The Gateway Cities Air Quality Action Plan COMMUNITY MEDICAL NEEDS ASSESSMENT Final September 2011 P REPARED FOR: Los Angeles County Metropolitan Transportation Authority (Metro) and Gateway Cities Council of Governments P REPARED BY: Human Impact Partners Table of Contents 1. Introduction ........................................................................................................... 1-1 1.1 Gateway Cities and Los Angeles County Planning Boundaries ........................................ 1-1 1.2 Data Sources Presented in the CMNA ............................................................................. 1-2 1.3 Demographic Characteristics of the Gateway Cities........................................................ 1-2 1.4 Health, Medical Need, and Quality of Life ....................................................................... 1-2 1.5 Existing Conditions of Health and Medical Need in the Gateway Cities ......................... 1-2 1.6 Summary .......................................................................................................................... 1-2 1.7 Recommendations ........................................................................................................... 1-2 1.8 Appendices....................................................................................................................... 1-2 2. Gateway Cities and Los Angeles County Planning Boundaries ................................... 2-1 2.1 Public Health Planning and Service Boundaries .............................................................. 2-2 2.2 Data Sources Presented in the CMNA ............................................................................. 2-4 2.2.1 U.S. Census Bureau, 2005-2009 American Community Survey 5-Year Estimates ....................................................................................................................................... 2-4 3. Health, Medical Need, and Quality of Life ................................................................ 3-1 4. Demographic Characteristics of the Gateway Cities .................................................. 4-1 4.1 Poverty and Income ......................................................................................................... 4-1 4.1.1 Occupation and Economic Hardship ................................................................................ 4-2 4.1.2 Unemployment ................................................................................................................ 4-2 4.1.3 Age and Education ........................................................................................................... 4-2 4.1.4 Housing Overcrowding..................................................................................................... 4-2 4.1.5 Travel Time to Work ........................................................................................................ 4-2 5. Existing Conditions of Health and Medical Need in the Gateway Cities ..................... 5-1 5.1 Self-Rated Health ............................................................................................................. 5-1 5.2 Asthma and Respiratory Illness........................................................................................ 5-2 5.2.1 Asthma ............................................................................................................................. 5-2 5.2.2 Respiratory Illness ............................................................................................................ 5-6 5.3 Diabetes ........................................................................................................................... 5-7 5.4 Hypertension.................................................................................................................... 5-8 5.5 Heart Disease and Heart Attacks ..................................................................................... 5-9 5.5.1 Heart Disease ................................................................................................................... 5-9 5.5.2 Heart Attacks ................................................................................................................. 5-11 5.6 Obesity and Overweight ................................................................................................ 5-12 5.7 Physical Activity ............................................................................................................. 5-13 ICF International The Gateway Cities Air Quality Action Plan i September 2011 Community Medical Needs Assessment – Final 5.8 Mental Health ................................................................................................................ 5-15 5.9 Activity Limitation and Unhealthy Days Due to Physical or Mental Health................... 5-18 5.10 Hospitalizations .............................................................................................................. 5-18 5.10.1 2009 Hospitalizations and ED Visits in the Gateway Cities ..................................... 5-19 5.11 Mortality and Premature Mortality ............................................................................... 5-22 5.11.1 Mortality .................................................................................................................. 5-22 5.11.2 Premature Mortality ............................................................................................... 5-23 5.12 Health Professional Shortage Areas (HPSA) .................................................................. 5-25 5.12.1 Health Professional Shortage Area (HPSA) for Primary Care .................................. 5-25 5.12.2 Health Professional Shortage Area (HPSA) for Mental Health ................................ 5-28 5.12.3 Health Professional Shortage Area (HPSA) for Dental ............................................ 5-30 5.13 Medically Underserved Areas (MUA) and Medically Underserved Populations (MUP) ............................................................................................................................ 5-33 5.13.1 Medically Underserved Areas ................................................................................. 5-33 5.13.2 Medically Underserved Populations ....................................................................... 5-35 5.14 Location of Healthcare Facilities in the Gateway Cities ................................................. 5-37 5.15 Access to Health Care Services ...................................................................................... 5-38 5.15.1 Access to Care for Health Problems ........................................................................ 5-40 5.15.2 Access to Mental Health Care ................................................................................. 5-40 5.15.3 Access to Dental Care .............................................................................................. 5-40 5.16 Health Insurance ............................................................................................................ 5-41 6. Summary ................................................................................................................ 6-1 6.1 Bellflower Health District (HD 6) ...................................................................................... 6-4 6.2 Compton Health District (HD 12) ..................................................................................... 6-4 6.3 East LA Health District (HD 16) ........................................................................................ 6-5 6.4 Long Beach Health District (HD 40) .................................................................................. 6-5 6.5 San Antonio Health District (HD 58) ................................................................................ 6-5 6.6 Whittier Health District (HD 91)....................................................................................... 6-6 7. Recommendations .................................................................................................. 7-1 Appendix A Appendix B Appendix C Appendix D ICF International The Gateway Cities Air Quality Action Plan ii September 2011 Community Medical Needs Assessment – Final Figures Figure On Page 2-1 Gateway Cities ......................................................................................................................... 2-2 2-2 Los Angeles County Service Planning Areas and Gateway Cities ............................................. 2-3 2-3 Health Districts in the Gateway Cities...................................................................................... 2-4 5-1 Percent of Adults that Reported Fair or Poor Health Status, Gateway Health Districts, 2007 .......................................................................................................................... 5-1 5-2 Prevalence of Children with Asthma, Gateway Health Districts, 2007 .................................... 5-2 5-3 Percent of Children and Teens who Missed ≥ 1 Day of School Due to Asthma, Gateway Cities Service Planning Areas (SPAs), 2009 ............................................................... 5-3 5-4a Asthma Hospitalization Rates (per 10,000 residents), Gateway Health Districts, 2009 ......................................................................................................................................... 5-4 5-4b Rates of ED Hospitalizations Due to Asthma (per 10,000 residents),