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Community Health (C228)
Task 1
Megan Smith
Student #
000473853
October 10, 2015

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Communities are often what shape and instill a sense of belonging for people. One such community is Northridge, which is a neighborhood located in the San Fernando Valley and is part of Los Angeles County. According to available data, there are 52,776 residents in
Northridge, and diversity is a key element. A snapshot of Northridge can be seen as 49.5% whites, hispanics/latinos 50.8%, Asians 14.5%, African Americans 5.4% and others 4.6%.
Along those lines, 7.6% are non­English speaking and a large percentage of these residents speak languages other than English in the home. Families (married with children) make up 24.1% of households with single parents accounting for 11.8% of the residents (Lacounty.gov).

Summary of Tools
Population Economic Status Assessment. The median household income for
Northridge in 2013 was $81,511, which is relatively high compared to the median income for
California which is $61,632 (Northridge Neighborhood). While the median income is high, one source of data states 20% ­ one in five residents­ of Los Angeles County receive public assistance (L.A. Times. 20% in Los Angeles County Receive Public Aid). While specific data could not be obtained for Northridge, in Los Angeles County (2011 Census) the birthrate was
130,312 and the death rate came in at 57,988, which means Los Angeles County as whole and its neighborhoods are growing both in population and diversity. In regards to health related deaths, coronary artery disease, stroke, and lung cancer remain the top three for the last ten years.
Another health concern is the consistent rise of diabetes in the county, with hispanics 12.3%

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followed by african americans at 12% who currently have diabetes, which is double than for
Whites and Asians (2011 Census). Windshield Survey orthridge is a highly dense urban city. It’s northern border runs
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along the 118 fwy, and surprisingly , just beyond this northern border there is a mountain range and open space. Despite the opening just north of the city, once traveling south of the freeway., the feeling of openness quickly disappears. Initially, you travel past small and modest homes, which for the most part are well maintained, but it seem a little odd on a busy four lane blvd.
After about a mile, you are immediately in the city: Gas stations, a car wash, fast food restaurants, shopping centers, bus stops and apartment buildings. This sets the trend for the rest of the city.
Continuing down Reseda, all the way to the 101 fwy, there is nothing but businesses, restaurants, apartments, health clinics, Churches, and gas stations. There is only one park on
Reseda, a Community Center, and it has a public pool with an awesome slide. Overall, there are ten parks dispersed throughout the city. Interestingly, while most of the area appears run down, there are small signs of improvements. One improvement is adding bike lanes and more parking on the street, which would help local businesses by making them more accessible to the public.
The only new building on Reseda was a Starbucks, and it did stand out from it’s surroundings ­ it was also very busy. Otherwise, scattered about are small areas which appear to be getting a facelift to shopping centers.
Approximately every six blocks or so, there is a major intersection. In between these intersections, if you were to turn down most any given street, you would enter a neighborhood.

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The running theme for most of the neighborhoods were small older homes, most needing some soft of repair or yard maintenance. However, veering away from Reseda and venturing more east or west, there were some neighborhoods that were very well maintained and appealing. These homes were also small and older, but the overall feel of the area was that it was more affluent.
Overall, it did not appear that Northridge has a lot of people out walking pets or jogging. Most people walking seemed to going to or coming somewhere specific as seen by women walking with school age children, vendors pushing carts, and people carrying bags of goods. This being said, you can drive one block away to a shopping center and find it very run down with graffiti covering the local businesses. It was noted that there many small shopping centers throughout
Northridge that seemed to cater exclusively to the hispanic community as evidenced by signs and billboards in Spanish only. The same could be said for some of the public buses, which also had ads in Spanish only. Another visible sign of the hispanic influence are vendors located on corners offering fruit on sticks, bags of oranges and flowers.
Most of the shopping centers tended to be on or near intersections, right near bus stops.
Most bus stops will often have a large number of people waiting, and it appears that this is an important form of travel for many residents. There is also a train station located mid­city, which is handy for commuters traveling farther for work, but it didn’t appear that the train station was as busy as the bus lines appeared to be.
In regards to education, Northridge is the proud home to California State University
Northridge as well as five elementary school, three middle schools, one high school, and ten private schools (Mapping L.A.: San Fernando Valley). It was noted that there was a heavy and dense amount of apartment buildings located around the college. Some complexes were

