Chronic Disease Prevention: a Public Health Perspective (Dr. Paul Simon)

How many square miles is LA county?

4060

How many residents are there in LA county?

10 million (more than 41 states)

How many incorporated cities does LA country have?

88

How many unincorporated areas does LA county have?

>100

How many school districts does LA country have?

81

What are the racial demographic percentages in LA county?

Latino - 19%

White - 26%

Asian - 16%

Black - 8%

0.2% - NA

0.2% - NHPI

What percentage of the population in LA county are living in poverty? What abt the percentage of children?

16% of the population are living in poverty, including 24% of children

What are the top 10 leading causes of death in LA county (2022-2023)?

1. Coronary heart disease

2. Alzheimer’s disease

3. Hypertension

4. stroke

5. diabetes mellitus

6. chronic obstructive pulmonary disease

7. drug overdose lung cancer

8. pneumonia/influenza

9. liver disease/cirrhosis

What are the top 10 leading causes of premature mortality in LA county (2022-2023)?

1. drug overdose

2. coronary heart disease

3. motor vehicle crash

4. diabetes mellitus

5. liver disease/cirrhosis

6. suicide

7. homicide

8. hypertension

9. stroke

10. certain conditions originating in the perinatal period

Smoking Prevalence Among High School Students (LAUSD, 1997-2019)

1997: 26.5%

2001: 14.5%

**straight decline

2003: 14.4%

—> steady decline to 2019

2019: 2.3%

What are the 3 tobacco control policies adopted in LA county, 2004-2022 (oct.)?

1. Tobacco retail licensing policies

2. Smoke-free outdoor area ordinances

3. smoke-free multi-unit housing ordinances

Why is there an obesity epidemic?

• a chronic energy imbalance (calories in greater than calories out)

• what has changed that would lead millions more to be obese than a generation ago?

• “Lifestyles have changed”

• But why have lifestyles changed so dramatically?

• loss of willpower?

• Lack of knolwedge and awareness?

• What about the environment?

Children “Branded” at a very young age: McDonald Wrapper Test

• a study of 3-5 year old low income children found that they rated foods in McDonald’s wrappers as tasting better than the identical food served in wrappers without the McDonald’s logo

• Effect was found for chicken nuggets, french fries, carrots, and milk or apple juice

• the effect was stronger among children who watched more television and those who ate at McDonald’s more often

What are 5 prevention strategies?

1. community education and social marketing

2. skills-building

3. policy, systems, and environmental change (“making the healthy choice the easy choice”)

4. Prioritization of communities with high rates of childhood obesity

5. surgical interventions and emerging drug treatments (secondary and tertiary prevention) very costly