USC State of the Neighborhood Report 2015

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USC STATE OF THE NEIGHBORHOOD REPORT April 2015

HORTENSIA AMARO, PH.D. Associate Vice Provost for Community Research Initiatives, Dean’s Professor of Social Work and Professor of Preventive Medicine, Keck School of Medicine of USC University of Southern California and

ADVANCEMENT PROJECT

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USC STATE OF THE NEIGHBORHOOD REPORT April 2015

HORTENSIA AMARO, PH.D. Associate Vice Provost for Community Research Initiatives, Dean’s Professor of Social Work and Professor of Preventive Medicine, Keck School of Medicine of USC University of Southern California and

ADVANCEMENT PROJECT

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USC State of the Neighborhood Report Copyright Š 2015 by the University of Southern California’s State of the Neighborhood Project and Advancement Project. All rights reserved. Printed in the United States of America. Suggested citation: Amaro, H. and Advancement Project (2015). State of the Neighborhood Report, 2015. University of Southern California. For information about the State of the Neighborhood Project, please contact: Hortensia Amaro hamaro@usc.edu (213) 821-6462 (213) 821-5567 (assistant)

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TABLE OF CONTENTS ACKNOWLEDGMENTS...................................................................................................................................................................vii EXECUTIVE SUMMARY....................................................................................................................................................................ix INTRODUCTION....................................................................................................................................................................................1 RESEARCH APPROACH................................................................................................................................................................... 5 UNIVERSITY PARK CAMPUS Community History and Demographics...................................................................................................................................................... 17 Community Conditions.................................................................................................................................................................................19 n Economic Stability................................................................................................................................................................................19 n Education............................................................................................................................................................................................ 30 n Health and Health Care........................................................................................................................................................................ 36 n Neighborhood and Built Environment.................................................................................................................................................. 43 n Social Capital....................................................................................................................................................................................... 50 Community Resources..................................................................................................................................................................................55 Recommendations........................................................................................................................................................................................ 59

HEALTH SCIENCES CAMPUS Community History and Demographics..................................................................................................................................................... 69 Community Conditions.................................................................................................................................................................................71 n Economic Stability................................................................................................................................................................................71 n Education.............................................................................................................................................................................................81 n Health and Health Care........................................................................................................................................................................ 88 n Neighborhood and Built Environment.................................................................................................................................................. 95 n Social Capital......................................................................................................................................................................................103 Community Resources............................................................................................................................................................................... 109 Recommendations........................................................................................................................................................................................112

CONCLUSION......................................................................................................................................................................................121 APPENDICES Appendix 1: Acknowledgment of Faculty Task Force and Community Advisory Board Members.................................................................... 125 Appendix 2: Overview of Research Design Background................................................................................................................................. 126 Appendix 3: Focus Group Discussion Outline................................................................................................................................................ 128 Appendix 4: Focus Group Maps....................................................................................................................................................................130 Appendix 5: Resource Categories used to Identify Resources on Healthycity.org.......................................................................................... 132 Appendix 6: Technical Notes on Boundary Selection Process....................................................................................................................... 137

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APPENDICES (continued) Appendix 7: Secondary Data Methodology................................................................................................................................................... 138 Appendix 8: Stability of Secondary Data Estimates and Margins of Error...................................................................................................... 141 Appendix 9: Significance of Differences between USC Study Area and City of Los Angeles Estimates, with Coefficients of Variation.............. 142 Appendix 10: USC Community Program List................................................................................................................................................. 147

TABLES Table 1: Families with Children in Poverty as a Percentage of all Families with Children....................................................................................19 Table 2: Unemployed Persons Ages 25–64 as a Percentage of the Civilian Noninstitutional Labor Force by College Education, 2008–2012..... 21 Table 3: Job-to-Worker Ratio by Monthly Earnings Level, Years 2002 and 2011.............................................................................................. 23 Table 4: Median Rent in Unadjusted Dollars, 2008–2012.................................................................................................................................25 Table 5: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, 2008–2012..................................25 Table 6: Banks per 10,000 Persons.................................................................................................................................................................27 Table 7: Percentage of Children Ages 0–5 with a Licensed Child Care Seat...................................................................................................... 31 Table 8: Third-graders Scoring Proficient or Advanced on English Language Arts Exam, 2012–2013.................................................................33 Table 9: High School Graduation Rate, 2011–2012........................................................................................................................................... 34 Table 10: Middle School Truancy Rate, 2010–2011.......................................................................................................................................... 34 Table 11: Persons Aged 25 or Older Attaining Some College or More as a Percentage of all Persons Aged 25 or Older.......................................35 Table 12: Percentage of Persons without Health Insurance..............................................................................................................................37 Table 13: Federally Qualified Health Centers per 1,000 Persons...................................................................................................................... 39 Table 14: Preventable Hospitalizations per 1,000 Adults.................................................................................................................................41 Table 15: Violent Crimes per 1,000 Persons.................................................................................................................................................... 43 Table 16: Child Abuse Allegations per 1,000 Children..................................................................................................................................... 45 Table 17: Square Miles of Open Space per 1,000 Persons............................................................................................................................... 47 Table 18: Nonprofit Organizations per 1,000 Persons..................................................................................................................................... 53 Table 19: Families with Children in Poverty as a Percentage of all Families with Children..................................................................................71 Table 20: Unemployed Persons Age 25-64 as a Percentage of the Civilian Noninstitutional Labor Force by College Education 2008–2012......73 Table 21: Job-to-Worker Ratio by Monthly Earnings, 2002 and 2011................................................................................................................75 Table 22: Median Rent in Unadjusted Dollars, 2008–2012.............................................................................................................................. 77 Table 23: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units.................................................. 77 Table 24: Banks per 10,000 Persons.............................................................................................................................................................. 79 Table 25: Percentage of Children Ages 0–5 with a Licensed Child Care Seat................................................................................................... 83 Table 26: Third-graders Scoring Proficient or Advanced on English Language Arts Exam, 2012–2013.............................................................. 84 Table 27: High School Graduation Rate, 2011–2012......................................................................................................................................... 85 Table 28: Persons Age 25 or Older Attaining Some College or More as a Percentage of all Persons Aged 25 or Older....................................... 86 Table 29: Middle School Truancy Rate 2010–2011........................................................................................................................................... 87 Table 30: Percentage of Persons without Health Insurance............................................................................................................................ 89 Table 31: Federally Qualified Health Centers per 1,000 Persons.......................................................................................................................91 Table 32: Preventable Hospitalizations per 1,000 Adults................................................................................................................................ 93 Table 33: Child Abuse Allegations per 1,000 Children..................................................................................................................................... 99 Table 34: Square Miles of Open Space per 1,000 Persons.............................................................................................................................. 101 Table 35: Nonprofits per 1,000 Persons.........................................................................................................................................................107

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MAPS Map 1: University Park Campus Study Area......................................................................................................................................................18 Map 2: Families with Children in Poverty as a Percentage of all Families with Children, 2008–2012................................................................. 20 Map 3: Employment Rate with No College Education, 2008–2012...................................................................................................................22 Map 4: Median Rent in Unadjusted Dollars, 2008–2012.................................................................................................................................. 24 Map 5: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, 2008–2012................................... 26 Map 6: Banks per 10,000 Persons, 2014......................................................................................................................................................... 28 Map 7: Children 0–5 with Licensed Child Care Seats, 2013...............................................................................................................................32 Map 8: Percentage of Population without Health Insurance, 2008–2012......................................................................................................... 38 Map 9: Federally Qualified Health Centers per 10,000 Persons, 2012..............................................................................................................40 Map 10: Preventable Hospitalizations per 1,000 Adults, 2012......................................................................................................................... 42 Map 11: Violent Crime per 1,000 Persons, 2010.............................................................................................................................................. 44 Map 12: Child Abuse Allegations per 1,000 Children, 2012.............................................................................................................................. 46 Map 13: Modified Retail Food Environment Index, 2011................................................................................................................................... 48 Map 14: Nonprofit Organizations per 1,000 Persons, 2011............................................................................................................................... 52 Map 15: Community Resources by Domain..................................................................................................................................................... 56 Map 16: Community Resources by Frequency Identified................................................................................................................................. 58 Map 17: Health Sciences Campus Study Area................................................................................................................................................. 70 Map 18: Families with Children in Poverty as a Percentage of all Families with Children, 2008–2012................................................................72 Map 19: Employment Rate with No College Education, 2008–2012................................................................................................................. 74 Map 20: Median Rent in Unadjusted Dollars, 2008–2012................................................................................................................................ 76 Map 21: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, 2008–2012..................................78 Map 22: Banks per 10,000 Persons, 2014.......................................................................................................................................................80 Map 23: Children 0-5 with Licensed Child Care Seats, 2013............................................................................................................................ 82 Map 24: Percentage of Population without Health Insurance, 2008–2012.......................................................................................................90 Map 25: Federally Qualified Health Centers per 10,000 Persons, 2012............................................................................................................ 92 Map 26: Preventable Hospitalization Rates per 1,000 Adults, 2012................................................................................................................. 94 Map 27: Violent Crime per 1,000 Persons, 2010–2011..................................................................................................................................... 96 Map 28: Child Abuse Allegations per 1,000 Children, 2012............................................................................................................................. 98 Map 29: Modified Retail Food Environment Index, 2011................................................................................................................................. 100 Map 30: Nonprofit Organizations per 1,000 Persons, 2010........................................................................................................................... 106 Map 31: Community Resources by Number of Times Identified...................................................................................................................... 110 Map 32: Community Resources by Focus Group and Domain......................................................................................................................... 111

FIGURES Figure 1: Structural Determinants: The Social Determinants of Health Inequities.............................................................................................. 6 Figure 2: Healthy People 2020 Framework....................................................................................................................................................... 8 Figure 3: Study Domains of Community Conditions......................................................................................................................................... 11 Figure 4: Year Householder Moved into Housing Unit, 2008–2012.................................................................................................................. 51 Figure 5: Violent Crime per 1,000 Persons, 2007 and 2011............................................................................................................................. 97 Figure 6: Year Householder Moved into Housing Unit, 2008–2012................................................................................................................105 Figure 7: Elements of an Authentic Partnership............................................................................................................................................. 122

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ACKNOWLEDGMENTS The University of Southern California’s State of the Neighborhood Project is pleased to partner with Advancement Project California to present The State of the Neighborhood Report, 2015. The report was prepared by a team led by Hortensia Amaro and comprised of Melissa Gaeke (previously Executive Director, Academic Partnerships at USC), the Project’s Community Advisory Board and Faculty Task Force, and Advancement Project staff: Maidel Luevano, Caroline Rivas, Chris Ringewald, Janice Miller, Erin Coleman, Leila Forouzan, JuHyun Yoo, Juana Rosa Cavero, Silvia Paz, Jacqueline Coto, Lori Thompson Holmes, Gilberto Espinoza, John Kim, and Jonathan Nomachi. We would also like to thank the USC Office of the Provost, Office of the Senior Vice President for University Relations, the University Relations Academic Advisory Council, and the Deans Advisory Council for supporting this important work. Our undertaking would not have been possible without the support and insightful input from members of our Community Advisory Board, Faculty Task Force, and senior advisors (listed in Appendix 1), We also thank the community-based organizations that assisted in recruitment of focus group participants and provided space for us to conduct the focus groups. Finally, we appreciate and thank focus group participants for sharing their knowledge of the communities surrounding the UPC and HSC.

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EXECUTIVE SUMMARY The city of Los Angeles is home to more than 3.8 million residents and spans approximately 468 square miles. Community conditions across the city of Los Angeles vary widely, with some communities having a wealth of resources and others few. A significant body of research has documented that features of communities play a central role in shaping life opportunities. The major purpose of this report is to elucidate specific community conditions that shape life opportunities of residents in the neighborhoods surrounding the University of Southern California’s (USC) University Park Campus (UPC) and Health Sciences Campus (HSC). An assessment was conducted comparing data for the communities within the UPC and HSC study areas to the city of Los Angeles, highlighting the largest disparities facing the communities neighboring USC. The report provides baseline data that can be used to guide efforts to create positive change within these local neighborhoods. As such, the report is meant to serve as a starting point that we hope will encourage the faculty, students and community stakeholders to look more deeply into community conditions through further research and engage key players in the development of strategies to uplift the life conditions of residents.

Background In 1992, USC launched an initiative to develop community–university partnerships to guide activities in priority areas in civic engagement, academic units and departments. Priority areas identified were successful schools, healthy families, connecting campus and community, thriving businesses and safe streets. Currently, USC invests $35 million annually to support community initiatives which now serves nearly 40,000 community members. Two decades after the initial priorities were outlined, a community assessment was needed to determine if they remained the most relevant and strategic domains for targeting programs and research. Thus, in 2013, USC introduced the State of the Neighborhood Project, an effort designed to increase the understanding of community needs and inform community efforts in cultivating, strengthening and enhancing new and existing resources. The project was conceptualized and supported under the auspices of the USC Office of the Senior Vice President for University Relations, the Office of the Provost, and deans across various colleges and schools. A community advisory board and faculty task force were formed to provide guidance and input during the development and implementation phases of the project. Advancement Project was contracted to assist in the preparation of the report under the leadership of Hortensia Amaro, Associate Vice Provost for Community Research Initiatives. During a series of meetings in 2013 and 2014, the aforementioned State of the Neighborhood Project stakeholders provided input on the project goals, definition of neighborhood boundaries, methods, data and findings. The recommendations were developed from discussions held with the Project’s Community Advisory Board and Faculty Task Force. The goals of the State of the Neighborhood Project are to: 1. Examine current data trends in local neighborhoods and propose strategies that USC and community stakeholders could pursue to achieve positive community impacts; 2. Identify strategic priority areas for USC civic engagement efforts; 3. Identify opportunities for interdisciplinary faculty research and scholarship that could further inform community needs and assets and place-based research and interventions; and

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4. Serve as a resource and framework for university and community stakeholders in the areas of civic engagement, place-based research and student service learning. It was foreseen that the State of the Neighborhood Project would continue beyond the initial assessment to engage stakeholders in using the data presented and consider recommendations to inform initiatives to address community needs.

Framework After consideration of various frameworks, it was determined that the social determinants of health framework was most appropriate for our purpose of gaining an understanding of how conditions in the communities surrounding UPC and HSC shape the life opportunities of local residents. Major initiatives in the United States and worldwide seeking to improve the life conditions of populations have used this framework to guide their work in identifying and addressing conditions that shape life opportunities and liabilities. Thus, health refers not only to disease, illness or health care but also to the underlying socioeconomic, social and political contexts that shape well-being. “ Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” — World Health Organization, 1948.

Approach The UPC and HSC study areas included geographies slightly larger than those used for the USC Good Neighbors Campaign. The community advisory board and faculty task force felt that it was important to slightly expand the boundaries for the purpose of this assessment because they include important social service, education and business resources relevant to the target communities. Two methods were used to assess community conditions. First, indicators of demographics and five domains (economic stability, education, health and health care, neighborhood and built environment, and social capital) were identified from existing available datasets with the capacity to generate census tract-level data. The data indicators of each domain are presented for the overall study areas (UPC and HSC) and compared to the city, mapped by census tracts in each of the two study areas. When available, the most recent data are compared to data from previous years. Second, focus group data collection occurred with community residents, community agency staff members, and USC faculty and staff members. In each of the sections reporting on the five study domains, related themes that emerged during focus group discussions were reported.

UNIVERSITY PARK CAMPUS: FINDINGS AND RECOMMENDATIONS The University Park Campus is positioned between downtown Los Angeles and South Los Angeles. As of 2010, the UPC study area had approximately 162,390 residents. The majority of the population identified as Hispanic or Latino (68.9%), with a notable share of AfricanAmerican (11.8%), Asian (9.8%) or White (7.5%) residents. The State of the Neighborhood Project found inequities in UPC indicators as summarized below. Recommendations were developed with input from the Project’s Community Advisory Board and Faculty Task Force.

Economic Stability • The proportion of families with children under age 18 living in poverty from 2008–2012 in the UPC study area (47.3%) was almost double that of the city (25.2%), reflecting an increase from 35.8% in 2000.

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• The median monthly rent in 2008–2012 for the UPC area ($895) was lower than for the city overall ($1,156). However, the aforementioned high poverty rate, along with a slight decrease in the percentage of rental units protected under the city’s Rent Stabilization Ordinance between 2000 (82%) and 2008–2012 (79.8%) and increased student housing demand were noted by community residents as barriers to affordable housing. • The communities within the UPC study area had a lower rate (1.09 per 10,000 people) of banks per capita than the city of Los Angeles (1.87). Negative impacts on the UPC study area residents included the need to rely on check cashers, payday lenders and other costly alternatives, particularly in the southern portion of the study area. • Focus group participants noted that unemployment, underemployment and informal employment are critical issues. They would like to see initiatives to increase hiring of local residents, particularly in major economic development initiatives. Participants also noted problems of low-quality and overcrowded housing and displacement. They would like to see increased opportunities for local residents to purchase homes and receive rental assistance. Of importance, community residents seemed unfamiliar with available resources and economic resources in the UPC study area. Recommendation 1. USC can serve as a nexus of research on strategies for economic inclusion that help low-income families to move out of poverty and benefit from the rapid development in the surrounding area. Recommendation 2. Local institutions should work jointly to increase investments in job development, workforce training and the local economy. Local employers should create entry-level pathways for community residents at varying educational levels to better access jobs at their company. Recommendation 3. In collaboration with elected officials and other stakeholders, community organizations should develop a joint effort to encourage community members’ participation in the planning and implementation of current and upcoming economic development projects in the area.

Education • Access to licensed child care seats in the UPC study area was slightly higher (21.2%) than in the city of Los Angeles (20.2%). However, the availability of child care seats was not evenly distributed, with child care seats most available in the immediate area surrounding USC and lowest in areas farthest from downtown. • Early grade reading proficiency is a predictor of future school success. Only four of 30 schools in and around the UPC study area had more third-graders scoring proficient or advanced compared to the Los Angeles Unified School District (LAUSD) as a whole (40% scored proficient or advanced). • Among 14 UPC area schools with grades 9 through 12, all but two reported graduation rates above the LAUSD graduation rate of 66.6%. The schools affiliated with the USC Family of Schools had higher graduation rates than LAUSD schools overall. • Low school truancy rate is another predictor of future school success. Half of the 20 UPC area schools with grades 6 through 8 had lower truancy rates than the LAUSD as a whole (43.9%) in the 2010–2013 school years.

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• Compared to the city overall (55%), only 28.8% of UPC study area residents 25 years of age or older had some college education. The increase since 2000 in residents with some college education was greater for residents of the city of Los Angeles (from 49.2% in 2000 to 55% in 2008–2012) than for residents in the UPC study area (from 22.9% in 2000 to 28.8% in 2008–2012). • Focus group participants identified the need for greater parental involvement with schools and opportunities for affordable pathways to higher education for youths and young adults. Through focus group discussions, it also became evident that residents may not be familiar with existing education resources. Recommendation 4. Local institutions of higher education should continue to prioritize and develop focused efforts on increasing use of evidence-based early childhood education strategies to improve school readiness among children living in the local community. The USC-affiliated Head Start program should be encouraged to conduct research on school readiness of children served, how the program affects school readiness among children served, and how gains in school readiness may be improved and further enhanced in the early elementary school years. Recommendation 5. USC can serve as a nexus for research on the use of child care services by local residents. Such research should provide information about the populations served by local child care services, assess the quality of services, and identify strategies to support and improve child care services for local residents. Recommendation 6. Local institutions, parents and community partners should collaborate to develop programs that inform parents of their rights at the school site pursuant to state law and build an environment that promotes parental engagement and advancement of student education. Recommendation 7. In collaboration with community stakeholders, USC should continue efforts to (a) inform and engage community members in existing USC education service programs in order to increase participation among local residents and their children and (b) support programs that enhance engagement with recent high school graduates and link them to fulfilling education and employment options with a focus on career development.

Health and Health Care • A greater proportion of UPC study area residents (37.5%) lacked health insurance compared to residents in the city of Los Angeles (25.8%). These data are from 2008–2012, before the implementation of the Affordable Care Act (ACA). Recent reports on ACA enrollment among Hispanics, who comprise a large portion of the UPC community population, have suggested significant underenrollment. Assessment of current health insurance enrollment among UPC area residents is needed, along with efforts to enroll eligible residents who have not enrolled to date. • Federally qualified health centers provide an important source of care in underserved areas. The rate of federally qualified health centers was high in the UPC study area (7.1 per 1,000 persons compared to 3 in the city of Los Angeles), except near campus and in a small pocket west of Normandie Avenue between Washington and Exposition boulevards. • Rates of 2012 preventable hospitalizations in the UPC study area (12.5 per 1,000 adults) and the city of Los Angeles (12.2) were similar. However, in the areas west of Normandie Avenue and south of Exposition Boulevard, rates were about 50% higher than that of the city of Los Angeles.

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• Community residents identified challenges including accessing quality health care, cost of health care and lack of availability of primary care physicians. Further, local residents who participated in focus groups seemed unfamiliar with existing health care resources. Recommendation 8. Local educational institutions, community organizations, foundations and health care entities should conduct research to (a) better understand the impact of the Affordable Care Act on health insurance status among local community residents, (b) identify cost and quality barriers faced by residents in accessing health insurance and health care under the Affordable Care Act, and (c) identify strategies for improving access and use of preventive health care services. Recommendation 9. Community agencies in collaboration with elected officials should develop strategies to better inform community members about available health resources in the area.

Neighborhood and Built Environment • The rate of violent crimes in the UPC study area was significantly higher (7.7 per 1,000 persons) compared to the city of Los Angeles (4 per 1,000 persons). Although these rates represent a decline from 2007 (from 8.4 for UPC and 5.0 for the city), they are concerning. Although violent crime rates appeared evenly spread through the community, rates were lower in sections of the Adams– Normandie neighborhood and the census tract where the UPC is located. • The 2012 rate of child abuse allegations for children under age 18 was higher in the UPC study area (68.8 per 1,000 children) compared to the city of Los Angeles (56.9 per 1,000 children). These rates showed a greater increase in the UPC study area since 2010 (60.4 per 1,000 children) compared to the city of Los Angeles (50.3 per 1,000 children). • Availability of open and green space increases the likelihood of park usage and rates of physical activity. Residents in the UPC study area had minimal green space to access—about 45 times less park space per person than the city overall. The UPC study area had a rate of 0.03 square miles of open space with public access per 1,000 persons, compared to 1.40 for the city. • Access to healthy food contributes to health. We used the Modified Retail Food Environment Index (MRFE), a summary indicator of the presence of healthy versus unhealthy food (e.g., fast food) retailers. The MRFE for UPC was high, indicating the presence of many more fast food restaurants than healthy food retailers. This indicator does not allow for data aggregations at the study area or city geographic levels; it can only be mapped by census tracts. Areas west of Hoover Street had more healthy food options, whereas the Figueroa Corridor along the 110 Freeway had fewer healthy food options. • Residents noted concerns about children’s safety while playing outdoors and a desire for better policing and communication with law enforcement to improve community safety. They also expressed interest in more green space, better maintained sidewalks and bike lanes, and more accessible and affordable sources of healthy foods. Many focus group participants were unaware of existing environment and safety resources available in the community. Recommendation 10. Local community agencies, elected officials, and educational institutions should develop initiatives to (a) further increase access, safety and programming of existing parks in the local area, (b) increase bike lanes and improve sidewalks, (c) identify ways to use Exposition Park as another local green space to promote

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physical activity, such as the addition of a walking path and play areas, and (d) collaborate with owners of local vacant lots to revitalize them into park space and community gardens. Recommendation 11. USC can serve as a nexus of research to (a) identify the underlying conditions fueling the high rates of child abuse allegations and (b) test preventive evidence-based strategies that can be taken to scale in the community. Recommendation 12. USC, city officials and local community members work to (a) identify a nearby feasible location for the development of a large supermarket offering affordable healthy food, (b) incentivize other affordable healthy food retailers and local farmers markets to locate in the local area, (c) coordinate and support more community and home gardening programs, and (d) improve consumer education about healthy eating.

Social Capital • Social capital, which refers to the institutions, relationships and norms that shape the quality of life in societies and communities, has been linked to health and well-being. Although direct measures of social capital were not available for the study area or the city of Los Angeles overall, we used two potential indicators of social capital: length of residence and nonprofit organizations. The majority (69.2%) of UPC study area residents moved into the study area during the last 10 years, with only 10.5% being long-term residents dating back to the 1990s or earlier. With regard to nonprofit organizations, in 2011 the UPC study area had 4.1 nonprofit organizations per 1,000 persons, compared to 3.0 in the city of Los Angeles. • In focus groups, longstanding community members expressed a desire to see more local residents participating in community efforts. Focus group participants saw the benefit and need for civic engagement efforts. Participants were unaware of social capital resources in the UPC study area. Recommendation 13. Community organizations, elected officials and local educational institutions should develop strategies to enhance social capital including those that seek to (a) increase mutual trust and accountability, (b) collect and disseminate information about services and programs available, including those available through USC, to local residents to ensure optimal use of such services by community residents, (c) increase safe spaces for community engagement and collaborative partnerships driven by the community that enhance unity among local groups, institutions and community residents, and address community needs, and (d) better connect densely populated residential areas located on the borders of the study area to the Figueroa Corridor and the other areas in which resources are concentrated.