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obviously old and need of repair, with a few new and very modern apartments buildings scattered about ­ some still in the process of being built. Most religious denominations and their places of worship can also be found in this city as well as ten parks to be used by the residents for their enjoyment. Two police stations, two fire stations and two post offices provide protection and service to Northridge residents.
While Northridge has numerous shopping centers it only has one mall, and according to a blogspot in the L.A. Times, most people who wrote comments complained about the mall being a hangout for teenagers, who by many reports were rude, and even gang members. Most people said the city should ‘do something’ and that they preferred to drive to a different mall for their shopping. While one might think driving to another city would waste time, the fact is that
Northridge flows into other surrounding cities effortlessly, with no natural boundaries or signs indicating you have entered a new city. So going elsewhere to shop or do business would not be too much of an issue. (Mapping L.A.: San Fernando Valley).
Healthcare in the area is quite abundant with Northridge Hospital providing care to the surrounding areas as well as numerous clinics, medical groups, and urgent cares scattered throughout the city. There was a billboard offering care to young women who were pregnant free of charge, and while there is no statistical data for Northridge, L.A. County reports that
11.8% of residents are single parents and obviously there is a need to address this population.
Neighborhood Safety/Community Survey ccording the the L.A. Times, the city of
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Los Angeles and the Central Valley violated the federal law standards for ozone 122 days a year on average (L.A. Times, April 2014). The Environmental Protection Agency (EPA) developed the Air Quality Index (AQI) to measure five pollutants for the air. These pollutants include:

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Ground­level ozone, particle pollution, carbon monoxide, nitrogen dioxide, and sulphur dioxide.
All pollutants are measured on a daily basis and broken down into six categories which serve as indicators on how healthy the air quality is for the day. The AQI graphs pollution from 0­500 ­ the higher the number, the more pollution. Once levels reach 101­200, the air quality is considered unhealthy for sensitive people. This means for that the city of Los Angeles, one third of the year the air quality is unhealthy for the very young, very old, and those suffering from illness such as heart or lung disease (Los Angeles County: Quality of Air).
Water is another source of potential pollutants for any given city. Los Angeles County regularly tests for over 200 water pollutants through the county, although there are thousands of chemicals used in industry that can potentially leak into the water system (L.A. County Health
Department: Quality of Water). Some pollutants tested include mercury and benzene which there is an allowable amount in the drinking water. Another potential for health concerns is the amount of E. Coli found in the drinking water. If any level of measured contaminant is found to be above regulated and accepted ranges, the water is treated to rectify the problem.
Another source of potential harm from the environment comes from radiation. According to the Health Department, radiation is found everywhere: the sun, soil, computer screens, television sets, microwaves, and the lights in our homes and workplaces (L.A. County Public
Health. Ionizing Radiation). While radiation might be present, the general consensus is that concern occurs when someone is exposed to high levels or are repeatedly exposed such as in a workplace. Small amounts of radiation are unavoidable however, residents can protect

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themselves by applying sunscreen, and if their workplace exposes them (such as an x­ray tech) wearing appropriate protective gear should be supplied.
While many parts of the country are exposed to extreme weather conditions, L.A. County is a dry, desert area with little rainfall each year. The biggest danger would be the high temperatures that occur for a large part of the year. Staying protected from the sun and maintaining hydration are key during hot weather to avoid heat exhaustion, heat stroke and dehydration. On the rare occasion heavy rainfall occurs and there is a large amount of water in a short period of time, the L.A. river (a man­made aqueduct) can fill quickly and has caused the occasional drowning. But for the most part the ‘river’ has only a trickle of water. Northridge itself has no lakes or rivers, and only one public pool.
There are no natural preserves or vasts amounts of open area surrounding Northridge, so wildlife is not too much of an issue other than rats and mice, and the occasional raccoon or possum which roam the neighborhoods looking for food.
Cultural assessment
. Cultural diversity is very evident in Los Angeles County and for
Northridge as well. A large part of this diversity comes from the hispanic population. When it comes to aging, hispanics consider themselves to have inner strength as they age, and believe they are important members of the family and deserve respect. The expectations for this group is that the younger generation will take care of the older generation, and often times this task falls to the daughter(s) and female relatives (Hispanics and Health Care in the United States). It is very uncommon for hispanics to place loved ones into institutions or nursing homes, but will allow care to be provided in the home by outside agencies if needed. In general, hispanics are less likely to seek medical care. This is especially true if they are foreign born, did not graduate high school, and if they are male. However, the likelihood of seeking medical care increases for Hispanics after the age of 50, most likely after the manifestation of disease or declining health start to emerge. Often times, this culture will use

