Black residents in Los Angeles experience the worst health outcomes out of any racial group, including the highest rates of high blood pressure, asthma and obesity, the 2023 Los Angeles County Health Survey found.
The Los Angeles County Department of Public Health presented survey results at a Thursday press conference, painting a stark portrait of the racial disparities in Angelenos’ health.
These inequities are most pronounced among Black residents, but are also prevalent among the Latino community, which experienced the highest rates of diabetes and COVID-19. Asian residents, in general, had among the best health outcomes, but reported the highest rates of loneliness and serious thoughts of suicide.
The community health survey has been conducted every two to four years since 1997. But due to delays caused by the pandemic, this year’s survey was the first since 2018.
The survey’s purpose is to “provide data to drive public health decision-making and community health improvement efforts,” said Dr. Rashmi Shetgiri, chief science officer for the L.A. County health department.
The survey also closely examines the social determinants of health such as economic insecurity, housing instability, air pollution, food insecurity, stress and discrimination.
“Our work is to make sure that this information never gets used to perpetuate false narratives, but is always used to drive action to promote equitable health outcomes and to really look hard at what it’s going to take to be able to realize a more just society,” said Dr. Barbara Ferrer, director of the L.A. County health department.
As in years past, the survey found a strong overlap between social determinants and negative health outcomes.
For example, about two-thirds of Black and Latino residents are housing burdened, meaning they spend 30% or more of their income on rent or a mortgage. In comparison, about 43% of White and Asian residents are housing burdened.
“The cost of housing is a significant underlying determinant of health,” said Shetgiri. “Families may be forced to make difficult choices between necessities such as paying for housing and quality food, and health care needs such as medications and healthcare visits.”
The problem is getting worse. In 2023, 54% of Angelenos reported being housing burdened, compared to 42% in 2018.
The study found a similar trend between food insecurity and health outcomes.
Around 35% of Black and Latino households experienced food insecurity in 2023, compared to 16% of Asian households and 14% of white households. Food insecurity is defined as the inability to reliably afford or access sufficient quantities of food.
In addition, over a third of Black adults reported living in households that are nutritionally insecure, meaning that it is challenging to regularly eat healthy foods.
“I want to really point out that this data that we see is not the result of any individual or household choices that they’re making,” said Dipa Shah-Patel who directs the public health department’s Nutrition and Physical Activity Program. “When we’re talking about nutrition and food access, we’re talking about the results of structural racism, systemic biases, historical redlining and divestment in communities that has resulted in a lack of access.”
The survey results will be used to guide public health campaigns. For example, the department is exploring policies to decrease the rate of sugary beverage consumption in low-income neighborhoods. These drinks are associated with an elevated risk of obesity, tooth decay, heart disease and diabetes.
Almost half of all Latino adults reported drinking at least one soda or sugar-sweetened beverage per day in 2023, an increase from 39% in 2015. In addition, 54% of adults living in poverty reported consuming a sugary drink a day compared to 25% of the general population.
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“We’re observing predatory marketing that is happening specifically to Black and Latino youth and resulting in higher consumption of sugar-sweetened beverages,” said Shah-Patel. “Our first recommendation is to consider limiting sugar-sweetened beverage marketing in public buildings and spaces where youth are congregating, so that could be schools, parks, etc.”
Other strategies the department is exploring are increasing access to drinking water fountains in these communities and advocating for a tax on sugary beverages — with profits to be directed to health programs in low-income communities, she added.
Sugary beverage consumption is just one example of how data from the survey can be used to drive public health solutions. Ferrer noted that all programs must be crafted in close consultation with the community members expected to benefit from them.
“Behind every single data point is a person, a family and a community,” she said, “and our approach to public health must recognize the importance of also capturing the stories of the individuals and their families in order to recognize and appropriately understand the profound impact of social determinants on health.”