HEALTH SCIENCES CAMPUS: FINDINGS AND RECOMMENDATIONS The Health Sciences Campus is located in the northeast region of Los Angeles and features approximately 124,285 residents. Residents of the HSC study area were predominately of Hispanic or Latino descent (90%), with 26% living in non-English-speaking households. The HSC study area exhibited similar disparities discovered in the UPC study area (e.g., child poverty and child abuse allegations), while also demonstrating additional inequities. Recommendations were developed with input from the Project’s Community Advisory Board and Faculty Task Force.

Economic Stability • Estimates from 2008–2012 indicated that the HSC study area had a significantly greater percentage of families with children living in poverty (34.2%) than the city of Los Angeles (25.2%). The percentage of HSC study area families with children living in poverty

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decreased significantly since 2000, when 41% of such families were living in poverty. For the city of Los Angeles, the poverty rate remained unchanged at 25% of families during the same time period. • Among HSC study area adults (25–64 years of age) without a college education, unemployment was higher (12.2%) than among those with some college education or more (9%). By comparison, unemployment rates were slightly lower in the city of Los Angeles (11.1% for those without a college education and 8.9% for those with some college education or more). Rates of unemployment varied in the HSC study area and were highest in areas north and south of campus. • Job-to-worker ratios in the HSC study area were lower for every category of monthly earnings compared to the city of Los Angeles. There were roughly two local workers for each local job at all earning levels in the HSC study area. Compared to figures for 2002, job-to-worker ratios in the HSC study area remained approximately the same or decreased. • The HSC study area median monthly rent between 2008 and 2012 was $922, compared to $1,156 for the city of Los Angeles. Estimates from 2008–2012 indicated that the HSC study area had a larger proportion of rental units protected under the Rent Stabilization Ordinance (81.1%) than the city of Los Angeles (75.9%). It is important to note that in both the HSC study area and the city of Los Angeles, the percentage of protected rental units decreased from levels in 2000 (86.9% and 80%, respectively). • The HSC study area had a very low rate of banks per 10,000 persons (0.4) compared to the city of Los Angeles (1.9). These 2014 rates are lower than in 2010 (0.9 and 2.7, respectively). •F ocus group discussions highlighted challenges for residents related to finding local jobs, experiences with unaffordable housing costs and overcrowding, interest in opportunities to become homeowners, and the need for continued efforts that increase enforcement of Rent Stabilization Ordinance protections and renters’ rights. Participants also noted problems resulting from the low number of banks in the local area. Recommendation 1. Elected officials, community organizations, institutions of higher education, and business leaders should jointly (a) identify effective and systematic strategies to disseminate information about existing financial literacy and capacity-building programs, (b) assess training program needs, and (c) develop such programs. Recommendation 2. Local chambers of commerce should continue to work in collaboration with local employers to promote hiring of local residents, particularly in labor market areas with expected growth, and policies to prioritize training. Recommendation 3. Elected officials and financial business institutions should (a) implement strategies to attract banks to the communities surrounding the HSC and (b) develop community-based strategies to increase access to credit and lending to promote home ownership and foster financial literacy among local residents.

Education • In 2013, less than 14% of children ages 0–5 in the study area had access to a licensed child care seat, compared to 20% of such children in the city of Los Angeles. These figures represent a very slight improvement from 2009. • Early grade reading proficiency is another indicator of future school success. In the HSC study area, public schools fell behind LAUSD rates of third-grade English language arts proficiency. For the 2012–2013 school year, in the HSC study area, only one of

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the 20 schools offering third grade had more proficient and advanced third-graders than LAUSD (40%). Most of the HSC study area schools had a much lower percentage of third-grade children who tested at proficient or advanced levels in English language arts. • High schools in the HSC study area generally outperformed LAUSD high schools in 2011–2012 graduation rates (LAUSD graduated 66.6% of students). The two high schools with lower graduation rates than the district were in Boyle Heights. • In 2008–2012, the HSC study area had a lower percentage of residents aged 25 or older that had some college education or more than the city of Los Angeles (25.1% and 55.0%, respectively). Compared to 2000, these figures revealed an increase in individuals aged 25 or older without any college education (17.3% in the HSC study area and 49.2% in the city). • Another predictor of educational attainment is a low school truancy rate. Data from the 2010–2011 school year indicated that most middle schools in the HSC study area had much lower truancy rates than LAUSD overall, which had a truancy rate of 43.9. • Focus group participants expressed the need for post-high-school education and training opportunities, better preparation of educators to work with diverse student populations including non-English-speaking students, more English as a Second Language courses for adults, and improvement of school safety. Recommendation 4. Local high schools and community colleges should continue to develop adult education programs that improve employment readiness and employment options among local residents. This includes English as a Second Language courses, vocational training and workforce development programs that could be linked to small businesses and large employers. Recommendation 5. Local public schools and parents should join efforts to increase grade-level reading and literacy. Recommendation 6. Local foundations, elected officials and institutions of higher education should forge an alliance to create more pathways and support for low-income residents to access higher education. Recommendation 7. In collaboration with community stakeholders, USC should continue efforts to (a) inform and engage community members in existing USC education service programs to increase participation among local residents and their children and (b) support programs that enhance engagement with recent high school graduates and link them to fulfilling education and employment options with a focus on career development.

Health and Health Care • The HSC study area had a high rate of residents without health insurance. Data from 2008–2012 showed that 33.7% of individuals living in the HSC study area lacked health insurance, compared to 25.8% in the city of Los Angeles. As noted in the UPC findings section, these data predated the implementation of the Affordable Care Act. Yet there are good reasons for concern that HSC study area residents may be underenrolled and continue to have high rates of uninsured. • The HSC study area enjoyed more federally qualified health centers than the city overall. Data from 2008–2012 indicated that the HSC study area had 6.9 federally qualified health centers per 1,000 persons, compared to 3 for the city of Los Angeles.

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• Another indicator of access to health care is the rate of preventable hospitalizations. The HSC study area had a rate of preventable hospitalizations among adults that was similar to the city (12.8 and 12.2 per 1,000 adults, respectively). For the HSC area, this represented a slight decrease from the rate in 2011. The Boyle Heights neighborhood had a higher incidence of preventable hospitalizations than the surrounding areas. • Focus group participants noted several areas of concerns, including unique barriers to health care access such as undocumented residents, lack of quality care and the need for cultural competence among providers. Participants seemed unaware of health-related resources in the HSC study area, which offers a rich set of services. Recommendation 8. Community stakeholders, along with elected officials, local foundations and policymakers, should explore health impact bond opportunities to improve population health in the local area. Such programs pay back investors through the savings that the government accrues should a preventive program succeed in its goals of reducing a specific costly and pernicious health condition. Recommendation 9. Local institutions of higher education, community organizations, foundations and health care entities should conduct research to (a) better understand the impact of the Affordable Care Act on health insurance status among local community residents, (b) identify cost and quality barriers faced by residents in accessing health insurance and health care under the Affordable Care Act, and (c) identify strategies for improving access and use of preventive health care services.

Neighborhood and Built Environment • Data from the Los Angeles Police Department and Los Angeles County Sheriff ’s Department indicated that the rate of violent crime in the HSC study area was about the same as for the city of Los Angeles. Both the HSC study area and the city of Los Angeles have experienced a decrease in violent crimes from rates in 2007. • Rates of child abuse allegations were significantly higher in the HSC study area than the city overall. For 2012, the rate of child abuse allegations in the HSC study area was 74.6 per 1,000 children, compared to 56.9 per 1,000 children in the city of Los Angeles. For both the HSC study area and the city of Los Angeles, these rates are higher than in 2010 (60.4 and 50.3 per 1,000 children, respectively), with a greater increase in the HSC study area between 2010 and 2012 in rates of child abuse allegations. • The HSC study area had significantly fewer square miles of open space per 1,000 persons (0.4) than the city of Los Angeles (1.4). There has been no change in the availability of open space since 2010 in the HSC study area and the city of Los Angeles. • As a whole, data based on the Modified Retail Food Environment Index (MRFE), a summary indicator of the presence of healthy versus unhealthy food (e.g., fast food) retailers, showed that the HSC study area had about the same ratio of healthy to unhealthy food retailers as the city of Los Angeles. However, in the HSC study area, healthy food access was unevenly distributed. Areas around the campus and the East Los Angeles portion of the study area had higher index scores, indicating the presence of many more fast food restaurants than healthy food retailers. • Focus group participants identified the following challenges and needs: the need to change the perception of nonresidents that the area is unsafe, which they felt has a negative impact on local businesses and development opportunities; insufficient space and afford-

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able facilities for physical activity and concern about safety in some parks; and the need to increase access to supermarkets that offer healthy and affordable food options. Participants seemed unaware of many neighborhood and built environment resources. Recommendation 10. USC can serve as the nexus of research to (a) identify the underlying conditions fueling the high rates of child abuse allegations and (b) test preventive evidence-based strategies that can be taken to scale in the community. Recommendation 11. Community agencies, residents, law enforcement and elected officials should collaborate to develop initiatives to (a) improve relationships between the community and local law enforcement, (b) further increase access, safety, programming and use of existing local parks such as Hazard Park, and (c) develop new green spaces. Recommendation 12. Stakeholders from health agencies, organizations and foundations should develop collaborative efforts with the new Wellness Center at the Historic General Hospital and other community-based health programs to implement multipronged strategies for increasing consumption of healthy foods, decreasing consumption of unhealthy foods and increasing physical activity among local residents. Such approaches should combine policy strategies, evidence-based community and family education programs, and availability of outlets for purchase of affordable healthy food options and physical activity programs and facilities. Recommendation 13. Local responsible agencies should (a) improve city services related to trash collection and clean up, (b) develop programs to encourage community resident participation in community clean up, (c) implement approaches to mitigate pollution, and (d) implement strategies that reduce the impact of freeways as barriers to residents’ access to community resources.

Social Capital • Social capital, which refers to the institutions, relationships and norms that shape the quality of life in societies and communities, has been linked to health and well-being. Although direct measures of social capital were not available for the study area or the city of Los Angeles overall, we used two potential indicators of social capital: length of residence and nonprofit organizations. • The HSC study area had roughly 1.5 times the proportion of long-term residents than the city of Los Angeles. However, the percentage of long-term residents dropped by roughly half in the HSC study area and the city of Los Angeles between 2000 and 2012. With regard to nonprofit organizations, in 2011 the HSC study area had 1.4 nonprofit organizations per 1,000 persons, compared to 3.0 in the city of Los Angeles. • Focus group participants expressed concern regarding the sense of disempowerment among community residents and their desire for greater leadership and engagement from elected officials. They also felt that citizenship status, the cost of some services and the lack of child care limit the ability of residents to use available services. Recommendation 14. USC should encourage faculty members to conduct research to assess social capital indicators in the local community to inform community-led strategic approaches to strengthening social capital. Recommendation 15. USC, in collaboration with community members, should develop strategies to increase mutual trust between the university and the community and improve coordination and collaboration on the various USC community engagement initiatives and programs, as well as between USC and local organizations.

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Recommendation 16. Community stakeholders and local residents should build on the rich cultural history of the study area by developing it as a culture and arts destination and economic opportunity for local residents.

CONCLUSIONS This report noted specific areas of strength, challenges and need in the communities surrounding UPC and HSC. Addressing these challenges and needs is the responsibility of a broad spectrum of local stakeholders. Community-based organizations, the faith community, elected officials, residents, policymakers, educational institutions, foundations, and other public and private funders share this civic responsibility. As a major institution and employer in the city of Los Angeles and a neighbor within the communities of the UPC and HSC study area, USC can play an important role as a convener, agent of change and leader to form mutually beneficial transformative collaborations. Focus group participants and members of the community advisory board and faculty task force noted opportunities for strengthening the relationship between the university and the communities within the UPC and HSC study areas. These include continued efforts to improve information dissemination to widen access to USC community programs and services; increase and strengthen university involvement and partnerships in the community, including strategies to plan a future for the neighborhood together; and prioritization of workforce development among community residents and building community social capital. One of the goals of this report was to assess whether the priority areas set forth in 1992 for USC’s community engagement and programs are still relevant. Overall, findings from the report provide support for a continued focus on the five current priority areas: successful schools, healthy families, connecting campus and community, thriving businesses and safe streets. In some of these areas, progress has been made but continued effort is still needed. In other areas, additional effort may be needed to more directly target goals for improvement. Our findings indicate the need to expand USC’s priority areas to include three additional priorities. The first additional priority is building a vibrant local workforce through collaborative programs with local community partners that build a training pipeline to prepare local community residents for jobs, including those at USC. The second additional priority is strengthening community social capital through programs that enhance mutual trust and promote civic engagement and community action. The third additional priority is prevention of child abuse and neglect, which fits under the existing priority of healthy families. The recommendations put forth in this report were developed with input from the Project’s Community Advisory Board and Faculty Task Force. The recommendations provide an initial guide to the development of action steps, which can lift community conditions to a level that offer residents the promise of a better future. The significant scholarly, research, and practice expertise among USC’s units and faculty members represents a wealth of resources to inform our approaches and advance our understanding of how to bring about and document community change that benefits all partners. As an anchor institution along with other key stakeholders, USC is poised to provide national leadership, impactful scholarship, and innovative student learning approaches that will serve as an exemplar of community–campus partnerships and innovation in advancing equity and economic inclusion.

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INTRODUCTION HISTORY In 1992, the University of Southern California (USC) launched five community initiatives that set the foundation for USC’s work in the neighborhoods adjacent to its University Park and Health Sciences campuses. These initiatives have guided much of the civic engagement conducted by programs like the USC Good Neighbors Campaign and the university’s various academic units and departments. The initiatives were: 1. Successful Schools 2. Healthy Families 3. Connecting Campus and Community 4. Thriving Businesses 5. Safe Streets Two decades after these priority areas were outlined, a community assessment was needed to determine if they remained the most relevant and strategic domains for targeting programs and research. Thus, in 2013, the State of the Neighborhood Project was initiated under the leadership of Hortensia Amaro, Associate Vice Provost for Community Research Initiatives and Dean’s Professor of Social Work and Preventive Medicine. The project was conceptualized, developed and implemented in collaboration with the USC Office of the Provost; Office of the Senior Vice President for University Relations; the University Relations Academic Advisory Council; the Deans Advisory Council to the Senior Vice President for University Relations; and an advisory group composed of a faculty task force and a community advisory board. USC contracted with Advancement Project to assist in the assessment.

GOALS The goals of the State of the Neighborhood Project are to: • Examine current data trends in local neighborhoods and propose strategies that USC, community stakeholders, elected officials, policymakers and foundations could pursue to achieve positive community impacts by advancing key neighborhood indicators; • Identify strategic priority areas for the USC Good Neighbors Campaign and other USC civic engagement efforts; • Identify opportunities for interdisciplinary faculty research and scholarship that could further inform community needs and assets, and place-based research and interventions; and • Serve as a resource and framework for university stakeholders, community residents and community leaders working in the area of civic engagement, place-based research and student service learning. From the onset of the project, we envisioned this report as the start of an ongoing collaborative process with community residents and stakeholders. Our long-term vision is to develop ongoing collaborative mechanisms and strategies that lead to measurable

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improvements in community conditions and assets, and to further engage community stakeholders, USC students and faculty, elected officials, policymakers and foundations.

STAKEHOLDER INPUT AND COLLABORATION At the onset of the project, an advisory group was assembled to guide and assist with the community assessment process. The advisory group consisted of two subgroups: a faculty task force and a community advisory board. The faculty task force was appointed by Office of the Provost and included faculty members from across the university with specific knowledge and expertise in the areas of housing, economic development, health, education and safety. In addition, we relied on input from five senior USC faculty advisors leading centers related to this project: professors Manuel Pastor (Center for the Study of Immigrant Integration), William Vega (Edward R. Roybal Institute on Aging), Richard Parks (Sol Price Center for Social Innovation), Brian Finch (Population Research Center) and John Wilson (Spatial Sciences Institute). The community advisory board members were selected based on suggestions from the senior vice president for university relations and his staff, agencies involved in the Good Neighbors Campaign and input from community leaders. Members included stakeholders from organizations and communities in the areas adjacent to the two USC University Park and Health Sciences campuses. A list of faculty task force and community advisory board members can be found in Appendix 1. During the course of the project, the community advisory board and faculty task force convened six1 times. They provided feedback on the following: • The study’s geographic boundaries for both University Park Campus study area and Health Sciences Campus study area; • Secondary data indicators for: 1. Demographics 2. Economic Stability 3. Education 4. Health and Health Care 5. Neighborhood and Built Environment 6. Social Capital; • Findings on secondary data indicator estimates for University Park Campus, Health Sciences Campus, census tracts and the city of Los Angeles, including margins of error where appropriate and time trends when available; • Recruitment of participants for focus groups with community stakeholders and residents in University Park Campus and Health Sciences Campus, and focus group findings; and • Analysis and recommendations stemming from project findings. In addition to input from the advisory group, the project benefited from input and support received from the University Relations Academic Advisory Council and the Deans Advisory Council to the senior vice president for university relations, the latter of which provided funding for the project.

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ORGANIZATION OF THE REPORT This report is organized into five major sections: Introduction, Research Approach, Findings and Recommendations on the University Park Campus, Findings and Recommendations on the Health Sciences Campus, and Conclusions. The two sections reporting findings for the University Park Campus and the Health Sciences Campus are each composed of subsections that present findings on each study domain and respective data indicators. These sections present data comparing each campus study area to data for the city of Los Angeles, trends over time when available and findings by census tract in each of the study areas. Findings from focus groups are integrated into each of the latter sections. Appendices contain a list of the Community Advisory Board, Faculty Task Force and Senior Advisors; and technical and methodological details.

 

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ENDNOTES 1

List of advisory group meeting dates: • 9/23/13 CAB in person meeting • 10/3/13 FTF in person meeting • 12/18/13 joint CAB and FTF webinar • 2/26/14 joint CAB and FTF webinar • 3/26/14 joint CAB and FTF convening • 4/25/14 joint CAB and FTF convening

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RESEARCH APPROACH CONCEPTUAL FRAMEWORK In the process of creating the research approach for this project, the following three frameworks were explored: • Social Determinants of Health • Community–Campus Partnerships • Community-based Participatory Action Research A literature review of each framework was conducted to highlight key tenets and best practices to identify the best-suited approach for this project. Ultimately, the social determinants of health framework was selected as the primary guide for developing the research design and implementation plan. The remaining frameworks were used as references throughout the project. An overview of the research design background for the community–campus partnerships and community-based participatory research frameworks can be found in Appendix 2.

Social Determinants of Health Framework This model was selected as the guiding framework for this project because of its relevance to understanding conditions in specific communities that shape life opportunities and liabilities. Figure 1 depicts the framework developed by the World Health Organization, which provides a comprehensive understanding of how health and well-being are affected by socioeconomic and political contexts. Intermediate determinants in this framework include social cohesion and social capital; socioeconomic position; material living conditions; behavioral, biological, and psychological factors; and the health system.1

This framework acknowledges that health disparities are linked to social disadvantage, and social and economic policies are integral

to shaping positive public health outcomes.2 “Social determinants of health are conditions in the environments in which people are

born, live, learn, work, play, worship, and age that affect a wide range of health, functioning and quality-of-life outcomes and risks.”3

For example, resources like income affect an individual’s ability to acquire safe housing and purchase fresh fruits and vegetables on an ongoing basis; quality of education may affect a person’s access to advanced education or ability to obtain a job with health care coverage. We chose this framework because we see equitable access to the drivers of health as critical for people and communities to grow and thrive. The social determinants of health framework has guided efforts to improve community conditions by various international and national organizations such as the Centers for Disease Control and Prevention, Robert Wood Johnson Family Foundation and

World Health Organization.2 Locally, this framework has also guided the Building Healthy Communities initiative by the California Endowment,5 Choose Health LA by the Los Angeles County Department of Public Health6 and Advancement Project’s Healthy

City program.7

More specifically, this framework has led to a deep understanding of how health and life opportunities are shaped by the conditions of the environments in which people spend most of their time (where they live, work, study, play, worship) and overall health issues.3, 4 Informed by this framework, our nation’s strategic plan for health, Healthy People 2020, is working toward creating “social and physical environments that promote good health for all.” This is one of the four overarching goals for the decade.8

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Figure 1. Structural Determinants: The Social Determinants of Health Inequities4

SOCIOECONOMIC AND POLITICAL CONTEXT Governance

Social Policies Labour Market, Housing, Land

Material Circumstances (Living and Working Conditions, Food Availability, etc.)

Socioeconomic Position

Macroeconomic Policies

Social Class Gender Ethnicity (Racism)

Public Policies Education, Health, Societal Protection Culture and Societal Values

Education Occupation

Behaviors and Biological Factors

IMPACT ON EQUITY IN HEALTH AND WELL-BEING

Psychosocial Factors Social Cohesion & Social Capital

Income

STRUCTURAL DETERMINANTS SOCIAL DETERMINANTS OF HEALTH INEQUITIES

Health System INTERMEDIARY DETERMINANTS SOCIAL DETERMINANTS OF HEALTH

Thus, by applying the social determinants of health framework, it is possible to examine health and other types of inequities and conditions in a community. As noted in Figure 1, this framework provides a platform to examine other inter-related needs (e.g., employment, economic conditions, education, housing, safety) in the community and support the development of various approaches to address important needs and issues. Therefore, the comprehensive nature of the social determinants framework provides an excellent lens through which to understand community conditions that affect and shape a host of outcomes of interest in the State of the Neighborhood Project. Examples of social determinants include3 : •A vailability of resources to meet daily needs (e.g., safe housing and local food markets) • Access to educational, economic and job opportunities • Access to health care services • Quality of education and job training •A vailability of community-based resources in support of community living and opportunities for recreational and leisure-time activities • Transportation options • Public safety • Social support • Patterns of social engagement • Sense of security and well-being Examples of conditions include3 : •E conomic stability: poverty, employment status, access to employment, housing stability (e.g., homelessness, foreclosure)

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• Education: high school graduation rates, school policies that support health promotion, safe school environments, enrollment in higher education • Social and community context: family structure, social cohesion, perceptions of discrimination and equity, civic participation, incarceration, institutionalization • Health and health care: access to health services, including clinical and preventive care, access to primary care, community-based health promotion and wellness programs, health technology • Neighborhood and built environment: quality of housing, crime and violence, environmental conditions, access to healthy foods Examples of environments include9 : • Schools • Places of worship • Workplaces • Neighborhoods • Public gathering places In some cases, the categories of conditions and environments are combined in the literature and referred to as place.3,9

WHY PLACE MAT TERS Robert J. Sampson, an internationally recognized sociologist and expert on the role of place, has found that place has enduring effects on a wide range of social phenomena such as crime, poverty, child health and teen births.10

Experts in the field of public health have also documented and recognized the central role of place in well-being, as noted by Amaro’s editorial11 in the American Journal of Public Health:

Life opportunities, including a healthy life, are largely determined either directly or indirectly by the contextual qualities of where we live. The last three decades have produced a large and rich body of research documenting that where we live, grow, work, and play determine not only life opportunities, but also determine risk of illness and individual actions taken to prevent or treat illness. Shaped by the distribution of resources and power, whether at the global, national, or local level, social determinants of health are internationally recognized as major drivers of health and health inequities (see http://www.who.int/social_determinants/en). As a result, at the forefront of contemporary public health discourse are complex questions of how to move upstream in community- and population-level interventions to improve health. Further, in a recent report, Bell and Lee12 found that an individual’s address makes a significant difference in that person’s health outcomes. For instance:

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If you live in a community with parks and playgrounds, grocery stores selling nutritious foods, access to good jobs and to other economic opportunities, clean air, safe streets, good schools, ample healthcare and social services, and neighbors who look after one another, you are more likely to thrive. If you live in a neighborhood without these essentials, you are more likely to suffer from obesity, asthma, diabetes, heart disease, or other chronic ailments. You are also more likely to die of a stroke, a heart attack, or certain forms of cancer. You are more likely to be injured or killed during a crime, in a car crash, or simply crossing the street.12

HOW THIS PROJECT USES THE SOCIAL DETERMINANTS OF HEALTH FRAMEWORK The project described in this report builds on the framework established by Healthy People 2020.3 Specifically, we used the five key conditions presented in Figure 2 to examine economic stability, education, health and health care, neighborhood and built environment, and social capital. It is important to note that although this project references and builds on the existing literature on social determinants of health,3, 4 , 9 we did not attempt to replicate the existing models. Instead, the existing sources were used as a starting point and conceptual framework through which we examined the particular State of the Neighborhood surrounding the two USC campuses: University Park Campus and Health Sciences Campus. Figure 2. Healthy People 2020 Framework

Neighborhood and Built Environment

Economic Stability

Health and Health Care

Social Determinants of Health

Education

Social and Community Capital

APPROACH The approach used in the State of the Neighborhood Project involved a multistage process, which is briefly described below. Please refer to the appendices for technical information.