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television or radio as an alternative for health advice (Hispanics and Health Care in the United
States).
The hispanic culture often times relies on home remedies for health maintenance which is passed down by the elders in their family and/or community. Attitudes regarding health can conflict with the culture when it comes to chronic illnesses such as diabetes, since many hispanics don’t seek routine health care until they have an issue that is manifested in some way.
Since oftentimes someone with diabetes doesn’t “feel” sick, they don’t understand why it is important to monitor blood sugar, maintain a diabetic diet, or take their medication for glucose control (Hispanics and Health Care in the United States). Hispanics have a higher percentage of being a teen parent and of dropping out of high school, which by default, will force them to live a more adult lifestyle if they are taking care of children and/or working to support themselves (A World Apart). Sixteen is an important as the coming of age for many hispanics who practice Catholicism, and signifies the passage into adulthood. Young hispanic females are more likely to help raise younger siblings and take care of house and home (Between Two Worlds).
Disaster assessment and planning guide
. In the event of a disaster, either natural or man made, everyone living in the area would be affected in some way. The range could be from a life­threatening injury or simply being without power or water for a period of time. However, the most vulnerable populations affected would be the very young, the very old, and those individuals affected by disease or illness requiring ongoing care.
The very young would be vulnerable due to their inability to help themselves, unable to problem solve, and an inability to obtain resources. They would be, for the most part, completely dependant on a caregiver. The same could be said for the oldest of the old, as their mobility is usually limited, dementia might be present, and their frailty would be a concern. In addition, it is reasonable to assume that this population would have some soft of illness or chronic disease.

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Statistical data shows that for Los Angeles County as a whole, chronic illness is an ever present factor for the well being of a large percentage of people, with coronary artery disease, stroke, and lung cancer making up the top three disease related deaths for the past ten years
(Chronic Diseases and Natural disasters) . Those people requiring medication to maintain themselves, such as an insulin dependant diabetic, would also be very vulnerable if they did not have an adequate amount of supplies or if resources were not readily available to them. Local hospitals and shelters would be inundated and must be prepared to meet the needs of the community. As of the 2014 Census, 48.4% of Los Angeles County residents are Hispanic/ Latino,
14.8% are Asian, and the remainder are from literally all over the world. The Census also shows that in Los Angeles County a significant number of people over the age of five speak a language other than English in the home, and if English is spoken, it tends to be limited (Los Angeles
County Censu). This could have a huge impact disaster management for the county causing confusion and delay in care if people do not how to access resources or health care.
While it is reasonable to assume cities and counties have some sort of disaster planning and relief aid in place, it is also important for communities to involve their residents in being prepared themselves in the event of a disaster. Education on disaster preparedness should be taught not only to adults, but to children as well, as often times, children know and speak
English but their parents do not.
Community Scavenger Hunt
Numerous resources are available to the residents of Northridge, although none were actually in the community itself. However, due to the close proximity of the surrounding communities, access would not be a problem. The Women’s, Infants, and Child Program is very important to a large number of people living in Los Angeles County, and this includes
Northridge. This program caters to women who are either pregnant (or in the postpartum state), infants, and children under the age of five. Annual income is a qualification, and for a family of

