When it comes to recreational space, not all neighborhoods are created equal. Low-income communities and communities of color consistently have the fewest recreational facilities. Even where recreational facilities do exist, there are often other barriers to meaningful access, such as safety concerns, lack of transportation to the facilities, and poor maintenance due to inadequate funding. The result: Residents of these communities often have the fewest opportunities for physical activity.
In Los Angeles, for instance, access to recreational space is disturbingly inequitable. While standards vary, many experts recommend that a city have at least ten acres of park and recreation space per thousand residents. White L.A. neighborhoods more than meet that standard – with an average of 32 acres of park space per thousand residents – but Latino and African-American neighborhoods have only 0.6 and 1.7 park acres, respectively. Similarly, low-income neighborhoods have less than a half-acre of park space per thousand residents, while higher-income neighborhoods have 21 acres.
These patterns are pervasive. Throughout California and the country, low-income communities and communities of color are far less likely to have access to recreational spaces than their white, higher-income counterparts. Unfortunately, and perhaps not surprisingly, the places with the fewest opportunities for physical activity often have worse health outcomes.
Health Inequities in California
The lack of safe, affordable places to play and be active contributes to the health inequities facing low-income communities and communities of color across the state. Residents of “park poor” communities disproportionately bear the burdens of the obesity and diabetes crises:
Last week, CPEHN was one of the many organizations that attended the PolicyLink “Equity Summit 2015: All in for inclusion, justice, and prosperity” in Los Angeles. This three day national gathering convened thousands of advocates, organizers, and elected officials from all over the country to discuss and brainstorm opportunities for policy change with a clear equity focus. Over 60 sessions were offered covering a broad swath of equity-focused topics including: social entrepreneurship, climate change, housing, transportation, incarceration, inclusive governance, employment, and many more.
CPEHN kicked off the Equity Summit by participating in a pre-summit Alliance for Boys and Men of Color Policy Convening where we worked with the Health Policy Workgroup to narrow down the Alliance’s primary focuses for 2016. We have been co-leading the workgroup with PolicyLink and have continued to bring health equity legislation and policy issues to the discussions.
California’s Office of the Patient Advocate (OPA) released its 2015-16 Health Care Quality Report Cards last week. The new report cards shed light on the quality of care under a variety of health care providers and plans, including California’s 10 largest HMOs, the six biggest PPOs, and more than 200 large medical groups covering 16 million consumers in California. The data is drawn from claims data and patient surveys.
The report cards are timely as consumers gear up for 2016 open enrollment, which begins Nov. 1, 2015, and continues through Jan. 31, 2016. With the release of the report cards, consumers should have an easier time shopping for coverage. Each HMO and PPO is evaluated on their overall medical care and for how it treats certain conditions like asthma and cancer as well as its behavior and mental health care. Further, the report card provides a deeper evaluation on how a health plan treats certain conditions through specific clinical indicators of good care. This helps consumers understand what they should expect from their coverage.
Topic areas to be discussed include: a historic perspective on mental illness across cultural and social groups, substance use disorders, mental health and resiliency among veterans and military families, mental health and the justice system, and California’s new strategic plan to reduce mental health disparities. The agenda is comprised of interactive presentations, panel discussions, networking activities, a poster session, as well as an optional working group over the lunch hour.
The FREE symposium is jointly hosted by the UCLA Kaiser Permanente Center for Health Equity, the Jonsson Comprehensive Cancer Center, Kaiser Permanente, and the UCLA Fielding School of Public Health. Breakfast, lunch, and parking will be provided. Expected attendees include leadership and staff of community-based organizations and local health departments, healthcare providers, faculty and students.
This is an excerpt from the new publication, Advancing Health Equity: Case Studies of Health Equity Practice in Four Award-Winning California Health Departments, that originally appeared on the Berkeley Media Studies Group's website.