1. Developed Conceptual and Empirical Grounding The first step after confirming the project goals was to conduct a review of the literature on social determinants of health, community– campus partnerships and community-based participatory action research.

2. Confirmed Key Community Condition Domains The second step was to confirm community conditions (domains) with the various stakeholder groups. This involved presenting the five community condition domains developed by the World Health Organization and discussing their application to the communities

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surrounding the University Park Campus and Health Sciences Campus. These groups largely accepted the domains of community conditions from the World Health Organization, with some subtle name changes.

3. Confirmed and Prioritized Data Considerations As a group, the stakeholders identified and prioritized important considerations for data indicating community conditions. (During the process, we referred to these data as measures of indicators.) The list of important considerations included: • Focus on “upstream” measures of conditions. Whenever possible, integrate measures that drive health outcomes, rather than solely focusing on outcomes themselves; • Maintain fit with the social determinants of health framework. Although there are excellent data to be found, data should fit within the indicators and community conditions of the social determinants of health framework; • Ensure sensitivity to geographic coverage. Data must be available at a granular level or scale to enable estimation for the campus communities. Much important data are not available at subcounty levels and only serve as context for the community conditions in the report. On the other hand, data need to be available for the entirety of the campus communities and the city of Los Angeles for comparison. Some local organizations surveyed smaller neighborhoods in and around the campus communities, but that data likewise could only serve as context; • Maintain availability over time. Stakeholders see this research as a baseline for future efforts and prefer timely data that are expected to be collected in the future. When possible, data collected using the same methodology over time are also preferable, because it allows comparisons to the past; and • Ensure accuracy. As a team, identify the highest quality data with the best accuracy. See more about handling error below.

4. Defined Community Boundaries During the time we confirmed domains, indicators and measures, we selected the areas of study by identifying community boundaries based on those underlying the geographic area for the USC Good Neighbors Campaign. After presentation and discussion of these boundaries with the various stakeholder groups, adjustments were made to the geographic target area based on input. Some comments related to adjusting the boundaries to include commercial areas that community residents frequented. Others sought to ensure that school attendance areas where area youths went to school were included. In aggregate, the comments increased the size of the campus community boundaries relative to the Good Neighbors Campaign boundaries. It is important to recognize that the geographic boundaries identified for our study areas may not reflect the various places where people work, go to school, shop, worship and conduct other important activities. For example, residents may shop or go to work outside of the boundaries, and nonresidents may go to school or work within the identified geographic areas. Understanding the places where people conduct major activities would require a larger effort than feasible for the current project. We also recognized that although residents are key stakeholders in the target geographic areas, there are stakeholders who do not live within the geographic boundaries identified. For example, individuals who work and have leadership roles in organizations that serve

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local residents have important insights regarding local needs. For that reason, it was determined that organizations that operate within the boundaries and people who may not live within but have detailed firsthand knowledge of these areas could also participate in the advisory group and focus groups for providers.

5. Collected, Compiled and Analyzed Data Finally, we gathered primary data via focus group discussion (see Appendices 3 and 4 for details) and secondary data from existing data sources (see Appendices 7–9 for details) to inform our analysis of community conditions in the University Park Campus and Health Sciences Campus study areas. Findings were presented and discussed by the stakeholder groups in several rounds of meetings and webinars.

COMMUNITY CONDITIONS DATA 1. Secondary Data Compiled from Existing Population-level Databases Each of the community condition domains presented in this report reflects critical components of the social determinants of health framework that seek to “create social and physical environments that promote good health for all.” It is important to note that each of these community conditions has linkages to the others, and the information that follows includes these connections. Figure 3 displays the demographic indicators and six domains that are the focus of this report, along with the data indicator(s) for each. The specified data indicators were selected as a result of a process that considered various criteria. We recognize that the indicators noted are an incomplete list of potential indicators for each domain of interest. Due to limited time and resources, we were forced to choose selected indicators for this first assessment of community conditions in the University Park Campus and Health Sciences Campus study areas. Data from various existing databases were used to map indicators by geographic area. The process of data collection varied by data sources, but a few data collection fundamentals were applied across data sources and are worth discussing here. Data were downloaded from public data sources, purchased from private data sources or obtained from semipublic sources after entering into agreements or submitting applications. See Appendix 7 for more information on the data sources used in this report. All data in this report were checked by at least two staff members for accuracy and reviewed by the entire project team and the various stakeholder groups. Unless otherwise noted, data can be found online at www.healthycity.org for interactive use. Some data associated with survey data have errors. To ensure rigorous analysis and reporting, we discussed our analysis and reporting approaches with secondary data experts, including USC professors John Wilson and Brian Finch, and Seth Spielman from the University of Colorado at Boulder. We agreed on the methods and presentation used in this report, which contains calculations of margins of error whenever applicable, calculations of estimate reliability based on this error, and visual and narrative descriptions of this error. All campus community estimates in this report are of high or medium reliability. Some individual census tract estimates are of low reliability and discussed in Appendix 8.

2. Primary (Focus Group) Data Collection Methods The primary data collection process included discussion and mapping during eight focus group sessions held in January 2014. The focus groups were held at convenient community locations according to the campus community and target audience, with one of the following sessions occurring in each campus community: • Spanish-speaking residents • English-speaking residents • Community-based organization staff members • USC faculty and staff members

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Figure 3. Study Domains of Community Conditions DEMOGRAPHICS Race/Ethnicity

ECONOMIC STABILITY

EDUCATION

Poverty

Academic Achievement

Age Groups

Families in poverty with children under 18

Truancy Rate (Middle School)

Population

Access to Housing

Population with Some College and Above

Median Rent

High School Graduation Rate

Linguistic Isolation

School Readiness

Rental Housing Protected by Rent Stabilization Ordinance (RSO)

Children 0-5 without Licensed Childcare Seats

Access to Employment

HEALTH AND HEALTH CARE Access to Health Care Federally Qualified Health Clinics per 10k Uninsured Population Preventable Hospitalization Rate per 1k

3rd Grade Reading Level

Access to Capital

NEIGHBORHOOD AND BUILT ENVIRONMENT Exposure to Community Violence Violent Crimes per 1K

SOCIAL CAPITAL Social Cohesion Length of Residence Nonprofits per 1k

Rate of All Child Abuse Allegations per 1k Opportunities for Physical Activity Parks per 1K Access to Healthy Food Modified Retail Food Environment Index (mRFEI)

Banks per 10K

Focus Group Sample. Sixty-six community stakeholders representing one or more of the aforementioned groups participated in the sessions. Demographic information regarding focus group participants is listed here: Health Sciences Campus • Spanish-speaking residents: 15 participants; 11 women, 4 men • English-speaking residents: 2 men • Staff members of community-based organizations: 6 participants; 2 women, 4 men • USC faculty and staff members: 5 participants; 3 women, 2 men University Park Campus • Spanish-speaking residents: 7 participants; 6 women, 1 man • English-speaking residents: 10 participants; 6 women, 4 men • Staff members of community-based organizations: 11 participants; 7 women, 4 men • USC faculty and staff members: 10 participants; 3 women, 7 men Recruitment of Focus Group Participants. A convenience sample was recruited for the focus groups through contacts generated from organizations and their members who collaborate with USC; faculty and staff members who lead initiatives that involve direct community engagement; organization, staff, and community members referred by the community advisory board and faculty task force; organization, staff, and community members referred by Advancement Project community partners; and other individuals who lived or worked in the local community and saw a flier for the focus groups or joined the session as a walk-in. Participants were screened prior to participation in the focus group to assess if they met the inclusion criteria of residence or employment in the focus areas and a member of a community of interest. Focus Group Data Collection. During facilitated focus group exercises, participants identified major factors they perceive as contributing to community conditions, critical place-based assets that effectively address these conditions, and how they envision working with one another and local organizations to improve community conditions. These exercises included an icebreaker, data gallery discus-

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sion, and community resources mapping and vision discussion. Each of the exercises and questions represented the following general categories of information, which would later guide the analysis: • Key community issues and conditions by domain • Resource strengths and gaps • Community vision and recommendations (overall community vision, vision for local organizations, vision for USC) • Challenges and opportunities Further description of these exercises and guiding questions can be found in Appendix 3. Facilitation teams for each group included a facilitator, scribe and notetaker. The facilitator guided the group through each exercise, the scribe captured and noted overarching themes identified by the group, and the notetaker captured and noted these themes, along with specific participant quotes on a laptop during the session. Using a notetaking worksheet, the scribe and notetaker later combined their notes and confirmed them with the recordings of the focus groups for analysis. Analysis of Focus Group Data. The analysis of the focus group data involved a mixed-method approach of culling themes from the focus group discussion notes and creating maps with the resources identified by the focus groups. A team-based thematic analysis of the discussion notes captured in the notetaking worksheet was performed. The team included three research staff members who analyzed the notes from each focus group to identify, finalize and apply common and different themes according to each target population and then generally across all groups.13, 14 Team members noted each theme and its supporting notes and quotes in an analysis matrix that included the focus group questions organized by the aforementioned categories as a

framework for the themes (which enabled cross-indexing of notes from the beginning of the analysis).15 , 16 Each team member read the notes for each group, generated an initial list of themes that emerged from each target group, and categorized the supporting notes and quotes into those themes. A theme was placed in order of the number of times it arose in the focus group notes. The team then met to review the analysis process and to share and compare the themes identified in the analysis matrices for each group. Using the themes and notes that team members individually identified, a consensus was reached on a final list of themes by target group. These themes were placed in a combined matrix that included all target group themes, supporting notes, and space for identifying similarities and differences across groups. Identification of similarities and differences across groups occurred during a subsequent meeting in which the team reviewed the themes and supporting notes and quotes identified as a group, noted similarities and differences in themes that emerged across groups, and placed them in the combined matrix in order of the number of times identified by distinct target groups. To prepare final results for writing, these themes were compared and confirmed with the notes and quotes from all groups. Any additional themes that emerged from the notes during this process were added during this final step. Esri’s ArcGIS 10 software was used to digitize and geocode all resources identified during the community-engaged mapping portion of the focus group sessions. These points were used to map and analyze the responses from specific physical locations and clusters of existing assets and to determine the types of assets that existed or may be missing from the community. Using the mapping data, common areas (e.g., the intersections, streets, locations and spaces that reflected the location of assets) were also identified from the discussion notes and analysis of the map points. The resulting themes from the focus groups were used to prioritize the community conditions that are most important to the community, existing assets that can aid in strengthening positive conditions and minimize negative conditions, the community’s vision for changing and improving these conditions, any opportunities and barriers to achieving this vision, and the key roles that USC and local organizations, institutions and leaders could play in working with the community to realize this vision. The themes yielded by the qualitative and mapping analysis,

12

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coupled with participants’ nuanced stories, events, experiences and observations that supported the analyses, are integrated throughout this report.

STUDY LIMITATIONS Key study limitations should be noted in relation to both secondary and primary data. First, real-time population-level data were not available for the indicators discussed in this report; therefore, it relied on data from the recent past (e.g., from the previous two to five years). For some of the indicators, multiple years of data were combined to provide statistically stable estimates for populations of interest. This included American Community Survey 5-year estimates of demographic characteristics of the campus communities. This limitation inhibits the ability to draw conclusions for a precise point in time, but allows for more general conclusions regarding the recent past. As described in the aforementioned data considerations, upstream measures covering the study areas and subsections of the study areas that were available over multiple years are used whenever possible in this report. Not all data were available over multiple years or at a granular level, and there are additional limiting factors associated with some of the measures presented. In these cases, data are at times presented for a single year, for fewer geographic levels, or otherwise constrained. A particular constraint worth noting is the availability of population data in the denominators of rates. Depending on the indicator, population data from the U.S. Census, Esri and Nielsen Claritas are used, sometimes in combination. When these data are used in combination, and even when alone, the reader should regard rates with a discerning eye toward how the base population changes a statistic. Appendix 8 describes how common estimates from sources used in this analysis vary and how they might affect rate calculations. On the other hand, some indicators were limited by the availability of too much rich data. The authors took the liberty of limiting the number of quotes, statistics, maps or other visuals to those that most clearly illustrated the community conditions discussed. For example, when community members mentioned a trend, a corresponding map, table and chart are not always presented as supporting evidence, and perhaps only one of those devices supports the qualitative evidence. This streamlines the arguments without reducing their weight. Readers interested in obtaining more detailed information and interacting with secondary data used to develop this report are encouraged to visit www.healthycity.org, where all the publishable data are available for further research. Primary data are from focus group participants’ current views of community conditions. Participants might have felt differently about community conditions two to five years ago. Viewing of the aforementioned secondary data by participants may have further compounded this issue. This limitation, unfortunately, weakens the connection between the primary and secondary data presented jointly. The reader is advised to view data reported from different sources with a discerning eye toward how conditions such as employment, health insurance and others have changed during the previous five years and how administrative data might or might not connect with people’s lived experiences. Although data obtained from focus groups provide important information about the opinions, experiences, observations and suggestions of participants, it is important to note limitations of this approach. The use of a convenience sample that may not be representative of community residents and stakeholders, limited participant demographic information and varying opportunity for in-depth discussion based on varying size of focus groups should be taking into consideration. We cannot qualitatively derive conclusions on behalf of all community residents based on these data, and instead are limited to bringing key considerations from community members to bear.

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ENDNOTES 1

World Health Organization. (n.d.). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en

2

World Health Organization. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Retrieved from http://whqlibdoc.who. int/publications/2008/9789241563703_eng.pdf?ua=1 3

Healthy People 2020. (2014). Social determinants of health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39

4

Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health (Social Determinants of Health Discussion Paper 2). Geneva, Switzerland: World Health Organization 5 6 7

The California Endowment. (2010). Building healthy communities. Retrieved from http://www.calendow.org/healthycommunities/ Los Angeles County Department of Public Health. (n.d.). Choose Health LA. Retrieved from https://www.choosehealthla.com/about-us/ Advancement Project. (n.d.). Healthy City. Retrieved from http://www.healthycity.org

8

Secretary’s Advisory Committee on National Health Promotion and Disease Prevention Objectives for 2020. (2010). Healthy People 2020: An opportunity to address the societal determinants of health in the United States. Retrieved from http://www.healthypeople.gov/2010/hp2020/advisory/SocietalDeterminantsHealth.htm 9 Brennan Ramirez, L. K., Baker, E. A., & Metzler, M. (2008). Promoting health equity: A resource to help communities address social determinants of health. Atlanta, GA: Centers for Disease Control and Prevention. 10

Sampson, R. J. (2012). Great American city: Chicago and the enduring neighborhood effect. Chicago, IL: University of Chicago Press.

11

Amaro, H. (2014). The action is upstream: Place-based approaches for achieving population health and health equity. American Journal of Public Health, 104, 964. doi:10.2105/AJPH.2014.302032

12

Bell, J., & Lee, M. M. (2011). Why place & race matter: Impacting health through a focus on race and place. Oakland, CA: PolicyLink.

13

Carroll, A. M., Perez, M., & Toy, P. (2004). Performing a community assessment curriculum. Los Angeles, CA: UCLA Center for Health Policy Research. Retrieved from http:// healthpolicy.ucla.edu/programs/health-data/trainings/Documents/tw_cba4.pdf

14

Fernald, D. H., & Duclos, C. W. (2005). Enhance your team-based qualitative research. Annals of Family Medicine, 3, 360–364. doi:10.1370/afm.290

15

Taylor-Powell, E., & Renner, M. (2003). Analyzing qualitative data. Madison, WI: University of Wisconsin-Extension. Retrieved from http://learningstore.uwex.edu/Assets/ pdfs/G3658-12.pdf

16

Bradley, E. H., Curry, L. A., & Devers, K. J. (2007). Qualitative data analysis for health services research: Developing taxonomy, themes, and theory. Health Services Research, 42, 1758–1772. doi:10.1111/j.1475-6773.2006.00684.x

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UNIVERSITY PARK CAMPUS STUDY AREA COMMUNITY HISTORY AND DEMOGRAPHICS COMMUNITY CONDITIONS n Economic Stability n Education n Health and Health Care n Neighborhood and Built Environment n Social Capital

COMMUNITY RESOURCES RECOMMENDATIONS

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COMMUNITY HISTORY AND DEMOGRAPHICS The University Park Campus (UPC) study area forms a gateway between downtown Los Angeles and South Los Angeles. It encompasses all or parts of several Los Angeles neighborhoods, including Pico–Union, Harvard Heights, Historic South Central, Adams–

Normandie and Vermont Square.1 The area is physically split by the 110 Freeway and the adjacent Figueroa Corridor, a resource-rich stretch of Figueroa Street lined with the museums and centers of Exposition Park, University of Southern California (USC), a host of businesses and nonprofit organizations, Metro light rail stations, and the L.A. Live sports and entertainment district. See Map 1 for an illustration of the UPC study area. The UPC study area is a community mixed with residential, industrial and commercial uses, historically influenced by changing demographics, population migration, and shifting land use patterns. In the 1940s, this area experienced a notable increase in its African-American population largely tied to the Second Great Migration, during which large numbers of African-Americans (originally residing in the Southern United States) migrated West in search of better job opportunities in the burgeoning defense industry, which was spurred by World War II and anchored in Southern California.2 The neighborhoods in the study area became permanent residences for many of these newcomers, and during the course of generations, the built environment of these neighborhoods grew to reflect the changing demographic. It is important to note that these neighborhoods did not develop evenly; some fared better than others, particularly in terms of access to resources. This area experienced a second major shift in demographics during the 1980s, when it underwent an influx of new immigrant Latinos (mainly from Mexico and Central America) coupled with an outflow of AfricanAmerican families to “new developments far away from the urban core, buying up affordable and sprawling homes in then-growing cities like Riverside in the east and Palmdale in the north.”3

The impact of these demographic shifts continues to play a significant role in the neighborhoods that comprise the study area. The area has been subject to the struggles and benefits of community redevelopment efforts that arguably surfaced in response to the 1992 civil unrest that took place in the area and South Los Angeles. This environment spurred community redevelopment efforts led by private developers, city planners and local institutions seeking to revitalize the area, in addition to grassroots community organizing led by community-based organizations seeking to ensure maximum community representation and benefit in these development efforts.4

The 2010 U.S. Census counted 162,390 people living in the study area,5 an increase of nearly 3,000 people since 2000.6 The majority of residents moved into the community during the previous 10 years, with more than two thirds of residents moving into the areas after 2000.7 The remaining one third of the population moved into the area in 1999 or prior,7 representing a smaller but significant longstanding residential population. Residents were predominantly Hispanic or Latino (68.9% in 2010), with notable

shares of African American (11.8%), Asian (9.8%), and White (7.5%) residents.5 This racial and ethnic mix of the study area has not changed substantially since 2000, although Asian and White racial and ethnic groups increased slightly in proportion (from

6.7% and 6.3%, respectively).6 Compared with the city of Los Angeles, the UPC study area had similar shares of youths (24.7% in

2010), adults (68.1%) and seniors (7.2%) comprising its population,5 with the share of study area youths decreasing most since 2000 (from 30.4%).6

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NEIGHBORHOOD Park LA Metro HI G HL A ND PA R K

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Vista Hermosa Natural Park

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Map 1: University Park Campus Study Area Source: Neighborhood name data from the Los Angeles Times Neighborhood Project (2010), parks data from GreenInfo (2013) and Google Maps (2014), public transit data from Los Angeles County Metropolitan Transportation Authority (2012).

St oto Euc l

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L.A. Live


COMMUNITY CONDITIONS ECONOMIC STABILITY The resources available, planned and needed in the UPC study area present an opportunity to connect the strengths of the community’s economic vitality with the vital needs of the community. Connecting economic development with residents’ needs is essential to improving economic outcomes and quality of life for all members of the community. The landscape of economic revitalization currently underway in the area has great potential to bring economic opportunities to community members and organizations in the study area. Being home to USC (the largest private employer in the city of Los Angeles); the L.A. Live sports and entertainment district; and myriad nonprofit, cultural and governmental agencies, the study area further reflects employment and economic development opportunities.

POVERTY Although the proportion of families with children under age 18 has decreased, the proportion of families with children under age 18 in poverty has increased. For the purposes of this study, we measured poverty using two commonly used methods: poverty thresholds and poverty guidelines. The U.S. Census Bureau calculates poverty thresholds that do not vary geographically, but are updated for inflation using the Consumer Price Index. These thresholds consider only pretax income and do not include noncash benefits such as Medicaid or Supplemental Nutrition Assistance Program, a federal program that “offers nutrition assistance to millions of eligible, low-income individuals and families and provides economic benefits to communities.” The U.S. Department of Health & Human Services releases poverty guidelines that are used primarily administratively to determine eligibility for public programs and benefits. Many have made the connection between poverty and poor outcomes. Researchers have found that children in poverty are almost twice as likely to be reported in “fair to poor health” and that their families are more than twice as likely to experience violent crime. The effects of poverty go beyond just those mentioned here; it is a critical driver to assess in this type of needs assessment. Living in poverty means fewer choices and opportunities, a lack of access to resources, and greater insecurity and discrimination. The proportion of families with children under age 18 living in poverty from 2008–2012 in the study area (47.3%) was almost double that of the city (25.2%), reflecting an increase from 35.8% in 2000 (see Table 1). Table 1: Families with Children in Poverty as a Percentage of all Families with Children year(s) area

2000 2008–12

Study Area

35.8%

47.3%

City of Los Angeles

25.3%

25.2%

Source: U.S. Census 2000 Table QT-P35, American Community Survey 2012 5-Year Estimates Table S1702

Study area census tracts generally had higher rates of poverty compared with the city, except for some lower poverty census tracts near downtown and in small sections of Harvard Heights, University Park and Vermont Square (see Map 2). One study area focus group

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No Data

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Health Sciences Map 2: Families with Children in Poverty as a Percentage of all Families with Children, 2008–2012 Campus study area No Data 0 4.2 11.4 20.7 32.9 100 (%) The map shows families with related children under age 18 whose income in the previous 12 months was below the census poverty threshold as a percentage of all families with related children under age 18 by census tract. To create this map, Los Angeles County census tracts were grouped into even fifths based on reported rates of families with children in poverty. Census tracts with darker colors have higher percentages of these families in poverty. Data Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

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participant described poverty and a lack of resources in the area: “There aren’t as many programs to help families in poverty sign up for assistance. Might hear about it from a friend of a friend, but don’t know when open enrollment for [federal food assistance] or other programs and [you] find out about it too late.”

ACCESS TO EMPLOYMENT The high ratio of jobs to workers is an opportunity to create pathways to better connect local residents with local jobs. Access to employment refers to the geographical proximity of workers to jobs that match their skill set, in addition to access to a reliable mode of transportation to work.8 Access, by this definition, varies largely in relation to the income level of families and individuals, which affects where they live and the mode of transportation they can afford to take to and from work. Low-income people face many barriers to employment. Their job skills and educational background are often limited, and they often must depend on unreliable transportation due to financial constraints.9 Commute distances and employment opportunities are linked to the level of economic hardship faced by low-income people.10 One way to explore the employment picture in the study area is to examine the unemployment rates of adults 25–64 based on their educational attainment levels. For the UPC, the unemployment rate was similar to the city across educational attainment levels, as shown in Table 2. People without a college education were less likely to be employed than people with some college education or more. Table 2: Unemployed Persons Ages 25–64 as a Percentage of the Civilian Noninstitutional Labor Force by College Education, 2008–2012

college education

area

None

Some College or More

Study Area

11.3%

10.1%

City of Los Angeles 11.1%

8.9%

There is no comparable 2000 Census table. Source: American Community Survey 2012 5-Year Estimates Table B23006.