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four, $36,375 or under for an annual income would qualify someone for the program. The focus for W.I.C. is checks to buy healthy foods, nutritional information, and breastfeeding support.
Written information is provided in both english and spanish, and several staff members speak spanish (USDA: Food and Nutrition Service).
The Health Department, while providing much needed care and resources for the public, was not very accessible to the residents of Northridge, with it’s three locations scattered about
Los Angeles County. However, they do provide information in different languages as well as referrals if needed.
Planned Parenthood is an important part of many communities in the care it provides, such as men’s and women’s health, STD screening and treatment, vaccines, HIV testing, and abortions. The closest Planned Parenthood is located in Van Nuys, which is directly adjacent to
Northridge. The office provides a non­threatening atmosphere and adequate information is provided in spanish if needed.
Considering 20% of county residents are at or below the poverty level, having a Food
Pantry available would a good resource for people. The closest food pantry to Northridge is again in Van Nuys. This pantry provides a five day supply of emergency food once a month, as well as resources in both english and spanish. This Food Pantry was located in an industrial area behind a strip mall.
The Y.M.C.A is a great resource for families and offer a wide variety of programs that promote health and well­being. There are three Y.M.C.A’s located in San Fernando Valley which Northridge is a part of . Their goal is to: Promote youth development, healthy living, and social responsibility. While some Y.M.C.A’s offer social services, the closest one to Northridge does not.
While one might want to think about domestic violence, it is unfortunately a problem in society. There are numerous domestic hotlines, shelters, and services throughout Los Angeles
County which offer protection and resources for those who need it. These entities work closely

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with local police and social workers with the aim to end domestic violence. Locations of shelters are not provided to maintain the safety of those using their services. The city of Los Angeles provides 24 hour/365 days a year services for emergency and transitional housing (Domestic
Violence Shelter Operations, n.d.). Interpretation of Data
In summary, Northridge is a dense urban city with much of its diversity coming from the hispanic population, and while the median income is high, there is a significant number of people at or below the poverty level. And while there is a high number of families consisting of two parents, there is also a significant number of single parents. Healthy People 2020 has numerous goals for our country: high quality longer lives free of disease, creating safe environments that promote health, and to promote health, quality of life and behaviors (Healthy People 2020).
Three health issues that apply for Northridge are obesity, diabetes, and the need for the youngest of the young, newborns, to get the best start in life through breastfeeding. These three problems are all directly tied together.
Problems in the Selected Community
Most people would agree the obesity is on the rise in the United States, and Northridge is no exception to this rising health problem with the high amount of fast food restaurants, its urban setting with not a lot of open area to encourage exercise. One study showed adult obesity for Los
Angeles County rose from 13.6% in 1997 to 22.2% in 2007. For children the rise also increased to 23% in 2008 (reference). Another factor is the high percentage of hispanics in the area, which traditionally have a diet high in fat and carbohydrates and are, by default, already at risk for obesity as shown by 29.4% which are already obese (Obesity ­ Department of Public Health).
One health issue directly linked to obesity is diabetes, Type 2 specifically, which can be prevented by lifestyle choices. Using Healthy People 2020 as a guideline, education is key for

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communities at high risk and this must start at a young age. Again, the hispanic population as a whole are at risk for diabetes, with 12.3% already having diabetes (L.A. Health Trends, 2007).
This is why education is key for prevention and should not be provided to just individuals but to whole families, and making sure the education is at a level they can understand and in Spanish if they do not speak English. Primary Prevention Topic
Since obesity and diabetes often times go hand in hand, with the hispanic population especially at risk, making sure the youth get the best start in life can be accomplished through breastfeeding, and is the top problem for this community.
Breastfeeding it itself is not a problem, but the lack of breastfeeding is the issue that needs to be addressed. Breast milk is tailored made for each baby by their mother. Specific antibodies help the newborn's gut adjust to receiving nutrition orally and well as provide protection from disease and illnesses (California Department of Public Health 2012). Breast milk provides all the nutrients and baby needs and changes as the baby ages and their demands change. Breastfeeding also has been shown to decrease the risk of respiratory diseases, asthma, high blood pressure, obesity and diabetes (Diabetes Stops Here, n.d.). Breast milk is free, which is important for those at the poverty level, and doesn’t require special storage or handling unless it is pumped.
In 2012, Northridge Hospital had 2,133 births and 1,997, or 93.6% of those new mothers attempted breastfeeding, which is impressive. However, that number dropped significantly to
49.5% of moms who maintained exclusive breastfeeding for the first six months. A surprising finding was that hispanic mothers have a high rate of maintaining breastfeeding, up to 80%, which would suggest their risk for diabetes and obesity would be lessened (California
Department of Public Health, 2010). With this in mind, education should remain the number one