Call any local health department in the United States and, chances are, you won't have much trouble finding information on the health problems its surrounding communities face. You might learn that a county's populations of color have higher rates of asthma than white community members, or that its low-income adults are more likely to experience a heart attack. Or you might discover that the region experiences excellent health overall but still struggles with wide differences in life expectancy from one neighborhood to the next.
That's because health departments are increasingly focused on understanding health inequities — unjust differences in health outcomes and longevity that can't be explained by genetics or individual behavior — and how to prevent them. Going beyond public health's traditional purview of infectious disease control and clinical services, many health departments are now exploring how social, economic, and political inequalities, all of which are rooted in power differences, are causing some groups to live sicker and die younger than others. These inequalities show up in indicators like education and income levels, rates of violence, and policies and practices that create advantages for some populations and disadvantages for others, based, for example, on race, gender, or sexuality.
As most of California endures near-record high temperatures this week, it seems like an appropriate time to discuss the intersection of the state’s historic drought, climate, and equity. A new report from Wendy Ortiz at the Center for American Progress, Lessons on Climate Change and Poverty from the California Drought, makes these connections and shows that low-income areas and communities of color are disproportionately impacted by the ongoing drought and climate change in general.
In her report, Ortiz summarizes the inequities faced by communities of color and low-income people and discovers that climate change serves as an escalating factor for these conditions:
The enduring effects of racial segregation and the underinvestment in low-income communities — in California and elsewhere — have placed people of color and low-income people in environments that threaten their physical and emotional health. Low-income communities and communities of color are most vulnerable to the effects of climate change due to poor-quality housing and infrastructure, proximity to environmental hazards, and economic instability. Because these communities have been institutionally excluded from accruing wealth and assets — which are prominent indicators of a family’s ability to prepare for unexpected shocks — they are less able to survive and recover from disastrous events.
Today marks my one year anniversary as CPEHN’s Executive Director. It’s hard to believe it has already been one year! When I started, CPEHN had just been awarded the 2014 “Impact Award for Advocacy” by the UCLA Center for Health Policy Research, the election season was upon us, and staff were wrapping up another successful legislative year.
Thanks to a tremendous staff, amazing funders and donors, and a committed Board of Directors, CPEHN has achieved a number of key accomplishments. A few noteworthy highlights of our work include:
Advancing policies that improve health in California’s communities of color
In 2012, California took a significant step toward addressing the health needs of its diverse communities with the creation of the Office of Health Equity (OHE) within the California Department of Public Health. In the years since, OHE has taken a leading role in bringing attention to the health needs of the state’s communities of color and other underserved populations such as LGBTQ populations, while also looking at health through a gender lens.
The report goes into great detail about the benefits and challenges posed by California’s diversity and looks at the root causes of inequities across the state. OHE also makes a considerable effort to document the social determinants of health and how income, food security, education, housing, neighborhood planning, and the environment are all inextricably linked to the public’s health. The report also addresses gaps in access to health care among communities of color and low-income populations and the importance of cultural and linguistic competence in health care services.
Across California, there’s a great network of advocates and health professionals working to promote equity and improve the health of the state’s communities of color. This network has led to a vibrant online community filling social media with great resources on a daily basis. Here are some of the highlights as part of our inaugural This Week in Equity Engagement on Twitter (or TWEET for short…sorry!) feature on Voices for Health Equity:
The California Budget & Policy Center had an analysis on the California budget special sessions that resumed in full force this week after a month-long summer recess.
The Summit will inspire physicians and healthcare providers to participate in community health efforts and to be challenged to improve health care and the quality of life in their communities. You will have the opportunity to hear from nationally acclaimed thought leaders and network with colleagues. Our keynote speakers include California Secretary of State Alex Padilla and George Halvorson, the chair of the First 5 Commission of California. We are also pleased to offer CME credits.
The BHC Summit will also be hosting a poster presentation session for current medical students. We would like to extend to any medical student an opportunity to participate in a poster presentation displaying their health care research. This is a wonderful opportunity for students to display their work and network with other health care providers. For additional information, including guidelines and application, click here.