As shown in Map 3, employment varied by census tract for people without a college education in the study area, though there were somewhat higher employment rates closer to campus. Undergraduate and graduate students ages 25 or older without employment were counted in this population. Local residents who participated in the focus group described their perceptions and experiences of unemployment as higher than reflected in administrative data. In reviewing unemployment figures during the focus groups, many community residents and organization staff members felt that unemployment, underemployment and informal employment affected a larger share of the population than captured in the employment rate alone. One participant stated that “there are really more people that are unemployed,” with one reason being “having a flat rate for employment doesn’t take into account people who are underemployed [or] the cash economy.” Residents also shared personal stories, such as a mother mentioning the difficulties her son had faced in trying to find employment. Yet U.S. Census figures indicated a high job-to-worker ratio in the study area, particularly among the highest income or earnings bracket, as shown in Table 3. It is important to note that a high job-to-worker ratio does not necessarily translate to jobs for local residents, because such jobs are open to nonresidents as well. In this report, a worker is defined as someone employed with positive earnings during the current and preceding quarter as reported to the U.S. Census Bureau and Local Employment Dynamics partner states.11

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0

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Health Sciences 92 95 100 (%) 88 The map shows people ages 25 to 64 without any college education who were employed as a percentage of all people ages 25 to 64 without any college education by census tract. To create this map, Los Angeles County census tracts were grouped into even fifths based on reported employment rates. Census tracts with darker colors had higher percentages of people ages 25 to 64 without any college who were employed. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

Map 3: Employment Rate with No College Education, 2008–2012 Campus study area

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(%)

Ch

E 4Th St

Employment Rate with Some College W 54Th St

rE

SE ver g

W Vernon Ave

Avalon Blvd

San

Ped ro P

l

S Figueroa St

W Martin Luther King Jr Blvd

Hooper Ave

S Central Ave

adw Bro

MLK Jr. Park

EC

l

Los Angeles Memorial Sports Arena

St

Ave

SH

ope

oyl e

an SS

St

101

ffith

lvd

t

sB

id A ve

dam

University Park Campus

Exposition Blvd

Health Scienc Campus ren go St

Ma EA

110

R

5

Blv d

Ped ro S

W Jefferson Blvd

NM

St

Gri

S Hoover St

S Vermont Ave

S Western Ave

S Normandie Ave

6T h

ion

iss

St

Euc l

Blv d

pic

e2

ce

lym

Staples Center

St

Rd

6T h

St

St

n do

Ven i

Rosedale Cemetery

W

4T h

5T h

u en Av

W

W

W

EO

N

St

u Fig

na Fer

W Pico Blvd

oa er

St

an NS

W Olympic Blvd

1St

ea ud ry

Av e

nda le B lvd

St

Gle

St

t

nio n

W8 Th

W6 Th Ave

Irolo St

Macarthur Park

Griffin Ave

SR

Wilshire Blvd

NB

Lafayette Park

W

t Bl vd

Health Scien

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Table 3: Job-to-Worker Ratio by Monthly Earnings, 2002 and 2011

less than $1,250/mo

$1,250 to $3,333/mo

over $3,333/mo

area

2002

2011

2002 2011

2002 2011

Study Area

1.25

1.4

1.26

1.3

4.18

3.4

City of Los Angeles

0.97

1

1.04

1

1.33

1.4

This table shows the job count based on the employer’s address divided by the job count based on the employee’s home address by census tract for three income categories. A job-to-worker ratio greater than 1 means the area is job rich and there are ample job opportunities. A job-to-worker ratio of less than 1 means the area is job poor and many workers will need to go outside the area to find employment. Source: U.S. Census Bureau, Center for Economic Studies, Longitudinal Employer-Household Dynamics (2002 and 2011).

The job-to-worker ratio for individuals earning more than $3,333 per month was 3.4, meaning there were 3.4 primary jobs in this earnings bracket for every worker with earnings at the same level (see Table 3). Although not as high, the low- and mid-range earnings bracket still reflected more than one job per worker at those income levels. Job-to-worker ratios were higher in the area where USC is located across all three income-levels. Being home to the largest private employer in the city, USC, and the vicinity of the area to the job-rich downtown Los Angeles area likely influenced this ratio. Economic redevelopment projects in the area present the opportunity of additional jobs, such as the USC Village project that is slated to provide “12,000 new jobs (4,000 construction-related, 8,000 permanent)” throughout its development area.12 The Promise Zones Initiative designation that covers neighborhoods in part of the study area will also potentially bring significant federal funding for workforce development. The high job-to-worker ratio, which indicates a high availability of jobs, suggests an opportunity to address residents’ perceptions of limited job options and challenges in finding employment, as well as development of initiatives to increase hiring opportunities for local residents. In discussing potential job sources such as the Staples Center, one resident noted in the focus group “[it’s] amazing there is Staples Center with so many jobs and it’s amazing we don’t have jobs.” These figures coupled with community experiences suggest a spatial skills mismatch between the availability of jobs in the area (of various skill levels, but especially high-skilled jobs) and the low accessibility and readiness of local residents to obtain these jobs.13 The shared desire and vision among community

organizations and residents for more investment in jobs, trainings and workforce development present an opportunity to explore ways to better connect local residents to local jobs, particularly to affect the economic conditions previously discussed.

ACCESS TO HOUSING Rents were lower than the city as a whole. Yet focus group participants who lived in the community shared experiences of housing unaffordability, displacement, overcrowding, property owner harassment and unemployment. Access to housing refers to the availability of high-quality affordable housing units. Housing is the largest expenditure for

consumers.14 For housing to be considered affordable, no more than 30% of household income should be spent on housing.15 By high-quality housing, we refer to housing that is not substandard. Substandard housing conditions can include mold, dampness, inadequate plumbing, inadequate ventilation, pest infestations, overcrowding and other housing conditions linked to negative health outcomes. A family with one full-time worker earning the minimum wage cannot afford the local fair-market rent for a two-bedroom apartment anywhere in the United States.16 Where individuals or families live is linked to their exposure to crime and their access to

employment and services, including grocery stores and schools, along with fire and police protection. Thus, affordability of housing has a significant impact on other goods and services and community conditions that affect opportunities or lack thereof and quality of life. The median rent was generally lower in the study area than in the city as a whole (see Table 4).

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100

989

1,305

1,131

1,629

2,001

Health Sciences Campus study area

($)

University Park Community

am par

St le mp Te

W3

Rd S

W

SB

SU

Flo ran we dA rS ve t

E1

ain

EW ash

ton

S Gr and

Ave

ing

5

ren go S

t

10

1,305

1,131

1,629

oto

St

Ave

Ave

St

S Santa Fe Ave

itti

E Ol ymp

er B

lvd

5

ic B

lvd

W

t Bl vd

Health Science Community

St

St er low

iss

ea ud ry

SB

Gle nda le B

nA ve SU

Av e

Rd

SF

26

St

ue

o and

St

St

n Fer

6T h

St

en Av

4T h

5T h

an

W

W

W

W

N Eastern Ave

Av e

S

NS

lva rad o

a ro

ue Fig

U S C StTA T E O F T H E N E I G H B tO R H O O D R E P O RNT

usc_son_upc_1f.indd 24 SA

1St

N Hu n ion ting Rd ton

W

lvd

24

t

nio

St

W6 Th

Dr

Rd S

NM

SR

W8 Th

St

am

ple

par

m Te

W3

Macarthur Park

na

Ave

ave z

SE ver g Wh

Euc l

E 7Th St

id A ve

E Vernon Ave

The map shows median gross rent by census tract. Median gross rent divides the gross rent distribution into two equal parts: one half of the cases falling below the median gross rent and one half above the median. Gross rent is the contract rent plus the estimated average monthly cost of utilities (electricity, gas, and water and sewer) and fuels (oil, coal, kerosene, wood, etc.) if these are paid by the renter (or paid for the renter by someone else). To create this map, Los Angeles County census tracts were grouped into even fifths based on median rents. Census tracts with darker colors had higher median gross rents. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

Lafayette Park

Ch

ree n

Hooper Ave

E4 Th

Health Sciences Campus study area

versity Park Community

rE

E 4Th St

University Park Campus study area

($)

($)

1,131

Avalon Blvd

E 54Th St

Map 4:989 Median Rent in Unadjusted Dollars, 2008–2012 1,305 1,629 2,001

100

S Central Ave

l Ped ro P San

2,001

esa

l S Main St

S Broadway S Flower St

Median Rent

W 54Th St

989

EC

ay P adw Bro S Figueroa St

W Vernon Ave

100

NB

an SS

SH

ope

nt Ave

St

101

ffith

lvd

t

sB

NS

dam

Ped ro S

EA

E 1St St

W Martin Luther King Jr Blvd

R

Blv d

Pleasa

MLK Jr. Park

NM

Ma

University Park Campus

Los Angeles Memorial Sports Arena

ion

iss

St

St

Gri

S Hoover St

S Vermont Ave

S Western Ave

S Normandie Ave

6T h

Exposition Blvd

N Broadway

ro a

NM

t

W 20Th St 10

110

Ave

SB

S Th E9

W Washington Blvd

W Jefferson Blvd

ena

ad Pas

dw ay

S

SG

Blv d

St

Daly St

St lva rad o SA

Blv d

pic

6

ce

lym

e2

6T h

St

St

Rd

Ven i

Rosedale Cemetery

W

4T h

5T h

u en Av

W

n do

EO

N

W

W

Staples Center

St

St

na Fer

W Pico Blvd

oa er

u Fig

an NS

W Olympic Blvd

1St

ea ud ry

Av e

nda le B lvd

St

Gle

St

t

nio n

W8 Th

W6 Th Ave

Irolo St

Macarthur Park

Griffin Ave

SR

Wilshire Blvd

oyl e

Lafayette Park

W

t Bl vd

Health Scien

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Table 4: Median Rent in Unadjusted Dollars, 2008–2012 years area 2008–12 Study Area

$895

City of Los Angeles

$1,156

There is no comparable 2000 Census table. Source: American Community Survey 2012 5-Year Estimates Table B25064.

However, as shown in Map 4, median rents were highest immediately surrounding the UPC and downtown Los Angeles areas. Residents’ experiences indicated that rents were increasingly unaffordable for local families. Focus group participants stated that rent costs were influenced by local property owners seeking to increase profits from the student population: “Students are in that area and the price is hiked up and families pay a higher rate because it’s right next to USC” and “Rent areas are smaller to accommodate more people and squeeze out rent.” Spanish-speaking community residents expressed feeling the simultaneous pressures of increased rent prices and unemployment, experiences exacerbated by the loss or destruction of housing stock and loss or discontinuation of unemployment benefits. These experiences reflect the sentiment among residents that property owners use nonstudent versus student housing demand to drive up rent prices. Resident concerns about housing costs were compounded by the disparity in housing quality. In a survey conducted to determine the quality of housing for students and community members, Enterprise Community Partners found that only 11% of multiunit community housing was rated as high quality, whereas about a third of multiunit student housing

was rated as high quality.17 A 2012 health impact assessment of the USC Specific Plan found “over one-third of owner-occupied units

and two-thirds of renter households have been classified as severely overcrowded.”18 The issue of overcrowding was reflected in a state-

ment by a focus group participant, “When I moved out here decades ago, it was a room with a basement, they put us up on the third floor and then students below us, renting out and divided rooms to get more money.” The USC Village project will house nearly 2,700 USC students in the new housing units and may relieve some of the housing demand forces referred to by the focus group participants from the local community. A measure of the affordable housing stock specific to Los Angeles is the percentage of rental units protected under the Rent Stabilization Ordinance (RSO), which protects renters in units with a certificate of occupancy issued prior to or on October 1, 1978, from “excessive rent increases.”19 Given this context, we examined renter-occupied units constructed in 1979 or earlier as a proxy for rent-controlled units. Although the percentage of rent-stabilized units (79.8%) is higher than that of the city (75.9%), community experiences indicated the perception that more can be done to ensure housing is affordable to residents (see Table 5). Table 5: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units year(s) area

2000 2008–12

Study Area

82%

79.8%

City of Los Angeles

80%

75.9%

Source: U.S. Census 2000 Table H036, American Community Survey 2012 5-Year Estimates Table B25036.

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1.5

64.7

77.0

84.8

91.9

Health Sciences Campus study area

100

University Park Community

am par

St le mp Te

SR

W3

Rd S

W

Av e SB

SU

Flo ran we dA rS ve t

St lva rad o

SG

E1 S Hoover St

ain

EW ash

ton

5

Blv d

ren go S

t

10

sB

S Flower St

RSO 91.9

St

E 4Th St E4 Th

St

SE ver g

Hooper Ave

S Central Ave

Wh

itti

id A ve

E Vernon Ave

er B

lvd

Euc l

S Main St

S Broadway

W Vernon Ave

Avalon Blvd

San

Ped ro P

l

S Figueroa St

W Martin Luther King Jr Blvd

84.8

Ave

l ay P adw Bro

MLK Jr. Park

NB

E 1St St

Los Angeles Memorial Sports Arena

oyl e

ffith Gri

an SS

SH

ope

nt Ave

St

101

Pleasa

Exposition Blvd

Ave

t

lvd

oto

dam

NS

EA

Ped ro S

S Gr and

Ma

USC

77.0

NM

St

ing

110

ion

iss

St

Ave

S Vermont Ave

S Western Ave

S Normandie Ave

6T h

W Jefferson Blvd

64.7

N Broadway

Daly St

NM

t

W 20Th St 10

1.5

Ave

ro a

S Th E9

W Washington Blvd

W 54Th St

ena

ad Pas

SB

Blv d

St

dw ay

S

SA

ce

Blv d

6

Ven i

pic

e2

6T h

St

St

Rd

lym

Rosedale Cemetery

W

4T h

5T h

u en Av

W

n do

EO

N

W

W

Staples Center

St

St

na Fer

W Pico Blvd

oa er

u Fig

an NS

W Olympic Blvd

1St

ea ud ry

St

Gle

St

t

nio n

W8 Th

W6 Th Ave

Irolo St

Macarthur Park

nda le B lvd

Wilshire Blvd

Griffin Ave

Lafayette Park

W

t Bl vd

Health Scie

E 54Th St 5

University Park Campus study area

100

Health Sciences

Map 5: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, Campus study area

1.5

64.7

77.0

2008–2012

84.8

91.9

100

The map shows percentage of rent-stabilized units by census tract. Tracts with darker colors had higher percentages of such units. To create this map, Los Angeles County census tracts were grouped into even fifths based on the percentage of rent-stabilized units. Source: American Community Survey 2012 5-Year Estimates Table H036.

University Park Community Blv d

W

t Av e

lvd

ry ea ud SB

nda

le B

W

we

rS

t

SU

St

6

6

St

and

W

4T h

5T h

2 ue

W

en Av

St

N

n Fer an

rad o

St

St

W

Gle

St

NS

W Olympic Blvd

6Th

St

nio nA ve

W8 Th

usc_son_upc_1f.indd 26

a ro

ue Fig

N Eastern Ave

Rd S

U S C S TA T E O F T H EW N E I G H B O R H O O D R E P OW 1RStT

Dr

W3

Macarthur Park

NM NH iss unt ion ing Rd ton

SR

Irolo St

26

St

am

par t

le mp Te

Lafayette Park

hire Blvd

Health Science Community

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Organizational staff and community resident focus group participants expressed a desire for improved housing opportunities for local residents, including more opportunities for residents to “purchas[e] their homes instead of renting” and “more affordable housing and assistance.” Although the RSO serves as a protective factor for renters against spikes in their housing costs, “even renters in RSO properties could be vulnerable to displacement resulting from illegal evictions, code violations resulting in unsafe properties, condo conversion or teardown of RSO-subject properties to be replaced by market rate residential development that would not be subject to RSO.”20 Between 2012 and 2017, a “record high number of rental subsidies, restrictions and covenants on income-restricted units in the State of CA are expected to expire. …Within the City of Los Angeles, nearly 15,000 units built and restricted under a variety of federal, state, and local programs (“affordability restrictions”)…will expire and/or terminate in this time period.”20

The stories and concerns described during many of the focus groups involved displacement, an issue that has affected local residents and families and is perceived to be catalyzed by local property owners: “Homeowners [are] forging paperwork to evict renters so that they can increase the rent.” University faculty and staff members also specifically expressed a desire for community improvements that promote community growth, not displacement. Community-based organization focus group participants also shared that they would like to see “more well-maintained, affordable housing for families and less displacement.” Because displacement and disempowerment of renters has contributed to the environment of distrust, community resident and organizational participants described a need “to change the dialogue about how renters are viewed” and for local institutions, elected officials and local property owners to build trust with community members. Thus, community resident and stakeholder concerns regarding displacement are at the heart of sentiment regarding major players in local development.

ACCESS TO CAPITAL There were fewer banks per capita in the study area, but there were other economic resources in the area that can assist residents. Access to capital refers to both the physical proximity between residential areas to banks and other mainstream financial institutions and conditions that might incentivize or restrict individuals from using traditional financial and banking services. It is also tied to financial literacy. A lack of access to formal banks “imposes high costs on basic transactions, creates barriers to homeownership, reduces opportunities for retirement planning, and interferes with the ability of small businesses to develop and grow.”21 Immigrant populations tend to depend primarily on the informal or alternative financial services sector, especially in terms of cashing checks, sending

remittances and paying bills.22 Economic disparities also factor into the location of mainstream financial institutions and can create

areas that lack banks and mainstream financial access.21 In a review of the literature concerning financial exclusion, Joassart-Marcelli and Stephens found that several scholars documented financial exclusion from mainstream financial services as a spatial phenomenon affecting and compounding issues of economic hardship faced by low-income and minority populations.21

Overall, as shown in Table 6, there was a lower rate (1.09 per 10,000 people) of banks per capita in the study area than in the city of Los Angeles (1.87 per 10,000 people). Table 6: Banks per 10,000 Persons

year

area

2012 2014

Study Area

1.79

1.09

City of Los Angeles

2.68

1.87

Source: DeLorme Street Atlas (2012 and 2014), population estimates from Esri (2012 and 2014).

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Health Sciences Campus study area

University Park Community W

am par

St le mp Te

SR

W3

Rd S

W

Av e SB

SU

Flo ran we dA rS ve t

E1 S Hoover St

ain

ing

ton

5

Blv d

ren go S

t

10

sB

St

E 4Th St St

SE ver

E4 Th

Wh

itti

id A ve

E Vernon Ave

er B

lvd

Euc l

Avalon Blvd

Hooper Ave

S Central Ave

l Ped ro P San S Flower St

Banks per 10k

W 54Th St

S Main St

S Broadway

W Vernon Ave

3.7

Ave

l ay P adw Bro

S Figueroa St

W Martin Luther King Jr Blvd

2.0

NB

E 1St St

Los Angeles Memorial Sports Arena

oyl e

ffith Gri

an SS

SH

ope

nt Ave

St

101

Pleasa

Exposition Blvd

Ave

t

lvd

oto

dam

NS

EA

Ped ro S

S Gr and

Ma

USC

1.1

NM

St

EW ash

110

ion

iss

St

Ave

S Vermont Ave

S Western Ave

S Normandie Ave

6T h

W Jefferson Blvd

0.6

N Broadway

SB

NM

t

W 20Th St 10

0

Ave

ro a

SG

S Th E9

W Washington Blvd

MLK Jr. Park

ena

ad Pas

dw ay

S Blv d

St

Daly St

St lva rad o SA

ce

Blv d

6

Ven i

pic

e2

6T h

St

St

Rd

lym

Rosedale Cemetery

W

4T h

5T h

u en Av

W

n do

EO

N

W

W

Staples Center

St

St

na Fer

W Pico Blvd

oa er

u Fig

an NS

W Olympic Blvd

1St

ea ud ry

St

Gle

St

t

nio n

W8 Th

W6 Th Ave

Irolo St

Macarthur Park

nda le B lvd

Wilshire Blvd

Griffin Ave

Lafayette Park

t Bl vd

Health Scie

E 54Th St 5

University Park Campus study area

16,111.1

Health Sciences Campus study area

Map 6: Banks per 10,000 Persons, 2014

The map shows number of banks per 10,000 residents by Zip Code. Zip Codes with darker colors had more banks per 10,000 residents. To create this map, Los Angeles County Zip Codes were grouped into even fifths based on banks per 10,000 people. Zip Codes with darker colors had higher median gross rents. Source: Bank data from DeLorme Street Atlas (2014), population data from ESRI (2012).

University Park Community Blv d

W

t Av e

lvd

ry ea ud SB

nda

le B

W

we

rS

t

SU

St

6

6

St

and

W

4T h

5T h

2 ue

W

en Av

St

N

n Fer an

rad o

St

St

W

Gle

St

NS

W Olympic Blvd

6Th

St

nio nA ve

W8 Th

usc_son_upc_1f.indd 28

a ro

ue Fig

N Eastern Ave

Rd S

W RT U S C S TA T E O F T H EW N E I G H B O R H O O D R E P O 1St

Dr

W3

Macarthur Park

NM NH iss unt ion ing Rd ton

SR

Irolo St

28

St

am

par t

le mp Te

Lafayette Park

hire Blvd

Health Science Community

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Access to banks was not evenly spread throughout the study area; there was a higher rate of banks per capita in the northern section of the study area, including parts of Harvard Heights, Pico Union and downtown Los Angeles (see Map 6). The downtown region of the study area had more than three times as many banks per capita as the city of Los Angeles. Sections of historic South Central Los Angeles and Vermont Square particularly lacked access to banks, with 0 banks per 10,000 people. Although low-income “places like

South L.A. are often asset rich” and greatly contribute to the local economy, banks often choose not to locate in low-income areas.23 When community members do not have access to banks, they often turn to check cashers, payday lenders and other costly alternatives.23 Examples of local community-based financial institutions that have served to address these issues include the Broadway Federal Bank and RISE Financial Pathways (formerly the Community Financial Resource Center). Local organizations such as RISE Financial Services and Trust South L.A. exemplify local resources that provide “programs such as Individual Development Accounts (IDAs) [to] help families

accumulate assets for long-term investment and development, while land trusts and cooperatives preserve and enhance community assets.”24 The former provides a variety of financial services and training, including microlending, banking and asset development programs for individuals and businesses in the community, and recently produced an inaugural South Los Angeles Economic Forecast, analyzing economic conditions in five South Los Angeles Zip Codes.25 The low rate of banks per capita, especially in the southern portion of study area, suggests that the community would benefit from increased access to more financial and economic development services and resources such as these.

RESOURCES On HealthyCity.org Based on a search conducted using 211 data and other sources via www.HealthCity.org, there are an estimated 76 organizations in the study area publicly listed as addressing economic conditions such as basic needs (e.g., food and housing), consumer services (e.g., money management and tax services), income support and employment, organizational or community services (e.g., community

economic development agencies and social services government agencies), and bank institutions.26 See the resource categories used to identify resources on HealthyCity.org in Appendix 5 for more information. Most of these economic resources are located in the eastern and northern areas of the study area, which may present access barriers to residents of the southwestern area of the boundary because of the physical boundaries created by the 110 and 10 freeways.

USC Community Programs Below are examples of existing programs at the University Park Campus that are currently working jointly with local organizations to help sustain and increase entrepreneurship growth that in turn create jobs in the local economy. For a more complete list, see Appendix 10. The Los Angeles Minority Business Development Agency (MBDA) Business Center at USC is funded by the U.S. Department of Commerce and the center has been hosted at USC Civic Engagement and Economic Development since 1996. The program has provided business technical assistance services such as management consulting to small, minority-owned enterprises, and helped them access over $200 million in loans and equity investments, as well as more than $500 million in procurement contracts. As a result of these services, USC has aided in the creation of thousands of jobs in the Los Angeles area. The MBDA is the only federal agency created specifically to foster the full participation and entrepreneurial parity of minority business enterprises in our national economy. The USC Bridges to Business Success program (USC Bridges Program) is a capacity building procurement training program with a focus to enable the small, minority-owned and veteran-owned enterprises to be contractready and to be prepared to secure and manage new contracting opportunities. In 2011, USC led the design of a

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new innovative public/private/non-profit partnership between USC, the Los Angeles MBDA Business Center, the Southern California Supplier Development Council (SCMSDC), the U.S. Small Business Administration (SBA SCORE), and the Mayor’s Office of Economic Development. At December 2013, the USC Bridges Program has 100 graduates with outcomes that include 209 awarded contracts that total $11.2 million. As a whole, the program graduates created and retained 438 jobs in our communities and were able to successfully access $600,000 in financing. Currently, the program curriculum is designed for businesses in the real estate asset management industry such as construction contractors, plumbers, electricians, landscape architects, and related fields. USC and Univision provide one of the largest financial resource fairs in the country. More than 5,999 Latinos attend Feria Financiera to gain information on college aid, home financing, stock investments, consumer protection and resources for small businesses.

Identified by Focus Group Members Although these data suggest that many economic resources existed in and near the study area, community residents that participated in the focus group were familiar with few. This indicates an opportunity for multiple sectors to align to strengthen outreach and programs that can influence poverty and unemployment in the study area. Nevertheless, the resources that focus group participants, particularly community residents, were familiar with were organizations that serve multiple functions, address multiple community conditions, and are local experts in community engagement and organizing. Examples of these organizations are Esperanza Community Housing Corporation, which works on the issue of affordable housing development and availability and health outreach and promotion, and Magnolia Place, a one-stop source and community space for a variety of community services. These and the myriad community-based nonprofit organizations generate community-based economic and social development by not only helping “the original beneficiary but also generat[ing] other neighborhood improvements.” 24

EDUCATION Although the school readiness picture was mixed and almost all high schools had higher graduation rates than the LAUSD average, local stakeholders were concerned with the gap between secondary school completion and employment and higher educational attainment. The education conditions in the University Park Campus study area were among the most passionately discussed issues by community members and represent an important opportunity for community stakeholders to work together.