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resource to new mothers to establish and maintain breastfeeding exclusively for the first six months or longer, even after solids are introduced.
The community of Northridge offers several resources for new mothers such as a breastfeeding support group as well as videos on breastfeeding at Northridge Hospital, information provided by Planned Parenthood on the benefits of breastfeeding,Women’s,
Children, and Infants program, and free breast pumps now offered by insurance companies including those on Medi­Cal. Hopefully education starts during the prenatal visits, as this would reinforce and strengthen the importance of breastfeeding and the health benefits it provides.
With the Healthy People 2020 goals in mind, and the importance of breastfeeding well established, consistent education for the new mother, her family, and the community as a whole will benefit everyone and improve the quality of life for those at risk for obesity and diabetes.

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References

Between Two Worlds: How Young Latinos Come of Age in America. Retrieved from: http://www.pewhispanic.org/2009/12/11/between­two­worlds­how­young­latinos­come­of ­age­in­america/

County of Los Angeles Public Health: Environmental Health http://www.publichealth.lacounty.gov/eh/TEA/ToxicEpi/airpollution.htm County of Los Angeles Public Health. Water Quality. Retrieved on October 17, 2015 from: http://www.publichealth.lacounty.gov/eh/TEA/ToxicEpi/water.htm Diabetes Stops Here. Retrieved on August 14, 2015 from: http://diabetesstopshere.org/2012/08/28/breastfeeding­and­diabetes­whats­the­connection /
Domestic Violence Shelter Operations. City of Los Angeles. Retrieved from: http://www.fnshttp://www.lacity.org/311­directory­online­services/servicedetail/2093.usda .gov/wic/women­infants­and­children­wic

Hispanics and Health Care in the United States. Retrieved from: http://www.pewhispanic.org/2008/08/13/hispanics­and­health­care­in­the­united­states­a ccess­information­and­knowledge/

Los Angeles Times: L.A., Central Valley Have Worst Air Quality, American Lung Assn. says:
Retrieved from: http://www.latimes.com/science/la­me­0430­air­pollution­20140430­story.html Lacounty.gov. Retrieved from: http://www.lacounty.gov/government/geography­statistics/statistics L.A. Health Trends. Retrieved from: h ttp://publichealth.lacounty.gov/wwwfiles/ph/hae/ha/DiabetesTrends05.pdf Los Angeles County Public Health. Ionizing Radiation. Retrieved on October 17, 2015 from: http://publichealth.lacounty.gov/eh/TEA/ToxicEpi/ionizingradiation.htm Community Health Task 1

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Mapping L.A.: San Fernando Valley. Retrieved on October 17, 2015 from: http://maps.latimes.com/neighborhoods/neighborhood/northridge/schools/ Northridge Neighborhood. Retrieved on August 15, 2015 from: http://www.city­data.com/neighborhood/Northridge­Northridge­CA.html Overview of Latino Culture. Retrieved from: http://www.mhaging.org/info/10­04­Latino.ht l m

Obesity ­ Department of Public Health, Los Angeles County. Retrieved from: http://publichealth.lacounty.gov/ha/reports/habriefs/2007/Obese_Cities/Obesity_2011Fs. pdf Obesity Prevention in Latino Communities. Retrieved from: http://www.stateofobesity.org/disparities/latinos/ USDA: Food and Nutrition Service. Retrieved from: http://www.fns.usda.gov/wic/women­infants­and­children­wic