frequency decreased significantly over time. However, the age, race, and gender of billboard characters remained different among the different ethnic neighborhood thoroughfares, with greater ethnicity-specific content in African American neighborhood thoroughfares than in other neighborhood thoroughfares. These data are consistent with the assertion that tobacco companies target ethnic minorities with higher rates of advertising and ethnically tailored campaigns. This may be used in order to expand the total market of minority consumers.