SCHOOL READINESS In general, children attending schools within the study area were less ready for school than in the school district as a whole, yet reading scores have improved during the previous 10 years. School readiness refers to the preparation of young children to participate in and derive maximum benefit from kindergarten. Because kindergarten lays the foundation for success in all levels of school, school readiness is a critical benchmark.27 School readiness is a

fixed standard of physical, intellectual and social development required for kindergarten that sits within the larger domain of readiness to learn—the developmental level at which an individual has the capacity to learn specific material. A child’s readiness for school is connected with a school’s readiness for that child and the capacity of families and communities to provide developmental opportuni-

ties.28 Recent research has shown that children do not need to reach a specific age of maturity before they are ready to learn; readiness

is more a function of an exposure to learning opportunities.29

30

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Children with higher levels of school readiness have more self-confidence, higher self-esteem and a lower likelihood of being involved in crime or violence30 or teen pregnancy.31 School-ready children are less likely to drop out of high school and more likely to earn

more as adults,32 which benefits society by increasing worker productivity and government revenue through taxes, while reducing costs for special education services and social services.30 Children who get off to a good start in kindergarten maintain that advantage as

they progress through school, because the most powerful predictor of academic performance is previous academic performance.29 Disparities in readiness for school by income or poverty are among the strongest and most predominant disparities identified by

researchers.29 Children from low-income families are more likely to start school with limited language skills, health problems, and social and emotional problems that interfere with learning.33 By age 3, a low-income child has heard 30 million fewer words than

higher-income peers,34 and fewer than half (48%) of low-income children are ready for school at age 5, compared to 75% of children from moderate- and high-income families.32

Connections between early care and education and school readiness have also been well documented. Specifically, several studies have demonstrated a link between high-quality child care and children’s cognitive, language and social development.35 A lack of quality and affordable early care and education can be an obstacle to parental employment and child development. Budget cuts during the previous several years have disproportionately affected subsidized child care seats, which has had a disproportionate impact on lower-income families.36

In the UPC study area, 21% of children younger than 5 had access to a licensed child care seat in their Zip Code, which was a slightly higher rate than the city (of 20%) but left nearly four in five community children without access to licensed child care (Table 7). Map 7 shows access to licensed child care was highest in Zip Code 90007 (49%), surrounding the USC campus, and lowest in Zip Codes farthest from downtown. Table 7: Percentage of Children Ages 0–5 with a Licensed Child Care Seat

year

area

2009 2013

Study Area

17.3%

21.2%

City of Los Angeles

18.1%

20.2%

Source: Community Care Licensing Division (2009 and 2013), population estimates from Nielsen Claritas (2009) and (Esri 2013).

Due to the difficulty of obtaining standardized indicators of school readiness, some researchers have suggested using early grade reading proficiency, which is also a predictor of future school success.27,33 The California Department of Education reported the percentage of

students scoring proficient or advanced in third-grade English language arts on California Standards Tests among all students tested in 2013. Only four of 30 schools in and around the study area had more third-graders scoring proficient or advanced compared to LAUSD as a whole. Table 8 shows the percentage of third-graders scoring proficient or advanced on the English language arts exam (California Standards Test) for schools in the UPC study area and LAUSD overall. According to the California Department of Education, test scores have improved since 2003–04, yet these scores were lower than district scores, which increased from 21% to 40% of third-graders scoring advanced or proficient on English language exams during the same time frame. When discussing ways to address academic performance issues for local students, community residents highlighted the need for more hands-on, on-site parental involvement and more opportunities and spaces for youth development and enrichment.

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No Data

0

12.6

18.6

26.5

39.5

100

(%)

0

12.6

18.6

26.5

39.5

100

(%)

Univers Campus

Health S Campus

roa

Wilshire Blvd W3

N Av e ry

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ay

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SG

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ran

N Broadway

Blv d

Th E9

W Washington Blvd

St

W 20Th St 10

N Main St

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S Hoover St

S Vermont Ave

W Adams Blvd

S Western Ave

Griffin Ave

nio n SU

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26

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1St

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S Central Ave

Wh

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S Boyle Ave

E 54Th St

No Data

E4 Th

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S Main St

S Figueroa St

S Broadway

W Vernon Ave

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(%)

Health Sciences Campus study area

Map 7: Children 0–5 with Child100 Care(%) Seats, 2013 0 12.6 18.6 Licensed 26.5 39.5

N

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The map shows the percentage of children age 5 or younger with a licensed child care space in their Zip Code of residence. To create this map, Los Angeles County Zip Codes were grouped into even fifths based on children 0–5 with access to a child care seat in their Zip Code of residence. Zip Codes with darker colors had higher percentages of children with a licensedt child care seat. Source: California Department of Social Services aS Community Care Licensing Division (2013). ero igu F N W 3Rd

Euc l

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Exposition Blvd

101

Gri

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University Park Campus

Ave

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t

110

Mi

Health Sciences Campus

d nR

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Table 8: Third-graders Scoring Proficient or Advanced on English Language Arts Exam, 2012–2013 Downtown Value† 53% Accelerated Elementary Charter† Lou Dantzler Preparatory Charter Elementary† 53% Global Education Academy† 48%

29% † Accelerated 29% Normandie Avenue Elementary

29%

Ricardo Lizarraga Elementary

45%

Martin Luther King Jr. Elementary

28%

Los Angeles Unified School District

40%

Dolores Huerta Elementary

28%

Vermont Avenue Elementary

39%

Magnolia Avenue Elementary

27%

Leo Politi Elementary

39%

Twenty-Eighth Street Elementary

Birdielee V. Bright Elementary

36%

25% † Frederick Douglass Academy Elementary 24%

Dr. Theo T. Alexander Jr., Science Center†

34%

South Region Elementary #10

23%

Lenicia B. Weemes Elementary

34%

Camino Nuevo Elementary No. 3

22%

San Pedro Street Elementary

32%

Norwood Street Elementary

21%

Tenth Street Elementary

32%

John W. Mack Elementary

19%

Trinity Street Elementary

32%

Los Angeles Elementary

19%

Foshay Learning Center

32%

Twenty-Fourth Street Elementary

19%

Thirty-Second Street USC Performing Arts†

31%

Menlo Avenue Elementary

18%

West Vernon Avenue Elementary

31%

This table shows the percentage of third-graders scoring proficient or advanced on the English language arts exam (California Standards Tests) for schools in the UPC study area and LAUSD overall. Schools in red are in the USC Family of Schools. Schools with crosses have addresses in the study area; schools without crosses have 20% or more of attendance boundaries in the study area. Source: California Department of Education (2012–13).

ACADEMIC ACHIEVEMENT Although high school graduation rates were higher in the majority of schools in and around the UPC study area than in the city, there were gaps among high school preparedness, access to college education and employment options. Opportunities exist to strengthen the pathways from high school to higher educational attainment and career choices. The California Department of Education defines high school dropouts as “students that leave the 9-12 instructional system without a high school diploma, GED, or special education certificate of completion and do not remain enrolled after the end of the 4th year.”37

Risk factors for dropout are characteristics that increase the likelihood that a student will drop out and not graduate from high school. One such risk factor, truancy, is defined by the department as the percentage of students with three or more unexcused absences per school year. Researchers have found truancy particularly useful as an indicator because it also functions as a risk factor for substance abuse, poor health, gang involvement and criminal activity.38, 39

Healthy People 2020 considers educational attainment to be one of five key social determinants of health.40 Educational attainment,

defined as the “years or level of overall schooling a person has,”41 affects an individual’s ability to obtain a well-paying job and also factors significantly into health outcomes such as life expectancy.41 High school graduation rate is the most common measure of

academic achievement researchers use to understand the link between education and health.40 “High school graduates live longer, are

less likely to be teen parents, produce healthier and better educated children, and rely less on social services.”42 Dropping out of high

school has an impact on society and individuals. Economic effects include lost individual earnings and tax revenues due to unemployment, low-wage employment and costs associated with higher crime rates.43 Seventy-five percent of state prison inmates and 59%

of federal prison inmates did not complete high school.43 For these reasons, this analysis examined high school graduation rates and

middle school truancy rates as one risk factor for high school dropout.

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Data on high school graduation are presented in Table 9. During 2011–2012, high schools in the UPC study area generally graduated more students as a percentage of all enrolled students than in the district as a whole. Among 14 area schools with grades 9 to 12, all but two high schools reported graduation rates above the LAUSD graduation rate of 66.6%. Table 9: High School Graduation Rate, 2011–2012 Alliance Dr. Olga Mohan High† 100.0

New Designs Charter†

80.0

Alliance Gertz-Ressler Richard Merkin 6-12 Complex† 97.4

West Adams Preparatory High

80.0

Foshay Learning Center

97.4

Manual Arts Senior High

69.4

Thirty-Second Street USC Performing Arts†

97.3

Santee Education Complex

69.3

Animo Jackie Robinson High† Orthopaedic Hospital†

95.3

66.6

91.8

Los Angeles Unified School District Los Angeles Education Corps Charter†

Wallis Annenberg High†

91.6

Frank Lanterman†

Los Angeles Big Picture High†

81.0

19.7 0.0

This table shows high school graduation rates for schools in the UPC study area and LAUSD. The four-year adjusted cohort high school graduation rate is calculated by dividing the number of students in each four-year adjusted cohort who graduated in four years or less with either a traditional high school diploma or an adult education high school diploma, or have passed the California High School Proficiency Exam, by the number of students who form the adjusted cohort for that graduating class. Schools in red are in the USC Family of Schools. Schools with crosses have addresses in the study area; schools without crosses have 20% or more attendance boundaries in the study area. Frank Lanterman High School is a nontraditional high school with a cohort of 20 special education students. Source: California Department of Education (2011–12).

Another education indicator, school truancy rate, is a marker of school connectedness and an early indicator of whether a student will graduate or drop out of school. The California Department of Education reports middle school truancy rates for schools in and around the study area. It defines a truant student as, “A pupil subject to compulsory full-time education or to compulsory continuation education who is absent from school without a valid excuse three full days in one school year or tardy or absent for more than a 30-minute period during the school day without a valid excuse on three occasions in one school year, or any combination thereof.”44 Table 10: Middle School Truancy Rate, 2010–2011 Monsenor Oscar Romero Charter Middle† 0.0

Camino Nuevo Elementary No. 3

47.3

New Designs Charter† 4.3

John Adams Middle

56.7

Downtown Value† 6.2 City of Angels† 17.5

Berendo Middle

Accelerated† 21.8 Frank Lanterman† 24.0

Thirty-Second Street USC Performing Arts†

60.6

Pio Pico Middle

63.3

Magnolia Avenue Elementary

28.1 † Sophia T. Salvin Special Education Center 28.8

John H. Liechty Middle

79.9

Foshay Learning Center

82.8

Alliance Gertz-Ressler Richard Merkin 6-12 Complex† 30.3 Thurgood Marshall Charter Middle† 31.7

William Jefferson Clinton Middle

84.4

Los Angeles Unified School District

57.1 † Alliance Richard Merkin Middle 58.4

Barack Obama Global Preparation Academy

100.7

43.9

This table shows the truancy rate for schools in the UPC study area and LAUSD. The data included only schools that offered sixth to eighth grades. Schools in red are in the USC Family of Schools. Schools with crosses have addresses in the study area; schools without crosses have 20% or more attendance boundaries in the study area. Source: California Department of Education (2010–11).

Half of the 20 study area schools with grades 6 to 8 had lower truancy rates than LAUSD as a whole (43.9%) in the 2010–2011 school year (see Table 10). Foshay Learning Center and Thirty-Second Street USC Performing Arts, both in the USC Family of Schools, had

34

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above-average truancy rates. Because these schools receive added educational, cultural and developmental resources from USC,45 it will be important to monitor effects on future truancy rates. Although high school graduation rates in most schools in and around the study area were higher than the LAUSD graduation rate overall, community residents older than 25 had much lower rates of educational attainment than their citywide counterparts. The population older than 25 with some college education or more in the study area was 28.8%, in comparison to 55% for the city of Los Angeles (see Table 11). Lower levels of postsecondary educational attainment in comparison to higher levels of high school graduation suggest barriers to college education that both community members and organizations identified as a key educational issue. Both resident and community-based organization focus groups described a need to make local institutions of higher education, including USC, more accessible to local community members. Group participants also suggested that the university explore avenues, programs and funding that improve pathways from the local community college, Los Angeles Trade Technical College, to USC. In reference to the lack of postsecondary educational attainment, one participant explained “College education percentage has to do with get[ting] out of school and get[ting] to work. [We need] training to get out and get a job because most folks won’t be able to pay for college.” Overall, community residents and staff members of local organizations described a vision of creating a community with more fulfilling educational and career opportunities and programs. One USC faculty or staff member identified the need for “programs for adults…[because] much of the resources are focused on children and children in schools and if we’re effective they’ll get out of the community, but [I] would like to see after college ways to engage them even on job level.” Participants across all study area focus groups stated that local universities, including USC and community colleges such as Los Angeles Trade Technical College, have a key role to play in achieving this vision, helping to support and expand postsecondary workforce options, readiness and training that allow for higher educational attainment. Table 11: Persons Aged 25 or Older Attaining Some College or More as a Percentage of all Persons Aged 25 or Older year(s) area

2000 2008–12

Study Area

22.9

28.8

City of Los Angeles

49.2

55

Source: U.S. Census 2000 Table QT-P20, American Community Survey 2012 5-Year Estimates Table B15003.

Additionally, residents and organizational staff members expressed a desire for more resources and public education programs that address important community issues such as health, resources for people recently released from prison, and education on how government works. As staff members of community-based organizations highlighted, many local organizations and programs are already working to strengthen the capacity of residents, associations and organizations; these programs and partnerships can serve as building blocks toward developing and maintaining a programmatic infrastructure that effectively provides the local community with access to the educational and career opportunities it envisions. However, community residents did not generally seem aware of these resources, indicating the need for better communication methods to help residents become aware of such programs.

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RESOURCES On HealthyCity.org Based on a search conducted using 211 data and other sources via www.HealthCity.org, there were approximately 156 education resources available in the UPC study area boundary, ranging from grade schools, colleges and universities, child care centers, arts and cultural agencies, youth development agencies, and occupational and professional associations.26

USC Community Programs The following are only a few examples of existing educational community programs at the UPC. For a more complete list, see Appendix 10. The USC Neighborhood Academic Initiative is a seven year program offered in local middle and high schools structured to prepare low-income students for college admission, engage parents in their child’s education and provide ongoing support throughout the student’s collegiate years. USC School for Early Childhood Education provides comprehensive, high-quality Head Start and Early Head Start programs for more than 500 families in South Los Angeles. The Good Neighbors Campaign funds the Redeemer Community Partnership’s Family Learning Academy, which hosts parent learning days to assist parents with supporting their child’s academic achievement. USC’s Kinder to College program enrolls kindergarten boys in an initiative that prepares them to be proficient in reading and writing by the end of the third grade.

Identified by Focus Group Members Although there are a wide array of educational resources available in and surrounding the UPC study area, residents from the community may not be informed of and benefiting from them. Focus group participants identified 18 education resources, which included nonprofits and educational institutions. Interestingly, seven education resources were also identified as economic resources. Community focus group participants seemed to be unaware of the various USC-sponsored programs that provide education-related programming and activities for students in local elementary, middle and high schools and for entry to college and technical schools. This indicates a need for better channels through which to inform community residents about available resources and programs at USC.

HEALTH AND HEALTH CARE Health is an important issue for the UPC study area related to but different than health care. Many features of communities have been linked with both population health and individual health-related behaviors. These features include safe places to exercise; access

to healthy and affordable food; social networks and support; quality of schools; and fear, anxiety, despair and stress.46 UPC study area residents and organizational focus groups described how education, resource availability and coordination, the built environment and economic status affect their health. We cannot cover every facet of health in this report, so we focused on key elements of access to health care and make linkages to broader issues when possible.

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ACCESS TO HEALTH CARE Health insurance, access and cost represented barriers to health care in the study area. Increased access to health care is associated with less disease, disability and deaths; and better physical, social and mental outcomes,

including longer life expectancies.47 For this study, we considered access to health care using three measures: federally qualified health clinics (FQHCs) per 10,000 residents, uninsured population and preventable hospitalization rate per 1,000 residents. Having health insurance is the first step to accessing health care. People without insurance are less likely to have access to basic care and have a 25% higher mortality rate than insured persons.48 This means that conditions go undetected and untreated longer than experienced by

insured individuals, one consequence being a preventable hospitalization. There is evidence that FQHCs are effective at providing care in underserved areas and to populations that might otherwise not have access. “Patients in underserved areas served by Health Centers [including federally funded FQHCs and non-federally funded clinics] had 5.8 fewer preventable hospitalizations per 1,000 people over three years than those in areas not served by a Health Center.”49

Residents of the UPC study area are less likely to have health insurance compared to residents in the city of Los Angeles (see Table 12). According to American Community Survey estimates, 38% of University Park Campus study area residents lacked health insurance, compared to 26% of residents citywide, between 2008 and 2012. In most of the study area, more than 32% of residents did not have health insurance, except in the areas adjacent to the USC campus as shown in Map 8. According to community members, this issue has persisted for many years: “When I was younger, I didn’t have health insurance, had to go to the county, sleep on the bench until my son got to see the doctor. [I] imagine it’s a lot worse now.” Table 12: Percentage of Population without Health Insurance years area

2008–12

Study Area

37.5%

City of Los Angeles

25.8 %

There is no comparable 2000 Census table. Source: American Community Survey 2012 5-Year Estimates Table S2701.

The Affordable Care Act promises to improve access to health care50 and potentially to a regular source of care51 —an essential step

toward improving quality and use of preventive health services.52 Important parts of the health care infrastructure, including providers,

clinics, hospitals, nonprofits and others, will need to increase capacities to serve additional patients. Some populations may remain uninsured, however, including homeless, unemployed, undocumented and linguistically isolated populations. People working part-time, seasonally or in small businesses also may not gain insurance. Although the timing of this report did not allow us to assess how the Affordable Care Act has affected access to care among study area residents, there is reason to suspect that the legislative efforts to insure the uninsured may not have had equitable uptake in the UPC study area. First, recent reports have indicated that California is well behind other states in uptake, particularly among Hispanics.53

Second, Hispanics, who comprise the largest percentage of study area residents, have historically had the highest rates of uninsured. Our data, which indicated high percentages of uninsured persons in the study area prior to the Affordable Care Act, suggest that the number of uninsured may remain high even after Affordable Care Act implementation. Further assessment of the impact of the Affordable Care Act on local residents’ access to health insurance is needed to inform future targets for health insurance outreach

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0

10.8

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76.1

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Health Sciences Map 8: Percentage of Population without Health Insurance, 2008–12 Campus study area 0 10.8 17.8 25 32.9 76.1 (%) The map shows uninsured persons as a percentage of the total population. To create this map, Los Angeles County census tracts were grouped into even fifths based on reported insurance rates. Census tracts with darker colors had higher percentages of persons without health insurance. There is no comparable 2000 Census table. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

Community

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usc_son_upc_1f.indd 38

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Health Scie

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efforts by foundations and other health equity organizations. In this policy context, UPC study area residents would be a prime beneficiary of enrollment because of persistently low rates of coverage.

FEDERALLY QUALIFIED HEALTH CENTERS The presence of federally qualified health centers (FQHCs) was a strength of the University Park Campus study area. The study area had more than twice as many FQHCs per person than the city of Los Angeles (see Table 13). Table 13: Federally Qualified Health Centers per 1,000 Persons

years

area 2008–12 Study Area

7.1

City of Los Angeles

3

Source: U.S. Department of Health & Human Services (2012), population estimates from Esri (2012).

The rate of FQHCs is high throughout the community, except near the UPC and in a small pocket west of Normandie Avenue between Washington and Exposition boulevards, as shown in Map 9. Evidence has indicated that FQHCs effectively provide care in underserved areas and to populations that might otherwise not have access to health care, including the uninsured. Although the rate of FQHCsi was higher in the study area than in the city, residents still experienced challenges in accessing affordable and quality health care and described the area as having a “doctor shortage.” Better information on health resources available in the community could help residents access more of the services they need. Focus group participants who lived in the study area described experiencing challenges in accessing quality health care or paying relatively high costs for quality care. One resident explained, “[even] if I get sick once a year, I still have to pay a lot.” Another stated, “parents go to these places but don’t have money, so [they] don’t get [the] immediate care they need. [The facilities] say they are free but they are not taking care of you.” Although the rate of FQHCs was comparatively high in the area, community residents still stated that there are “too few community clinics,” particularly those viewed by residents as affordable and effective. The shortage of hospitals in the area further exacerbates this issue. There is only one full-service hospital located within the University Park Campus study area (also the only

emergency trauma center) and one around the margins.54 The hospital located within the study area, California Hospital Medical Center – Los Angeles, is located on the north-eastern end of the study area, where the 10 and 110 freeways intersect. Residents and stakeholders did not identify the hospital as a local health resource, perhaps connected to its location in an area that Spanish-speaking residents in particular identified as inaccessible due to safety, lack of familiarity and distance. Additionally, residents and stakeholders raised the issue of primary care clinics and primary care doctors, citing “a doctor shortage” as a “real issue.”

PREVENTABLE HOSPITALIZATIONS Preventable hospitalizations include admissions for one of the following conditions: diabetes, chronic obstructive pulmonary disease, asthma, hypertension, heart failure, angina without a cardiac procedure, dehydration, bacterial pneumonia or urinary tract i Health care service delivery sites, referred to here as federally qualified health centers (FQHCs), are community-based and patient-directed organizations that serve populations with limited access to health care, including low-income populations, the uninsured, those with limited English proficiency, migrant and seasonal farmworkers, individuals and families experiencing homelessness, and those living in public housing. Health care service delivery site information includes data about FQHC look-alikes, which are entities that operate and provide services consistent with all policy requirements that apply to Section 330-funded health centers, but do not receive funding under Section 330.

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t Bl vd

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Map 9: Federally Qualified Health Centers per 10,000 Persons, 2012 The map shows the number of FQHCs per 10,000 residents by Zip Code. Zip Codes with darker colors had a higher number of FQHCs per 10,000 residents. To create this map, Los Angeles County Zip Codes were grouped into even fifths based on FQHC rates. Markers showing the locations of the hospitals in the area were added to the map. Source: FQHC data from the U.S. Department of Health & Human Services (2012), population data from ESRI (2012), hospital data from Office of Statewide Health Planning and Development (2012).

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infection. On a national level, there are disparities across race and ethnicity in rates of preventable hospitalizations. Latinos are

twice as likely to lack a usual source of health care as Whites.55 Rates of preventable hospitalizations are higher among African-

Americans and Latinos than non-Latino Whites.55 Socioeconomic status also makes a difference; residents in lower-income

neighborhoods have higher rates of preventable hospitalizations than residents of higher-income neighborhoods.56 In terms of timeliness, the wait time for an abnormal screening mammogram is more than twice as long for Asian, African-American and Latino women as for White women.55

Table 14: Preventable Hospitalizations per 1,000 Adults

year

area

2011 2012

Study Area

12.9

12.5

City of Los Angeles

12.8

12.2

Source: Office of Statewide Health Planning and Development (2012), population estimates from Nielsen Claritas (2011) and ESRI (2012).

At a local level, the UPC study area had a similar rate of preventable hospitalizations (12.5 per 1,000 people) as the city of Los Angeles (12.2 per 1,000 people; see Table 14). Spatially, the rates of preventable hospitalizations were not evenly spread. West of Normandie Avenue and south of Exposition Boulevard had rates of preventable hospitalization approximately 50% higher than that of the city of Los Angeles, whereas the area surrounding UPC had the lowest rate, ranging from 1.6 to 9.2 hospitalizations per 1,000 adults (see Map 10). Further research should examine the modest rates of preventable hospitalizations given that the rate of insurance is exceptionally low.

RESOURCES On HealthyCity.org According to data from 211 LA County mapped on HealthyCity.org, the study area had approximately 60 health resources available within its boundaries, ranging from eldercare and mental health services, government agencies (e.g., health department divisions for aging and HIV/AIDS programs), community health centers and public health agencies that can be tapped as assets to help achieve the community’s vision.

USC Community Programs A healthy body fuels a healthy productive mind. Through numerous health and safety programs. USC enhances the well-being of its neighbors and offers abundant opportunities for learning, self-improvement and personal connections. Provided below are a few examples of USC programs that promote health around the UPC neighborhood. For a more complete list, see Appendix 10. The USC Neighborhood Mobile Dental Van provides free dental services to thousands of South Los Angeles residents. USC After School Sports Connection provides elementary school students with quality sports, fitness and general health programs in a cost-free, efficient and effective manner. The Fuente Initiative provides poison prevention education, appropriate drug use and self-management education, and general health education and screenings for diabetes, hypertension and obesity.

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0

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Health Sciences Map 10: Preventable Hospitalization Rates per 1,000 Adults, 2012 + Hospitals Campus study area 0 10.8 17.8 25 32.9 76.1 (%) The map shows the number of preventable hospitalizations for people age 18 or older per 1,000 residents by Zip Code. Preventable hospitalizations include admissions for one of the following conditions: diabetes-related conditions, chronic obstructive pulmonary disease, asthma, hypertension, heart failure, angina without a cardiac procedure, dehydration, bacterial pneumonia or urinary tract infection. Persons hospitalized with more than one of these conditions were counted once per hospitalization. The Zip Codes with darker colors had more preventable hospitalizations per 1,000 residents. To create this map, Los Angeles County Zip Codes were grouped into even fifths based on rates of preventable hospitalizations. Markers showing the actual locations of the hospitals in the area were added to the map. Source: Office of Statewide Health Planning and Development (2012).

Community

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Identified by Focus Group Members The fact that many focus group participants did not identify many of these resources indicates an opportunity to bridge the information gap between community residents and providers of community health services. Focus group participants identified addresses of 16 health resources in and around the study area, which included clinics, nonprofit agencies and social services departments. Agencies such as A Place Called Home and St. John’s Well Child & Family Center at Magnolia Place were health resources identified most often by focus groups.

NEIGHBORHOOD AND BUILT ENVIRONMENT Because physical and environmental design often connect to perceptions and realities of crime and safety, achieving the community’s vision of

healthier spaces, places, and overall improvement to infrastructure and the built environment can also mitigate safety concerns.57 Focus group participants had concerns about crime and expressed hope that safety improvements on University Park Campus can be expanded to include the whole study area. Poor access to healthy foods and open space is an obstacle to community health in the study area; however, declining violent crime rates and the community’s desire for more healthy resources are strengths to leverage in creating healthier spaces and places.

EXPOSURE TO COMMUNITY VIOLENCE Violent crime rates remained high and residents envisioned spreading safety efforts beyond the University Park Campus. Child abuse allegation reports were exceptionally high. The Federal Bureau of Investigation’s Uniform Crime Reporting Program defines violent crime as crimes involving force or threat of

force.58 It includes the following offenses: murder and nonnegligent manslaughter, forcible rape, robbery and aggravated assault.58 More than 18,000 law enforcement agencies across the country share this definition and use it for crime reporting at the federal level.58

The rate of violent crime incidents reported by the Los Angeles Police Department is a central measure to understand exposure to community violence. The true rate is somewhat higher than the rate presented here due to the limitations of data provided by the Los Angeles Police Department, because rape, domestic violence, child abuse and several other subtypes of violent crime are not included in the rates shown here. There may be some inconsistencies in the ways these data are collected across departments, but because violent crimes constitute a broad category of criminal activity, violent crime estimates here are comparatively less sensitive to errors based on collection methods. Table 15: Violent Crimes per 1,000 Persons year area

2007 2011

Study Area

8.4

7.7

City of Los Angeles

5

4

Source: Los Angeles Police Department, population estimates from Nielsen Claritas (2007) and U.S. Census 2010 Table DP-1.

There were nearly 1,250 violent crimes in the UPC study area in 2011. The violent crime rate in the study area declined from 8.42 to 7.7 violent crimes per 1,000 people between 2007 and 2011 (see Table 15). Nonetheless, the 2011 rate was almost twice as high as within the Los Angeles Police Department jurisdiction, which spans the city of Los Angeles (4 per 1,000 people). Several resident parents raised safety concerns connected to social capital and environmental factors, stating that “As a parent, you don’t want your kids

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outside” and “If I don’t know the parent, I’m not going to send my kid to the house [out of ] fear.” Another resident shared a recent experience of being a victim of crime near UPC. Although violent crime rates appeared evenly spread throughout the community, rates were lower in sections of the Adams– Normandie neighborhood and in the census tract that includes UPC (see Map 11). Residents noted the university’s success in keeping its campus safe as a potential means of addressing safety concerns for the community as a whole. Community stakeholders also stated that measures implemented by USC and its partnership with local law enforcement have increased safety, but that increased efforts to improve safety for the community overall are still needed. Specifically, organizational focus group participants noted that safety resources are located “away from dense residential [areas]” and “focused toward the Fig[ueroa] Corridor.” Community residents voiced a desire for better policing and better communication and interaction with local law enforcement. A participant in a resident focus group noted that, “As far as safety, there are at least two police stations and no one named [them] as safety resources.” Participants in both resident focus groups described their desire for more police patrols and improved relations between community residents and law enforcement. Participants noted that poor relations with law enforcement are likely to result in community members not turning to police to report problems. Child abuse and neglect is another important measure of community violence that can affect physical and mental health and outcomes in education, work and social relationships.59 Child abuse and neglect is often accompanied by family stressors and other forms of

family violence. Table 16 shows the number of children younger than age 18 with a child abuse allegation referral per 1,000 children under age 18. Please note these data include all allegation referrals, not only those later substantiated. Rates of child abuse allegations increased in the UPC study area between 2010 and 2012, from 60.4 to 68.8 per 1,000 children ages 0–17. The city of Los Angeles abuse allegation rate increased from 50.3 to 56.9 allegations per 1,000 children.60 Table 16: Child Abuse Allegations per 1,000 Children

year

area

2010 2012

Study Area

60.4

68.8

City of Los Angeles

50.3

56.9

Source: California Department of Social Services and University of California Berkeley Child Welfare Dynamic System (2010 and 2012)

Although the rate of child abuse allegations has increased throughout the city of Los Angeles, the gap between the UPC study area and the city is growing as the rate of allegations increases more in the study area than in Los Angeles. Causal factors for the increase in child abuse allegation rates are beyond the scope of this project, but future investigations should explore relationships with family stressors, substance use and abuse, enforcement, efforts to increase community awareness and data collection, among other factors. Spatially, there were higher rates of child abuse in the southwest region of the UPC study area, including sections of Exposition Park, Adams–Normandie and Vermont Square. Considering the high rates of child abuse allegations in the UPC study area, it is noteworthy that no focus group members brought up child abuse as an issue in the UPC study area. This may reflect lack of awareness or hesitancy to discuss the issue and indicates a need for education efforts to increase awareness and prevention programs.

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No Data

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Health Sciences Campus study area

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No Data 2.5 22.9 36.1 50 67.3 2000 The map shows the number of child abuse allegations per 1,000 children by census tract. Tracts with darker colors had higher rates of child abuse allegations. To create this map, Los Angeles County census tracts were grouped into even fifths based on the percentage of rent-stabilized units. Source: California Department of Social Services and University of California Berkeley Child Welfare Dynamic Report System (2012).

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OPPORTUNITIES FOR PHYSICAL ACTIVITY Given the minimal amount of park space in the study area, community members expressed a desire for increased park space and “the availability of green spaces when families need it.” The American Heart Association defines physical activity as “anything that makes you move your body and burn calories,” which

includes climbing stairs, walking, jogging and stretching.61 Approaches targeting individuals to increase physical activity have achieved minimal success.62 Scholars increasingly have recognized that environmental factors play a key role in levels of physical activity.63

This review focused on different environmental factors contributing to increased opportunities for physical activity, such as walkable environments and access to park space. Physical activity is critical to health. According to the Centers for Disease Control and Prevention, physically active people have longer life expectancy and a reduced risk of stroke, heart disease, type 2 diabetes, depression and certain types of cancers.64 Additionally, regular physical activity can also help with weight control and is linked to improvements in academic achievement outcomes for

students.64 In terms of disparities in environmental incentives or barriers to physical activity, neighborhoods with lower socioeconomic

status have fewer resources available for physical activity.62 Scholars have noted the inequality in recreational facilities and park space

as contributing factors to disparities in physical activity levels and obesity and overweight outcomes by race and class.65 Studies have

shown the importance of available open and green space in a community and that proximity to park space increases likelihood of park usage, which increases rates of physical activity and improves overall health. One study of park usage in Los Angeles showed that “people who lived within 1 mile of the park were 4 times as likely to visit the park once a week or more” and that “living within 1 mile of a park was positively associated with leisure exercise.”63

As shown in Map 1 (see Introduction), residents in the UPC study area had minimal access to green space. The community had about 45 times less park space per person than the city overall, with a rate of 0.03 square miles of open space per 1,000 persons (see Table 17), compared to 1.40 in the city (excluding open space with no public access). Table 17: Square Miles of Open Space per 1,000 Persons year area

2010 2012

Study Area

0.02

0.03

City of Los Angeles

1.4

1.36

Source: GreenInfo California Protected Areas Database (2010 and 2013).

There are pocket parks and at least two public parks in the area, Jesse Brewer Park and Denker Park, the latter of which was identified by focus group participants. Although there is large green space represented by Exposition Park, for individuals who may not be familiar with the Exposition Parks and Recreation facility or museums, much of the green space may not seem accessible for play, recreation or physical activity. In addition to the minimal amount of park space, residents also encountered challenges in accessing the park space that is available: “Some neighborhood pocket parks are locked in after 5 or 6 [p.m.], [further limiting] the availability of green space when families need it.” Organization staff members relayed that some families must also “take two buses to get to a pocket park, [which is] not ideal.” Park safety is also an important determinant of park usage, because residents are less likely to visit parks that they perceive as unsafe.66

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9.1

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During the focus groups, community residents called for more green space, even in the form of “parklets,” and more safe and secure parks and outdoor spaces for children to play and exercise. Focus group participants also connected safety to environmental design issues and solutions; for example, some participants explained that “the city has abandoned all of the sidewalk infrastructure. … People have to walk in the streets” and “children getting hit because no safe place to ride [their] bikes. … What if there was a bike lane to get the community to [the] park?” Participants proposed that better maintenance of sidewalks and installation of bike lanes would increase and improve the overall physical infrastructure of the community.

ACCESS TO HEALTHY FOODS The overabundance of fast food and dearth of healthy food options represented a major concern among residents, who sought more healthy options in the community. One way to consider access to healthy foods is to define a food desert, or a lack of access. These areas “lack convenient access to affordable and healthy food. Instead of supermarkets or grocery stores, these communities often have an abundance of fast-food restaurants and convenience stores. In addition, stores in low-income communities may stock fewer and lower quality healthy foods. When available, the cost of fresh foods in low-income areas can be high. Public transportation to supermarkets is often lacking, and long distances separate

home and supermarkets in many rural communities and American Indian reservations.”67 For this report, we considered access to healthy foods to have several aspects, including distance, affordability, availability and prevalence in relation to unhealthy food options. As an example of health-related environmental factors, access to healthy foods contributes to maintaining a healthy weight and preventing health conditions such as diabetes and heart disease.67 The UPC study area had few census tracts with high Modified Retail Food

Environment Index scores, indicating the presence of many more fast food restaurants than healthy food retailers. The Modified Retail Food Environment Index does not allow for data aggregations at the study area and city geographic levels, so can only be mapped by census tract. As displayed in Map 13, there was a concentration of census tracts with a low percentage of healthy food retailers in the eastern portion of the study area. Areas west of Hoover Street had more healthy food options, whereas the Figueroa Corridor along the 110 freeway had fewer healthy options. The overabundance of fast food and dearth of healthy food options represented a major concern among residents. One resident explained that he has to “drive far to get healthy, nice places.” Residents questioned why certain policies contribute to this issue, with one resident asking why “CalFresh can be used for fast food.” The CalFresh Program is California’s

iteration of the federal Supplemental Nutrition Assistance Program.68 In addition, healthier foods often prove to be a less affordable option for families with limited incomes due to the higher prices, a phenomenon noted by a resident. A recent study of the community surrounding UPC found that identifying food desert census tracts using a cost-based approach

resulted in more than twice as many food deserts as compared to distance-based approaches.69 Another key finding of the draft paper showed that losing even one low-cost grocery store can have a large impact on the number of food deserts in a community.69 The

recent closing of the lowest-cost supermarket in the area presented a new and additional challenge to healthy and affordable food for local residents. Further, in 2013, two Ralphs supermarkets closed in South Los Angeles. Because we do not have data on the impact of the closing of these supermarkets, it is not possible to determine the impact of their closure. However, the UPC study area also gained another healthy food resource in 2013. A local organization, Community Services Unlimited, launched a produce stand two blocks

from where one of the closed Ralphs was located.70 There were also two farmers markets in the study area that accepted CalFresh, one of which offered Market Match, a program that gives produce vouchers to shoppers using CalFresh.7 1 Although such farmers markets are important sources of healthy foods, they cannot replace or be compared to the availability of low-cost supermarkets.

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RESOURCES On HealthyCity.org Based on a search conducted using 211 data and other sources via www.HealthCity.org, there were approximately 166 existing environment and safety resources located in the UPC study area boundary, including transportation-related resources, police and fire

departments, nonprofit environmental agencies, parks and recreation areas, safety education programs and graffiti removal agencies.26

USC Community Programs USC supports a plethora of programs that promote and perpetuate a safer community. Provided are just a few of these programs. For a more complete list, please see Appendix 10. The Good Neighbors Campaign funds Peer Meditation USC University Park Campus. This meditation program teaches elementary school children mediation and conflict resolution with the goal of reducing community conflict and violence. Since 1996, USC Kid Watch has mobilized 800 volunteers each year to provide safe passage for more than 9,000 neighborhood children as they walk to and from school, local parks, museums and libraries, and other neighborhood areas. In partnership with USC Fire Safety and Emergency Planning, City of Los Angeles Emergency Management Department, and City of Los Angeles Fire Department, Kid Watch conducts Community Emergency Response Training for contingencies such as earthquakes and fires by building teams among the groups of community members.

Identified by Focus Group Members Environment and safety resources were least identified by focus group participants. They identified 12 resources, mostly located in the southeastern area of the UPC study area boundary, including nonprofit organizations and police agencies.

SOCIAL CAPITAL The UPC study area has a variety of community level social capital strengths, such as a strong nonprofit infrastructure, a resourcerich corridor, many longstanding community institutions and residents who want to be involved in their community’s growth. Many community-based organizations in the area involve local residents in collective action and community organizing. On the other hand, competing interests driving community development have contributed to an environment of distrust. Rebuilding mutual trust and improving communication and collaborative efforts should be a goal of future efforts. Connecting community members to the myriad resources and institutions that seek to serve them would be a step in that direction.

SOCIAL CAPITAL Lifting up resource strengths, improving communication, community engagement in civic matters and addressing barriers of community distrust will promote the community growth that residents and stakeholders envision. Social capital refers to the institutions, relationships and norms that shape the quality and quantity of a society’s social interactions, as well as the social networks and norms of reciprocity and trustworthiness that arise from them.72 , 73 The social capital of local

communities represents “mutually supportive institutions within a neighborhood that residents can turn to when the going gets rough”

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and “features of social organization such as networks, norms, and social trust that facilitate coordination and cooperation for mutual

benefit.”74 , 75 Trust among neighbors along with the willingness of neighbors “to intervene on behalf of the common good is linked to reduced violence.” 76

Specifically, disparities in social capital exist by age, race and ethnicity, and population density. Putnam73 found that generations following the World War II generation are less likely to participate in civic, religious, workplace and informal institutions, and rural and suburban areas have generally higher participation rates in these institutions compared to urban areas. Additionally, neighborhoods with less stability are less likely to have supportive networks of friends and neighbors and more likely to have lower involvement in civic organizations. Yet to build networks in a community, cross-group or bridging social capital has a stronger influence on Latino

participatory behaviors than within-group or bonded social capital.77 Considering that the UPC study area is overwhelmingly Latino and has a history of significant population change, this point is particularly relevant. As expressed in the call for more civic engagement, residents are seeking more communication and collaboration with law enforcement, elected officials, community members, schools and local institutions of higher education. When assessing social capital, we faced a major challenge because there were no data sources with census tract measures of social capital indicators such as sense of trust in neighbors, sense of mutual support, social networks and social norms. Thus, in this section we identified several proxies of social capital: length of residency in the neighborhood and number of nonprofit organizations per 1,000 residents. These are imperfect but the best available proxy indicators of social capital we could identify.

LENGTH OF RESIDENCY The probability of building social capital through the building of social networks increases with the length of residency in an area.78 The UPC study area has witnessed significant population shifts since 2000 that have resulted in more newcomers to the community than longstanding residents. As shown in Figure 4, the majority of residents recently moved into the study area during the last 10 years, with more than two thirds of current residents having moved into the area after 2000. The remaining one third of the population moved into the area in 1999 or prior, reflecting a significant longstanding residential population. Residents living in the community since 2010 mostly reside in the areas around USC and L.A. Live. As community improvements continue, it will be important to incorporate the strengths and needs of longstanding residents in addition to recent residents. 3%

Figure 4: Year Householder Moved into Housing Unit, 2008–2012 The chart shows the percentage of householders who moved into their current housing unit during specific time periods as a percentage of all householders. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

1%

6%

pre-1970 1970s 1980s 1990s

20% 69%

2000-12

During focus groups, longstanding community members expressed the desire to see more local residents participating in community efforts, revealing an opportunity to increase community engagement in local planning initiatives and participation in community

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fit Organizations per 1,000 Residents W 54Th St

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Map 14: Nonprofit Organizations per 1,000 Residents,Campus 2011 study area

1.1 2 3.2 5.8 42,750 This map shows the number of nonprofit organizations per 1,000 residents. Source: Nonprofit data from Internal Revenue Service (2011), population data from the U.S. Census (2010).

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programs and discussions. Community residents who participated in focus groups said they wanted more opportunities to be involved and see more of their peers involved in the community. They perceived some community members as not wanting to be involved for various reasons: “When we say community, it means coming together. …Some people don’t want to be involved or are afraid so they keep quiet.” This also related to reservations about helping one another: “I agree [about wanting to help] but you have to be careful how you step out on certain things. … Now you kind of take care of your little circle.” To help address and mitigate these concerns, both residents and stakeholders envisioned more resources that would help increase civic engagement and education: “While [it’s] a good idea to talk routinely, [we] need to educate communities on making change for themselves.” During focus groups, residents commented on how useful it had been to come together to discuss issues of concern and expressed interest in continuing such meetings with a focus on actions they could take to improve community conditions.

NONPROFIT ORGANIZATIONS Nonprofits foster civic engagement and build social capital for individuals associated with them. By increasing citizen participation in communities, nonprofits promote thriving communities and effective governance. A community with a high prevalence of nonprofits per capita is likely to have more social capital and subsequently greater opportunities for upward mobility. A strength of the study area is that it had a higher rate of nonprofit organizations per 1,000 residents than the city (see Table 18). Table 18: Nonprofits per 1,000 Persons

year

area

2011

Study Area

4.1

City of Los Angeles

3.0

Source: Nonprofit data from Internal Revenue Service (2011), population data from the U.S. Census (2010).

More nonprofits were located along the Figueroa Corridor and closer to downtown Los Angeles, although there were also concentrations of nonprofit organizations around UPC (see Map 14).

RESOURCES On HealthyCity.org Based on a search conducted using 211 data and other sources via www.HealthCity.org, there were approximately 172 social capital resources available in the study area vicinity and even more clustered at the northern part of the study area. These resources included advocacy organizations and programs, social and spiritual groups and organizations, arts and cultural venues, community centers, political organizations, philanthropic and volunteering organizations, and youth development and capacity-building organizations.

USC Community Programs USC supports programs and initiatives that work to build capacity among community agencies, strengthen leadership among community residents and bring community residents together to work on issues related to the neighborhood. Below are examples of USC programs that provide capacity-building support. For a more complete list, see Appendix 10. A Community Place is a student-run social service program providing meals, bus tokens, taxi vouchers and other resources to community residence.

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USC Galen Center Community Fund’s purpose is to provide a meeting and gathering space to local nonprofits and schools for events. The USC Community House is open to anyone in the USC neighborhood that wish to inquire about USC Civic Engagement Programs.

Identified by Focus Group Members Social capital resources were identified most often by focus group participants among all types of resources. They identified 27 resources with physical addresses. Fourteen resources were located in and dispersed throughout the study area. The resources identified included a local cafĂŠ, a school, nonprofit organizations, community centers and museums.

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COMMUNITY RESOURCES Several resources identified by residents and stakeholders in Map 15 represented an environment of organizations using many strategies to address multiple community conditions. Residents and stakeholders identified a variety of local resources overall. Yet there was a gap in the familiarity of residents and stakeholders with the range of nearby resources. For reference, see the varying degrees of resource awareness in Map 16. Residents shared a perception that the area is under-resourced. USC faculty and staff members identified programs closer to the university’s campus, acknowledging that “we know more about programs around where we work” or “only know what I do and [what] people I interact with [do].” Additionally, the more densely populated areas located toward the western border of the study area were located farthest from the resource corridor of Figueroa Avenue. Nevertheless, of the resources identified by focus group participants, those most often identified by residents and stakeholders were those that promote social capital. This suggests greater familiarity with organizations that promote social capital and reflects the many organizations in the study area that involve local residents in grassroots community organizing and increasing resident awareness and power in local decision-making and community development. The knowledge of representatives from community-based organizations about the work of various organizations and their participation in numerous issue-based networks positions them as experts on programs and resources available to the community. Such organizations serve as social capital assets by building local resident capacity for collective action and efficacy, increasing network and coalition building, and helping address the desire expressed by community residents in focus groups for more community involvement. This also suggests opportunities for further investment in efforts that connect community residents with the vast array of services and engagement opportunities that existing resources already offer. Stakeholders also discussed the gaps in coordination and collaboration among organizations and opportunities for improving these relationships. USC faculty and staff members discussed how improved coordination, collaboration and communication among local programs, services and organizations in the community would increase mutual awareness of what is going on in the community and at USC. As one USC faculty or staff person shared, “Capacity isn’t the issue; a number of organizations serve here but things are siloed. Strength (comes) when we can pull those together for a bigger purpose …and start seeing bigger gains. …Everyone coming together with common goals.” Community stakeholders recognized that trust must be built to promote and sustain effective collaboration, communication, mutual understanding and a general level of community growth that benefits all members instead of select groups. Focus group participants also raised the issue of distrust as a major barrier to communication and collaboration among community residents and between residents, community organizations and large local institutions, including USC. Community stakeholders and residents in particular said they viewed USC as being ideally positioned to serve as a community hub of information and resource sharing. Perhaps because of the central location of UPC between densely populated residential areas to its west and the line of organizational resources along the Figueroa Corridor, stakeholders proposed that USC should serve as a central location for information, resources and community gathering. This suggests an opportunity to improve communication and outreach from local organizations and institutions to community residents and improved communication between local institutions and community organizations.

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The map shows resources identified by focus groups. The resource symbols are colored according to which community condition(s) focus group participants stated they addressed. Resources assigned to more than one community condition W Slauson W Slauson Ave Ave are labeled. Each resource appears only once on the map. Source: Advancement Project HealthyCity Focus Groups (2014).

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Participants also felt that elected officials, civic leaders and local institutions could better connect with the community. Community residents shared their desire to see “more politicians coming to the area … spend[ing] more time in the community,” particularly that “the officials need to be involved, not just sending grunt soldiers out. People in the community don’t want to see just a one-time event.” They shared the importance of community members being “trained in civic participation … to know how to get things done … [and] know the most effective way to make change,” so that local community members can effectively connect to individuals who make key decisions that affect their lives or rise to become policy makers themselves. As one participant said: “Privileged folks get to talk to elected officials. [They get to] become elected officials. [We] need education about how government works.”

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S Main St

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RECOMMENDATIONS The section below summarizes community conditions identified in our analysis of primary and secondary data for the UPC study area, along with recommendations meant to draw on community strengths and address gaps in resources. The recommendations originated during discussions with resident and organizational focus groups and from input garnered from the community advisory board, faculty task force, university stakeholders and the study team. The focus groups and engagement with the community and faculty advisory boards also included a discussion of opportunities regarding the role that the University of Southern California and other stakeholders could play in addressing many of the community’s conditions.

ECONOMIC STABILITY The UPC study area is home to myriad economic resources and community-based organizations that address economic conditions such as lack of banking services, limited access to affordable housing and poverty. Although the proportion of families with children younger than 18 has decreased since 2000, the proportion of families with children younger than 18 living in poverty has increased. The community had a high job-to-worker ratio because it is home to the largest private employer in the city, USC, and other large employers such as the L.A. Live sports and entertainment district. Community residents, particularly those without a college education, struggle with the realities of unemployment. There are various burgeoning economic development projects that are designed to revitalize the area and will bring an influx of governmental and private funding to different parts of the study area, including President Barack Obama’s Promise Zones Initiative, the USC Village redevelopment project and the potential MyFigueroa revitalization project. In the past, economic development projects have been viewed as ignoring the voice of the most needy community residents and more likely to spur displacement instead of community growth for all community members. Recommendation 1. USC can serve as a nexus of research on strategies for economic inclusion that help low-income families to move out of poverty and benefit from the rapid development in the surrounding area. Recommendation 2. Local institutions should work jointly to increase investments in job development, workforce training and the local economy. Local employers should create entry-level pathways for community residents at varying educational levels to better access jobs at their company. Recommendation 3. In collaboration with elected officials and other stakeholders, community organizations should develop a joint effort to encourage community members’ participation in the planning and implementation of current and upcoming economic development projects in the area.

EDUCATION The UPC study area had above-average rates of licensed child care centers in the campus and downtown areas. Although many are improving, the majority of area elementary schools reported below average third-grade reading scores. Schools in and around the UPC study area have been successfully graduating more enrolled students than the school district overall and reported similar truancy rates as elsewhere in the district. The resident population was less likely to have a college education than

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in the city of Los Angeles as a whole, and community members have experienced challenges in securing formal living-wage employment in a university community with a high job-to-worker ratio. Recommendation 4. Local institutions of higher education should continue to prioritize and develop focused efforts on increasing use of evidence-based early childhood education strategies to improve school readiness among children living in the local community. The USC-affiliated Head Start program should be encouraged to conduct research on school readiness of children served, how the program affects school readiness among children served, and how gains in school readiness may be improved and further enhanced in the early elementary school years. Recommendation 5. USC can serve as a nexus for research on the use of child care services by local residents. Such research should provide information about the populations served by local child care services, assess the quality of services, and identify strategies to support and improve child care services for local residents. Recommendation 6. Local institutions, parents and community partners should collaborate to develop programs that inform parents of their rights at the school site pursuant to state law and build an environment that promotes parental engagement and advancement of student education. Recommendation 7. In collaboration with community stakeholders, USC should continue efforts to (a) inform and engage community members in existing USC education service programs in order to increase participation among local residents and their children and (b) support programs that enhance engagement with recent high school graduates and link them to fulfilling education and employment options with a focus on career development.

HEALTH AND HEALTH CARE There is a wide range of health resources and services in the UPC study area. The study area had above-average rates of federally qualified health clinics. Yet about four in 10 residents in the UPC study area did not have health insurance, versus between two and three in 10 residents in the city of Los Angeles. Although there was a high rate of FQHCs, residents described cost and quality of health care and doctor shortages as challenges. Recommendation 8. Local educational institutions, community organizations, foundations and health care entities should conduct research to (a) better understand the impact of the Affordable Care Act on health insurance status among local community residents, (b) identify cost and quality barriers faced by residents in accessing health insurance and health care under the Affordable Care Act, and (c) identify strategies for improving access and use of preventive health care services. Recommendation 9. Community agencies in collaboration with elected officials should develop strategies to better inform community members about available health resources in the area.

NEIGHBORHOOD AND BUILT ENVIRONMENT There are parks in the area, which could be programmed, developed and made safer to be more inviting to community. Other open spaces such as Exposition Park also exist. Yet overall, the community has minimal park space when compared to park space availability for other parts of the city.

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Violent crimes have declined in the UPC study area, and residents highlighted the university’s success in keeping its campus safe as a potential means of addressing safety concerns for the area as a whole. Yet violent crime rates remained high in the study area compared to the city. Further, child abuse and neglect allegation rates were very high. Residents said they care about healthy diets and desire to see more healthy food options and fewer fast food establishments. The overabundance of fast food and dearth of healthy food options represented a major concern among residents. Recommendation 10. Local community agencies, elected officials and educational institutions should develop initiatives to (a) further increase access, safety and programming of existing parks in the local area, (b) increase bike lanes and improve sidewalks, (c) identify ways to use Exposition Park as another local green space to promote physical activity, such as the addition of a walking path and play areas, and (d) collaborate with owners of local vacant lots to revitalize them into park space and community gardens. Recommendation 11. USC can serve as a nexus of research to (a) identify the underlying conditions fueling the high rates of child abuse allegations and (b) test preventive evidence-based strategies that can be taken to scale in the community. Recommendation 12. USC, city officials and local community members work to (a) identify a nearby feasible location for the development of a large supermarket offering affordable healthy food,(b) incentivize other affordable healthy food retailers and local farmers markets to locate in the local area, (c) coordinate and support more community and home gardening programs, and (d) improve consumer education about healthy eating.

SOCIAL CAPITAL Myriad organizations and resources call this community home; indeed, a strength of the study area is its high rate of nonprofits per capita in comparison with the city of Los Angeles. Community-based organization representatives in particular know about the various programs and organizations that exist to serve the community and are part of various issue-based networks. However, among local residents, familiarity with community resources varied, suggesting a need for increased communication and outreach about programs. Community residents were aware that there were more resources than they were familiar with and USC faculty and staff members described not being as familiar with local resources. Currently there is a perception of mistrust that deters collaboration between local institutions and community-based organizations. There is a concentration of resources in some parts of the study area. Figueroa Corridor reflects a resource-rich avenue, with many organizations located on or near this thoroughfare. Many residents live in areas of the community located near the western border of the study area, farther away from Figueroa Corridor. Recommendation 13. Community organizations, elected officials and local educational institutions should develop strategies to enhance social capital including those that seek to (a) increase mutual trust and accountability, (b) collect and disseminate information about services and programs available, including those available through USC, to local residents to ensure optimal use of such services by community residents, (c) increase safe spaces for community engagement and collaborative partnerships driven by the community that enhance unity among local groups, institutions and community residents and address community needs, and (d) better connect densely populated residential areas located on the borders of the study area to the Figueroa Corridor and the other areas in which resources are concentrated.

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ADDITIONAL RECOMMENDATIONS FOR USC During focus groups and meetings of the community advisory board and faculty task force, participants identified additional recommendations related to USC’s role in improving community conditions and addressing community needs. The recommendations fall under five major themes. Widen education access to community members. Focus group participants recommended that USC work to increase higher education pathways for local community residents. This includes deeper connections to local community colleges, investing in scholarships for local residents to attend USC, and increasing educational support programs and services for local residents. In addition, USC faculty and staff members expressed their desire to see USC double its efforts to increase community access to the university events and programs. Increase USC involvement with the community. The community advisory board and faculty task force members and community-based organization focus group participants recommended that USC further expand its learning community beyond the campus to programs and services through service-based learning courses, options for community members to take courses without matriculation, and systematically and universally integrating university student internships at local community-based organizations into curriculum requirements. Plan a future for the neighborhood together. Focus group participants recommended that USC develop a mechanism, such as a Community Advisory Council comprised of local residents and local stakeholders, to jointly create an agenda, set priorities and leverage its position as a major local institution to achieve these priorities on an ongoing basis. This should include creating a process and specific roles for local community organizations and residents to be involved in guiding community initiative investments in the study area, such as those made through the Good Neighbors Campaign. Improve information dissemination to the local community. Focus group members indicated a need to create effective mechanisms to inform local residents of the programs available to them through USC such as those from the Good Neighbors Campaign and other existing educational programs for children and youth. One idea proposed is that USC develop a staffed space at the USC Community House that could serve as a community hub where local residents can obtain information about such available resources. Prioritize workforce development. Focus group participants recommended that through USC’s leadership, local institutions should work to increase investment in jobs, training, workforce development and the local economy. Faculty task force and community advisory board members recommended that large local employers such as USC create entry-level pathways for community residents at varying educational levels to better access jobs at the university.

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ENDNOTES 1

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2

Simpson, K. (2012, February 15). The great migration: Creating a new Black identity in Los Angeles. KCET. Retrieved from http://www.kcet.org/socal/departures/columns/ portraits/the-great-migration-creating-a-new-black-identity.html 3 Medina, J. (2012, April 24). In years since the riots, a changed complexion in South Central. The New York Times. Retrieved from http://www.nytimes.com/2012/04/25/us/ in-south-los-angeles-a-changed-complexion-since-the-riots.html 4 Pastor, M., & Prichard, M. (2012). L.A. rising: The 1992 civil unrest, the arc of social justice organizing, and the lessons for today’s movement building. Los Angeles, CA: University of Southern California, Program for Environmental and Regional Equity. Retrieved from http://dornsife.usc.edu/pere/larising/ 5 6 7 8

U.S. Census Bureau. (2010). Census 2010, summary file 1, table DP-1. Generated by Advancement Project via www.healthycity.org U.S. Census Bureau. (2000). Census 2000, summary file 1, table DP-1. Generated by Advancement Project via www.healthycity.org U.S. Census Bureau. (2012). 2012 American Community Survey 5-year estimates, table DP04. Generated by Advancement Project via www.healthycity.org Hess, D. B. (2005). Access to employment for adults in poverty in the Buffalo-Niagara region. Urban Studies, 42, 1177–1200. doi:10.1080/00420980500121384

9

Boschmann, E. E., & Kwan, M.-P. (2010). Metropolitan area job accessibility and the working poor: Exploring local spatial variations of geographic context. Urban Geography, 31, 498–522. doi:10.2747/0272-3638.31.4.498 10 11

Ong, P., Firestine, T., Pfeiffer, D., Poon, O., & Tran, L. (2008). The state of South LA. Los Angeles, CA: UCLA School of Public Affairs.

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12

USC Village. (n.d.). Economic impact. Retrieved from http://villagearchive.usc.edu/information/economic-impact/

13

Stoll, M. A. (2004). Geographic skills mismatch, job search, and race (Discussion Paper No. 1288-04). Los Angeles, CA: Institute for Research on Poverty. Retrieved from http://www.irp.wisc.edu/publications/dps/pdfs/dp128804.pdf

14

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16 17

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21

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26 27

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Rhode Island Kids Count. (2004). State profiles: School readiness indicators and lessons learned. Providence, RI: Author. Boethel, M. (2004). Readiness: School, family, & community connections. Austin, TX: Southwest Educational Development Laboratory. Lara-Cinisomo, S., Pebley, A. R., Vaiana, M. E., & Maggio, E. (2004). Are L.A.’s children ready for school? Santa Monica, CA: RAND Corporation.

Stagner, M., Goerge, R., & Ballard, P. (2009). Improving indicators of child well-being. Chicago, IL: Chapin Hall at the University of Chicago.

32

Isaacs, J. B. (2012). Starting school at a disadvantage: The school readiness of poor children. Washington, DC: Brookings Institution. Retrieved from http://www.brookings. edu/research/papers/2012/03/19-school-disadvantage-isaacs

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34

Social Impact Research. (2010). School readiness. Boston, MA: Root Cause. Retrieved from http://www.rootcause.org/docs/Resources/Research/School-Readiness/ School%20Readiness-%20Social%20Issue%20Report.pdf

35

Speilberger, J., Gouvêa, M., & Rich, L. (2012). Improving school readiness: A brief report from the Palm Beach County Family Study. Chicago, IL: Chapin Hall at the University of Chicago. Retrieved from http://www.chapinhall.org/research/report/improving-school-readiness-brief-report-palm-beach-county-family-study

36

HealthyCity. (2011). Save my seat. Retrieved from http://www.savemyseatla.org/

37

California Department of Education. (2012). 4-year adjusted cohort outcome data processing. Retrieved from http://data1.cde.ca.gov/dataquest/cohortrates/ CohortOutcomeDefinitions2012_4_30.doc

38

Child Trends. (2013). High school dropout rates: Indicators on children and youth. Bethesda, MD: Author.

39

Yeide, M., & Kobrin, M. (2009). Truancy literature review. Washington, DC: U.S. Department of Justice.

40

Hillemeier, M., Lynch, J., Harper, S., & Casper, M. (2004). Data set directory of social determinants of health at the local level. Atlanta, GA: Centers for Disease Control and Prevention. Retrieved from http://www.cdc.gov/dhdsp/docs/data_set_directory.pdf

41

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42

Alliance for Excellent Education. (2003). The impact of education on: Health & well-being. Retrieved from http://all4ed.org/wp-content/uploads/2003/11/The-Impact-ofEducation-on-health-and-wellbeing.pdf

43

National Dropout Prevention Center/Network. (n.d.). Economic impacts of dropouts. Retrieved from http://www.dropoutprevention.org/statistics/quick-facts/ economic-impacts-dropouts

44 45

California Department of Education. (2013). Truancy. Retrieved from http://www.cde.ca.gov/ls/ai/tr/ University of Southern California. (2012). USC Family of Schools. Retrieved from http://uscfamilyofschools.com

46

Braveman, P., & Egerter, S. (2013). Overcoming obstacles to health in 2013 and beyond. Retrieved from Robert Wood Johnson Foundation website: http://www.rwjf.org/ content/dam/farm/reports/reports/2013/rwjf406474

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U.S. Department of Health & Human Services. (2014). Access to health services. Retrieved from http://www.healthypeople.gov/2020/topics-objectives/topic/ Access-to-Health-Services

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49

National Association of Community Health Centers. (n.d.). Delivering quality: The health center model of primary care. Retrieved from http://www.nachc.org/aaa-statistics. cfm

50

White House. (n.d.). Health care that works for Americans. Retrieved from http://www.whitehouse.gov/healthreform/healthcare-overview

51

Kaiser Family Foundation. (2012). The uninsured and the difference health insurance makes. Retrieved from http://kff.org/health-reform/fact-sheet/ the-uninsured-and-the-difference-health-insurance/

52

U.S. Department of Health & Human Services. (2013). Affordable Care Act rules on expanding access to preventive services for women. Retrieved from http://www.hhs.gov/ healthcare/facts/factsheets/2011/08/womensprevention08012011a.html

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Covered Calilfornia. (2014). Milestone enrollment numbers released by Covered California and Department of Health Care Services. Retrieved from http://news.coveredca. com/2014/01/milestone-enrollment-numbers-released.html

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U.S. Department of Health & Human Services. (2013). AHRQ activities to reduce racial and ethnic disparities in health care. Retrieved from http://www.ahrq.gov/research/ findings/factsheets/minority/index.html

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Centers for Disease Control and Prevention. (2011). Fact sheet: Health disparities in potentially preventable hospitalizations. Retrieved from http://www.cdc.gov/minorityhealth/reports/CHDIR11/FactSheets/Hospitalization.pdf

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HEALTH SCIENCES CAMPUS STUDY AREA COMMUNITY HISTORY AND DEMOGRAPHICS COMMUNITY CONDITIONS n Economic Stability n Education n Health and Health Care n Neighborhood and Built Environment n Social Capital

COMMUNITY RESOURCES RECOMMENDATIONS

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COMMUNITY HISTORY AND DEMOGRAPHICS The Health Sciences Campus (HSC) study area is located in the Northeast region of the city of Los Angeles, three miles northeast

of downtown and seven miles from the University Park Campus.1 The study area is physically split by the 5 and the 10 freeways, with the latter bisecting the area into two almost equally sized sections. The Health Sciences Campus itself is situated just north of the 10 freeway and just east of the 5 freeway. The study area encompasses parts of several Los Angeles neighborhoods including Boyle Heights, East Los Angeles, El Sereno and Lincoln Heights.2 See Map 17 for an illustration of the HSC Study Area.

The history of the HSC study area is rich, with some of the neighborhoods dating back to the 1800s,3 and thus has experienced a significant amount of change over time. Historically, many of the neighborhoods in the HSC study area have been havens for new immigrant communities.4 These neighborhoods have experienced several major demographic shifts, reflecting some of the broader regional trends in migration.

Over time, communities such as Boyle Heights have been home to several waves of new immigrant populations, including Jewish-Americans, Japanese-Americans, Russian-Americans and, most recently, Mexican-Americans.5 Many of the new immigrant communities were drawn to

the area because of its affordability in comparison to surrounding areas and its proximity to downtown. As new immigrant communities settled into the neighborhoods in the HSC study area, they became established over generations. Some segments of the population moved out of the area neighborhoods as part of the process of becoming upwardly mobile. Others stayed in the communities and cultivated roots. As a result, many of the residents in these neighborhoods have a strong sense of connection to place and neighborhood identity that spans generations. Currently, there is another shift happening: As the rapid and intense investment in and development of the downtown Los Angeles area grows, many people are finding themselves priced out of the downtown area and are looking to the neighborhoods adjacent to downtown for reprieve from the high costs of housing and living. The influx of new prospective residents into the neighborhoods in the HSC study area is a point of tension for current and long-term residents, who fear being priced out themselves if the demand for housing continues to grow exponentially in comparison to the available housing stock. The HSC study area is unique in many ways. According to the 2010 Census, the area was home to 124,285 people,6 an increase of 4,000 individuals since 2000.7 Residents are predominantly Latino (90%) and of Mexican descent,7 and 26% of HSC total population lives in

linguistically isolated households where no one in the household aged 14 or older speaks English well or very well.8 The community is younger

than the city of Los Angeles; however, youths younger than 18 comprised 34% of the study area population in 2007 and only 31% in 2010,6

indicating a declining share of the total population. The Pat Brown Institute report Boyle Heights: A Brief Demographic and Health Profile found that the Latino community in the HSC study area is getting older and is following the overall aging trend seen in the United States and most Western nations. As the median age in the study area increases, different services will be needed. Although the racial and ethnic composition has changed little since 2000,9, 10 fewer Latino immigrants moved into the area, increasing the percentage of the Latino population that is

native-born rather than foreign-born. In terms of educational attainment, a driver of economic prospects and health outcomes, approximately 25% of study area residents have completed some college education or more, which is half the rate of the city of Los Angeles (55%).8

When bringing these neighborhoods together under the umbrella of the HSC study area, the complex interplay between history, identity, politics and realities of lived experiences in the area as a whole is important to keep in mind as a contextual background to the forthcoming discussions in this report.

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H IG H L AND PARK

E C H O PA R K Cypress Park

M ONTEC I TO HEI GHTS r

Los Angeles River Center & Gardens

St

N

low er SF

ue El Serreno Recreation Center

Daly St

SB

SG

St Valley B

lvd

St 5

LAC+USC Medical Center

d nR

Hazard Park

Ma

M

ren go S

t

City Terrace Dr

10

State St Playground

St oto

Ave ree n t St

Evergreen Playground

St

oto

E 3Rd St

5

Map 17: Health Sciences Campus Study Area Source: Neighborhood name data from the Los Angeles Times Neighborhood Project (2010), parks data from GreenInfo (2013) and Google Maps (2014), public transit data from Los Angeles County Metropolitan Transportation Authority (2012).

NEIGHBORHOOD Park LA Metro

Lafayette Park

Wilshire Blvd

KO R E ATOW N Irolo St

Macarthur Park

W8 Th

St

U S C S TA T E O F T H E N E I G H B O R H O O D R E P O R T H A RVA R D H E I G H TS

W Pico Blvd

SA lva rad o

70

E Normandie Playground

PIC O - UNIO N Ven i

ce

usc_son_hsc_1e.indd 70

W St

nio

Seoul International Park W Olympic Blvd

WE ST L AK E

nA ve

lvd

S Downey Rd

er B

Obregon Park

Euc l

itti

id A ve

SS

Wh

E Cesar E Chavez Ave

N Gage Ave

E 1S

St

St

E Vernon Ave

E4 Th

EAST LOS ANGELES

N Indiana St

Hollenbeck Park

S Boyle Ave

ARK

C E N T R A LA L A M E DA

B OYL E HEI GHTS

Aliso Pico Recreation Center E 4Th St

S Central Ave

Avalon Blvd

rt Lindsay Park

e Pomeroy Av

Ave

NE ver g

Blv d

NS

NB rso n

Hooper Ave

effe

sh

Ave oyl e

SS EJ

Wa ba

SL ore na

ffith

101

Gri

an

C T R AL

Ave

Ped ro S

t

Marengo St

SU

N

io iss

N Eastern Ave

Blv d

S Eastern Ave

ton

Lincoln Park

Hazard Ave

ing

L INCOLN HEI GHTS

N Main St

CH I NATOW N 6T h

EL SERENO

Th E9

D OWNTOW N E1

Griffin Ave

N Broadway

ro ad w

ran

ay

Elysian Park

26

dA ve

en Av

St

d oR

lvd

St

St

and

6T h

4T h

n Fer

ic B

W

5T h

W

W

an NS

mp

Wa sh

h k

St

ea ud

St

W

Oly

1St

ry

Av e

W

Rose Hills Park

Heritage Square

N M Hun iss tin ion gt Rd on D

t

SB

W6 Th

igu

NF CY PRE S S PARK

Rd S

N Eastern Ave

Vista Hermosa Natural Park

W3

Ernest E Debs Regional Park

t

aS ero

W Washington Blvd

Blv d Toberman 4/6/15 7:18 PM Recreation Center

L.A. Live


COMMUNITY CONDITIONS ECONOMIC STABILITY The resources available, planned and needed in the HSC study area present an opportunity to connect existing strengths in the community with the needs felt by its residents. Connecting existing and future economic development opportunities with residents’ needs can improve economic outcomes and quality of life for all members of the community. Residents who participated in our study acknowledged links between economics and other community conditions. They identified issues such as lack of employment opportunities, limited job training and limited workforce development programs as pressing and tied these issues to an overall lack of investment in capital, programs and local services. Additionally, the Health Atlas, which compares the economic conditions across Los Angeles, shows that the Boyle Heights Community Plan Area has the

second highest score on the Hardship Index, representing a high level of economic hardship.11 However, by connecting existing strengths in the community, new and innovative opportunities may emerge to tackle some of these complex and entrenched issues.

POVERTY Although poverty rates decreased somewhat during the last decade, poverty rates were much higher compared to the city of Los Angeles. For the purposes of this study, we measured poverty following a commonly used method: poverty thresholds. The U.S. Census Bureau

calculates poverty thresholds that do not vary geographically, but are updated for inflation using the Consumer Price Index (CPI-U).12 These thresholds consider only pretax income and do not include noncash benefits such as Medicaid or Supplemental Nutrition

Assistance Program benefits.12 These are similar to but distinct from Department of Health & Human Services poverty guidelines,

which determine eligibility for public programs and benefits.13 Many have made the connection between poverty and poor outcomes. Researchers have found that children in poverty are almost twice as likely to be reported in fair to poor health and that their families

are more than twice as likely to experience violent crime.14 Living in poverty has also been found to be related with fewer choices and

opportunities, a lack of access to resources, and greater insecurity and discrimination.15 The effects of poverty go beyond just those mentioned here, making it a critical driver to examine in this type of needs assessment.

Although poverty itself was not directly raised as a major concern in focus groups, residents addressed contributing factors such as lack of steady income as pressing concerns. Spanish-speaking residents voiced a sentiment that people “rely on applying for welfare” due to difficulty finding steady employment. In this report, we examined the measure of families with children younger than 18 living in poverty. It is important to note that we chose this measure because it focuses on local families and excludes college students who likely have incomes below the poverty threshold but do not have children. Focus group participants highlighted employment issues as a main contributing factor to poverty. Table 19: Families with Children in Poverty as a Percentage of all Families with Children year(s) area

2000 2008–12

Study Area

40.6%

34.2%

City of Los Angeles

25.3%

25.2%

Source: U.S. Census 2000 Table QT-P35, American Community Survey 2012 5-Year Estimates Table S1702.

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4.2

11.4

20.7

32.9

Health Sciences Campus study area

(%)

100

Health Science Community

Av e

W

a ro

St

N

6

SG

dw ay

N Broadway

Daly St

ro a SB

S Th E9

NM

ain

t

E1

d nR

sio

is NM

St

Valley B

lvd

St ton

oto

ing

5

NS

Wa sh

St

6T h

NM

e2

ran dA ve

u en Av

lvd

W

ic B

St

Rd

mp

St

n do

Oly

6T h

St

na Fer

W

4T h

5T h

an NS

W

W

St

ue Fig

SB

ea ud ry

St

1St

N Eastern Ave

t

N H iss unt ion ing Rd ton Dr

Rd S

Griffin Ave

W3

Blv d

Ma

ren go S

t

10

EC

esa

rE

Ch

ave z

Ave

er B

St na ore SL

E 3Rd St S Downey Rd

itti

id A ve

E Vernon Ave

Wh

N Indiana St

Ave ree n

St

SE ver g

E4 Th

Hazard Ave

NB

NS

oyl e

oto

St

Ave

Ave

E 4Th St

Hooper Ave

S Central Ave

Families w/ Children in Poverty Euc l

lvd

60

No Data

0

4.2

11.4

20.7

32.9

100

(%)

University Park Campus study area

No Data

0

4.2

11.4

20.7

32.9

100

(%)

Health Sciences Campus study area

5

Map 18: Families with Children in Poverty as a Percentage of all Families with Children, 2008–2012

University Park Community

St

Dr NM N Broadway

Ave

dw ay

SB

Blv d

ro a

ran dA ve

pic

SG

lym

St

N Eastern Ave

Av e SB

nio nA ve

lva ra

Staples Center

6T h

d oR and

W

6 e2

4T h

Th

u en Av

St

N

St

u Fig

W

W

U S C S TA T E O F T H E N E I G H B O W R 5H O OSt D R E P O R T

EO Ven ice 72 usc_son_hsc_1e.indd Blv d

oa er

St

n Fer

do

St

1St

an

72

St

W

SU

W8 Th

W6 Th

t

N H iss unt ion ing Rd ton

Rd S

aly St

W3

Macarthur Park

ea ud ry

Lafayette Park

NS

mpic Blvd

Health Science Community

The map shows families with related children younger than 18 whose income during the previous 12 months was below the census poverty threshold as a percentage of all families with related children younger than 18 by census tract. To create this map, Los Angeles County census tracts were grouped into even fifths based on reported rates of families with children in poverty. Census tracts with darker colors had higher percentages of these families in poverty. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

SA

Avalon Blvd

sh

N Gage Ave

Ave ffith

Wa ba

Gri

Ped ro S an SS

101

E 1St St

dale etery

Marengo St

t

Blv d

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The HSC study area has a significantly higher poverty rate (34.2%) than the city of Los Angeles (25.2%; p < .01), according to American Community Survey 2008–2012 estimates (see Table 19). It should be noted that the rate of families in poverty in the HSC study area decreased roughly seven percentage points, from 41% in 2000, whereas the Los Angeles poverty rate remained unchanged at 25% of families during the same time period.

ACCESS TO EMPLOYMENT There were two workers for every job in the study area, and a high proportion of residents without a bachelor’s degree made employment a challenge for many. Access to employment refers to the geographical proximity of workers to jobs that match their skill set, in addition to access to a reliable mode of transportation to work.16 Access, by this definition, varies largely in relation to the income level of families and

individuals, which affects where they live and the mode of transportation they can afford to take to and from work. Low-income people face many barriers to employment. Their job skills and educational background are often limited, and they must often depend

on unreliable transportation due to financial constraints.17 Commute distances and employment opportunities are linked to the levels

of economic hardship faced by low-income people.18

One way to explore the employment picture in the study area is to examine the unemployment rates of adults age 25–64 based on their educational attainment levels. As Table 20 shows, people without a college education had a higher incidence of unemployment than people with some college education or more. Table 20: Unemployed Persons Age 25–64 as a Percentage of the Civilian Noninstitutional Labor Force by College Education, 2008–2012

college education

area

None

Some College or More

Study Area

12.2%

9.0%

City of Los Angeles 11.1%

8.9%

There is no comparable 2000 Census table. Source: American Community Survey 2012 5-Year Estimates Table B23006.

It is useful to parse out this age group to help separate local residents from most persons enrolled at local universities, because most undergraduate students will be younger than 25 and most graduate students and faculty members older than 25 will have bachelor’s degrees. Map 19 shows how unemployment varied by census tract for people without a college education in the study area, and shows pockets of high unemployment north and south of the campus. Employment data confirmed the perception of one Spanish-speaking resident “that there are not a lot of jobs in the community.” The measure of job-to-worker ratio by earning level shows the number of jobs available for each worker, with a worker defined as someone employed with positive earnings during the current and preceding quarter as reported to the U.S. Census Bureau and Local Employment Dynamics partner states.19

U.S. Census Bureau figures confirmed this perception by illustrating that the job-to-worker ratio in the study was lower than at the city level. Within the study area, those sections with the highest income and earnings bracket also had the highest job-to-worker

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84

92

88

95

Health Sciences Campus study area

(%)

100

Health Science Community W St le mp Te

ea ud ry

a ro

St

N

NM N Broadway

SG

dw ay

S

6

Flo ran we dA rS ve t

e2

SB

Daly St

ro a

lvd

u en Av

ic B

W

mp

St

Rd

6T h

St

St

n do

W

4T h

5T h

na Fer

W

St

ue Fig

an NS

W

Oly

1St

SB

Gle

S Th E9

NM

t

ain

E1

Valley B

lvd

St

ing

ton

oto

Wa sh

St

6T h

d nR

sio

is NM

St

5

NS

St

Av e

nda le B lvd

W

N Eastern Ave

t

N H iss unt ion ing Rd ton Dr

Rd S

Griffin Ave

W3

Blv d

Health Sciences Campus ren go St

Ma 10

ffith

Wa ba

esa

rE

Ch

ave z

Ave

er B

St na

E 3Rd St S Downey Rd

itti

SL ore

Wh

id A ve

E Vernon Ave

N Indiana St

Ave ree n

St

SE ver g

E4 Th

Hazard Ave

NS

oyl e NB

EC

E 4Th St

Hooper Ave

S Central Ave

Ave

oto

St

Ave

Gri

SS

sh

N Gage Ave

Ave

101

E 1St St

Employment Rate with Some College lvd

Euc l

Avalon Blvd

Marengo St

t Ped ro S an

Blv d

60 60

0

84

88

92

95

100

(%)

University Park Campus study area

0

84

88

92

95

100

(%)

Health Sciences Campus study area

5

Map 19: Employment Rate with No College Education, 2008–2012

versity Park CommunityThe map shows people ages 25 to 64 without any college education who are employed as a percentage of all people ages 25 to 64 without any college Health Science Community Blv d

W

St

NM N Broadway

ve

ay Br oa dw

SF

SG

ran

dA ve

low

er

do lva ra

26

SA

ue

Blv d

St

Rd

pic

St

o and

lym

6T h

n Fer

Staples Center

W

5T h

N Eastern Ave

SB

4

en Av

W

N Hu n ion ting Rd ton

ea ud

N

iss

ry Av e

lvd le B nda

St

St

W

SU

a ro

ue Fig

an

St

1St

U S C S TA T E O F T H E NWE I GThHSt B O R H O O D R E P O R T

EO Ven usc_son_hsc_1e.indd 74 ice B

W

NS

74

St

Gle

St

nio nA ve

W6 Th

t

Dr

Rd S

ly St

SR

W3

Macarthur Park

W8 Th

St

am

ple

par t

m Te

Lafayette Park

education by census tract. To create this map, Los Angeles County census tracts were grouped into even fifths based on reported employment rates. Census tracts with darker colors had higher percentages of people ages 25 to 64 without any college education who were employed. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

4/6/15 7:19 PM


ratio, as shown in Table 21. However, it is important to note that a high job-to-worker ratio does not necessarily translate to jobs for local residents because such high-income jobs are open to nonresidents as well. The highest job-to-worker ratio was found in the earnings bracket for incomes greater than $3,333 per month, but as Table 21 illustrates, that ratio decreased from 1.3 in 2002 to 0.9 in 2001. This means there were 1.3 primary jobs in this earnings bracket for every worker with earnings at the same level in 2002, before it declined in 2011. The number of primary jobs available in the study area was even lower in the low- and mid-range earnings brackets, which indicates less than one job per worker at those income levels. Job-to-worker ratios were lower in the area where USC is located across all three income-levels. Table 21 demonstrates that there were roughly two local workers for each local job at all earnings levels in the HSC study area, essentially twice the number of local workers than jobs across income levels. Table 21: Job-to-Worker Ratio by Monthly Earnings, 2002 and 2011

less than $1,250/mo

$1,250 to $3,333/mo

over $3,333/mo

area

2002

2011

2002 2011

2002 2011

Study Area

0.5

0.6

0.5

0.5

1.3

0.9

City of Los Angeles

0.97

1

1.04

1

1.33

1.4

Source: U.S Census Bureau, Center for Economic Studies, Longitudinal Employer-Household Dynamics (2002 and 2011).

ACCESS TO HOUSING Although median rent was lower in the HSC study area than in the city of Los Angeles, the compounding issues of unemployment and poverty made housing unaffordable. Housing is an immobile good that is bundled with neighborhoods and services. Where a person or family lives is linked to their exposure to crime and access to employment, services, schools, and fire and police protection. It is the largest expenditure of

consumers, after food and medical care.20 Access to housing refers to the availability of high-quality affordable housing units. For housing to be considered affordable, no more than 30% of household income should be spent on housing.21 High-quality

housing is housing that is not substandard or has conditions such as mold, dampness, inadequate plumbing, inadequate ventilation, pest infestations, overcrowding and other housing conditions linked to negative health outcomes. Negative health outcomes associated with substandard housing conditions include “respiratory infections, asthma, lead poisoning, injuries� and poor mental health outcomes.22

We considered median rent, rental housing protected by the Rent Stabilization Ordinance, and length of residence, which is also indicative of social capital. The study area median rent was roughly $922, which is lower than city’s median rent of $1,156 (see Table 22). Still, housing was not affordable for residents, and more than half of them spent more than 30% of their monthly income on housing, a threshold that denotes rent as a cost burden.11 Residents reported overcrowding and unfair rental pricing as major housing issues directly tied to the inability of residents to afford better housing options. For example, focus group participants reported that multiple families or generations live together in overcrowded housing and landlords charge rent per person, rather than per unit. Residents said they felt that homeownership opportunities are decreasing. They overwhelmingly voiced the need for and interest in increasing programs and services related to the homeownership process to increase opportunities for homeownership for local residents.

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989

1,305

1,131

1,629

2,001

Health Sciences Campus study area

($)

Health Science Community W St le mp Te

ea ud ry

a ro

St

N

St

ue Fig

St

NM

ve aA

den

a Pas

N Broadway

SG

dw ay

S

6

Flo ran we dA rS ve t

e2

SB

Daly St

ro a

lvd

u en Av

ic B

W

mp

St

St

Rd

6T h

n do

W

4T h

5T h

na Fer

W

an NS

W

Oly

1St

SB

Gle

S Th E9

NM

t

ain

E1

Valley B

lvd

St

ing

ton

oto

EW ash

St

6T h

d nR

sio

is NM

St

5

NS

St

Av e

nda le B lvd

W

N Eastern Ave

t

N H iss unt ion ing Rd ton Dr

Rd S

Griffin Ave

W3

Blv d

Ma

ren go S

t

esa

rE

Ch

ave z

Ave

itti

St na ore

E 3Rd St

S Santa Fe Ave

100

989

100

989

lvd

Euc l

Median Rent er B

S Downey Rd

Wh

SL

E 7Th St

id A ve

E Vernon Ave

N Indiana St

Ave ree n

St

SE ver g

E4 Th

60

ic B lvd 1,131

1,305

1,629

2,001

($)

University Park Campus study area

1,131

1,305

1,629

2,001

($)

Health Sciences Campus study area

E Ol ymp

5

Hazard Ave

EC

N Gage Ave

NB

NS

oyl e

oto

Ave

E 4Th St

Hooper Ave

S Central Ave

sh

St

Ave

Ave ffith Gri

nt Ave

SS

Wa ba

E 1St St

Map 20: Median Rent in Unadjusted Dollars, 2008–2012

versity Park Community t Bl vd

W

St

SF

ve aA

den

a Pas

N Broadway

SB

ro ad

SG

wa y

ran d

Av e

low

er

lva rad o SA

26

Blv d

St

ue

pic

St

d oR

lym

6T h

d nan Fer

Staples Center

W

NM

4

5T h

N Eastern Ave

N Hu n ion ting Rd ton

ry ea ud SB

W

iss

Av e

lvd le B

N

en Av

nio

St

St

W

SU

a ro

ue Fig

U S C S TA T E O F T H E NWE I GThHSt B O R H O O D R E P O R T

EO Ven usc_son_hsc_1e.indd 76 ice B

1St

an

76

W

NS

St

St

nA ve

St

t

Gle nda

W6 Th

Dr

Rd S

ly St

SR

W3

Macarthur Park

W8 Th

St

am

ple

par

m Te

Lafayette Park

Health Science Community

The map shows median gross rent by census tract. Median gross rent divides the gross rent distribution into two equal parts: one half of the cases falling below the median gross rent and one half above the median. Gross rent is the contract rent plus the estimated average monthly cost of utilities (electricity, gas, and water and sewer) and fuels (oil, coal, kerosene, wood, etc.) if these are paid by the renter (or paid for the renter by someone else). To create this map, Los Angeles County census tracts were grouped into even fifths based on median rents. Census tracts with darker colors had higher median gross rents. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

ve

Avalon Blvd

Marengo St

t Ped ro S

101

Pleasa

an

Blv d

10

4/6/15 7:19 PM


Table 22: Median Rent in Unadjusted Dollars, 2008–2012 years area

2008–12

Study Area

$922

City of Los Angeles

$1,156

There is no comparable 2000 Census table. Source: American Community Survey 2012 5-Year Estimates Table B25064.

In Los Angeles, renters in units with a certificate of occupancy issued prior to or on October 1, 1978, are protected from “excessive rent increases” under the Rent Stabilization Ordinance (RSO).23 Given this context, renter-occupied units constructed in 1979 or earlier were used as a proxy for rent-controlled or rent-stabilized units. Rent-controlled units can be viewed as a protective factor to help low-income families who are renters to address issues of potential displacement due to rapid changes in rental rates in their communities. By looking at the percentage of rental units that were built before 1980, we can gain an understanding of approximately how many rental units in Los Angeles are protected from rapid increases in rent. Table 23: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units year(s) area

2000 2008–12

Study Area

86.9%

81.1%

City of Los Angeles

80%

75.9%

Source: U.S. Census 2000 Table H036, American Community Survey 2012 5-Year Estimates Table B25036.

In the HSC study area, 81.1% of renter-occupied units were built prior to 1980, and therefore are protected by the RSO (see Table 23). This level of protected housing stock is higher than at the city level and thus represents a valuable community asset that can help maintain a balance in the overall inventory of affordable housing stock in the study area. At the same time, however, residents cited a recurrence of unfair renting practices in which landlords raised rents or changed rental agreements without advance notice to renters. Another challenge identified by stakeholders was the desire to maintain or decrease the level of density in the study area, which affects parking, trash and safety. Overall, participants view the enforcement of the RSO protections, renter’s rights and homeownership as priority housing-related issues in the study area.

ACCESS TO CAPITAL Banks were sparse outside of downtown and local businesses and nonprofit representatives cited a lack of investments in local business development. Access to capital refers to the physical proximity between residential areas to banks and other mainstream financial institutions and to conditions that might incentivize or restrict individuals from using traditional financial and banking services. It is also tied to financial literacy. A lack of access to formal banks “imposes high costs on basic transactions, creates barriers to homeownership, reduces

opportunities for retirement planning, and interferes with the ability of small businesses to develop and grow.”24 Immigrant popula-

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84.8

91.9

Health Sciences Campus study area

100

Health Science Community W St le mp Te

N

St

NM

ve aA

den

a Pas

N Broadway

SG

dw ay

S

Flo ran we dA rS ve t

6

SB

Daly St

ro a

lvd

e2

ic B

u en Av

6T h

St

St

Rd

mp

4T h

5T h

n do

W

W

W

N H iss unt ion ing Rd ton

ea ud ry

St

St

na Fer

Oly

a ro

ue Fig

an NS

W

S Th E9

NM

t

ain

E1

Valley B

lvd

St

ing

ton

oto

EW ash

St

6T h

d nR

sio

is NM

St

5

NS

es er

1St

SB

Gle

St

Av e

nda le B lvd

W

N Eastern Ave

t

Dr

Rd S

Griffin Ave

W3

Blv d

Ma

ren go S

t

Marengo St Wa ba

sh

Ave

oto

St

oyl e NB

Ch

St

itti

RSO

E 3Rd St

Euc l

er B

lvd

1.5

64.7

77.0

84.8

91.9

100

1.5

64.7

77.0

84.8

91.9

100

60

S Downey Rd

Wh

SL ore

na

St

SE ver g

E Vernon Ave

Hazard Ave

Ave

Ave

ave z

ree n

Hooper Ave

E4 Th

rE

N Gage Ave

esa

E 4Th St

id A ve

Avalon Blvd

S Central Ave

EC

N Indiana St

E 1St St

Ave

NS

Ave ffith Gri

Ped ro S

t

nt Ave

SS

101

Pleasa

an

Blv d

10

University Park Campus study area

5

Health Sciences Campus study area

Map 21: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units,

University Park Community 2008–2012 Blv d

W

St er low

ve aA

den

a Pas

N Broadway

ay oa dw

SF

dA ve

ran SG

N Eastern Ave

ea ud SB

SU nio

St do lva ra

26

SA

ue

St

t

en Av

Blv d

6T h

hS

St

Rd

pic

5T h

W

lym

Staples

W

W

o and

usc_son_hsc_1e.indd 78 Ve

N

St

NM NH iss unt ion ing Rd ton

St

U S C S TA T E O F T H E N E I G H B O R H O O D R WE 4PT O R T

EO

a ro

ue Fig

n Fer

Blvd

1St

ry Av e

lvd le B nda

Gle

St

nA ve

Irolo St

W

an

78

St

t

NS

W Olympic Blvd

W6 Th

Dr

Rd S

t

SR

W3

Macarthur Park

W8 Th

St

am

ple

par t

m Te

Lafayette Park

hire Blvd

Health Science Community

The map shows percentage of rent-stabilized units by census tract. Tracts with darker colors had higher percentages of such units. To create this map, Los Angeles County census tracts were grouped into even fifths based on the percentage of rent-stabilized units. Source: American Community Survey 2012 5-Year Estimates Table H036

4/6/15 7:19 PM


tions tend to depend primarily on the informal or alternative financial services sector, especially in terms of cashing checks, sending

remittances and paying bills.25 Economic disparities also factor into the location of mainstream financial institutions and can create areas that lack banks and mainstream financial access.24 In a review of the literature regarding financial exclusion, Joassart-Marcelli

and Stephens found that several scholars documented financial exclusion from mainstream financial services as a spatial phenomenon affecting and compounding issues of economic hardship faced by poor and minority populations.24

In terms of financial services, community-based organization staff members called this community a “bank desert” and reported “a big void in lending to this area,” even to well-established local businesses. An analysis of bank locations confirmed the lack of retail banking. There were more than 10 check-cashing businesses south of the 10 Freeway in the Boyle Heights and East Los Angeles areas but only 12 banks in the entire study area. Table 24 shows that Los Angeles has about 3.5 times as many banks per capita as the HSC study area. Table 24: Banks per 10,000 Persons

year

area

2012 2014

Study Area

0.9

0.5

City of Los Angeles

2.7

1.9

Source: DeLorme Street Atlas (2012 and 2014), population estimates from Esri (2012 and 2014).

Although banks were sparse in the study area, the amount and concentration of bank facilities increased west of the Los Angeles River in downtown Los Angeles (see Map 22). This is not surprising considering downtown is a major employment center with newer and more expensive housing. Residents expressed a need for financial literacy programs and services for both small business owners and residents. Community representatives said they view small businesses as resources that provide training and workforce development to youths and employment for local residents. However, as one community-based organization staff member said, “There may be businesses that have been here for 20 years and cannot access lending.” Therefore, investments in entrepreneurial capacity building, financial literacy and lending for small businesses would improve economic conditions in general for the community. Residents also identified changing the external perceptions of nonresidents of a “lack of safety” or stigma about the community to increase local business investment.

RESOURCES On HealthyCity.org A review of the economic resources listed with the County of Los Angeles’ 211 system and other sources via www.HealthyCity. org revealed approximately 24 economic resources within or along the study area boundary. The resources ranged from institutions that provide basic needs (e.g., food and housing), consumer services (e.g., money management and tax services), income support and employment, organizational or community services (e.g., community economic development agencies and social services government agencies), and bank institutions. These findings support the concern expressed by focus group participants that there is a general lack of economic support in the community, as evidenced by the limited amount of resources that were identified through the focus groups and www.HealthyCity.org. See Appendix 5 for a detailed description of the categories used to identify economic resources. The findings also suggest that residents may not be aware of all of the available economic resources.

USC Community Programs USC Office of Civic Engagement’s Health Sciences Campus Community Partnerships (USC HSC CP) was established to serve as a mechanism through which the university acquires neighborhood input and disseminates information to the surrounding community

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Health Sciences Campus study area

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Health Sciences University Park Campus area Campusstudy study area

5

Health Sciences Campus study area

Map 22: Banks per 10,000 Persons, 2014

University Park Community The map shows number of banks per 10,000 residents by zip code. Zip codes with darker colors had more banks per 10,000 residents. To create this Science Community map, Los Angeles County zip codes were grouped into even fifths based on banks per 10,000 people. Zip codesHealth with darker colors had higher median

t

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usc_son_hsc_1e.indd 80 Venic eB Rosedale

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gross rents. Source: Bank data from DeLorme Street Atlas (2014), population data from ESRI (2012).

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and build relationships across sectors in and outside of the university. In addition to USC HSC CP initiatives, there are a variety of existing programs that link community residents and youth to potential career paths. For a more complete list, see Appendix 10. The Health Sciences Campus Community Partnerships has launched a “Jobs at USC” awareness initiative, using a mobile computer technology van to link local residents in Boyle Heights, Lincoln Heights and El Sereno to employment opportunities at USC. In 2014, 145 job seekers were trained by USC’s Talent Management department to provide advice on entry-level pathways, conduct effective online job searches, set up an account to apply for jobs at USC and successfully complete job applications. In the 1970s, USC’s School of Medicine founded Medical Organizing, Counseling and Recruiting Programs (MED-COR) which improves and nurtures the motivation, dedication and academic skills of 40 Latino, black and other under-represented students at Bravo High School who are interested in health-related careers, including medicine, nursing and allied health. USC Concurrent Enrollment Program provides information on career opportunities in allied health occupations for high school students. This program offers certified nursing curriculum simultaneously with general education requirements while completing high school. Engineering for Health Academy prepares high school students, including under-represented minorities, for careers in biomedical engineering with firsthand laboratory experience.

Identified by Focus Group Members The HSC study area focus group participants identified 11 economic resources that included chambers of commerce, financial institutions and nonprofit organizations, with only nine of them located within or along the study area boundary. Although small businesses were not identified in this exercise, they were considered resources and seen as opportunities to invest in the community. Yet, focus group participants were not aware of about half of the other economic resources in the study area identified via HealthyCity.org as noted above.

EDUCATION Education conditions in the HSC study area present a conflicting picture. Some schools in and around the study area fared better than the Los Angeles Unified School District, but in other areas, local schools fared worse. One community-based organization staff member expressed worry about the pathway from education to employment, stating that there is no “safety net” for students after high school. The need for vocational training and workforce development for students also highlighted the urgency felt by families with regard to financial pressures and the decision to stay in school or drop out to find employment.

SCHOOL READINESS Although there has been improvement in school readiness during the previous decade among study area children, they continued to be less prepared than the average Los Angeles Unified School District student. School readiness refers to the preparedness of young children to participate in and derive maximum benefit from kindergarten. Because kindergarten lays the foundation for success in all levels of school, school readiness is a critical benchmark.26 School readiness is a

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0

12.6

18.6

26.5

39.5

100

(%)

0

12.6

18.6

26.5

39.5

100

(%)

Health Sciences Campus study area

t

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ay

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Health Sciences Campus study area

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Map 23: Children 0–5 with Licensed Child Care Seats, 2013 t

t

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U S C S TA T E O F T H E N E I G H B O R H O O D R E P O R T SB

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aS ero The map shows the percentage of children ages 5 or younger iguwith a licensed child care space in their zip code of residence. Zip codes with darker F N colors had higher percentages of these children with a licensed child care seat. To create this map, Los Angeles County zip codes were grouped into even fifths based on the percentage of children with a licensed child care seat. Source: California Department of Social Services Community Care W Licensing Division1S (2013).

Th E9 St

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fixed standard of physical, intellectual and social development required for kindergarten that sits within the larger domain of readiness to learn—the developmental level at which an individual has the capacity to learn specific material. A child’s readiness for school is connected with the school’s readiness for that child and the capacity of families and communities to provide developmental opportunities.27 Recent research has shown that children do not need to reach a specific age of maturity before they are ready to learn; readiness

is more a function of an exposure to learning opportunities.28

Children with higher levels of school readiness have more self-confidence, higher self-esteem and a lower chance of being involved in crime or violence29 or teen pregnancy.30 School-ready children are less likely to drop out of high school and

earn more as adults,31 which benefits society by increasing worker productivity and government revenue through taxes,

while reducing costs for special education services and social services.29 Children who get off to a good start in kindergarten maintain that advantage as they progress through school, because the most powerful predictor of academic performance is previous academic performance.28

Families in the study area encountered challenges with access to child care, a contributor to school readiness. There is a demonstrated link between high-quality child care and children’s cognitive, language and social development.32 In the study area, less than 14% of

children ages 0–5 had access to a licensed child care seat, compared to 20% of Los Angeles children younger than 6 (see Table 25). A lack of quality and affordable child care can be an obstacle to parental employment and child development. Additionally, budget cuts at the state level during the past several years have disproportionately affected subsidized child care seats, disproportionately affecting lower-income families.33

Table 25: Percentage of Children Ages 0–5 with a Licensed Child Care Seat

year

area

2009 2013

Study Area

12.5%

13.8%

City of Los Angeles

18.1%

20.2%

Source: Community Care Licensing Division (2009 and 2013), population estimates from Nielsen Claritas (2009) and (Esri 2013).

Map 23 illustrates that access to child care varied even within the boundaries of the study area. The western half of the study area had less access whereas neighborhoods in the eastern half, like Lincoln Heights and Boyle Heights, had better access to child care. Although it is hard to pinpoint an ideal number of licensed child care seats for the study area, the disparity between local, city and state level access and cuts to subsidized care indicate this area could benefit from more affordable licensed child care. Due to the difficulty of obtaining standardized indicators of school readiness across the city and in the study area, reports on the

subject have suggested using early grade reading proficiency, which is also a predictor of future school success.24 , 25 The percentage of third-graders in and around the HSC study area public schools scoring advanced or proficient on English language arts exams lagged behind that of Los Angeles Unified School District third-graders. For the 2012–13 school year, 40% of district third-graders scored proficient or higher on the exam (see Table 26), up from 21% in 2003–04.36 Of 20 schools offering third grade in and

around the study area, only Multnomah Street Elementary School (55%) had more proficient and advanced third-graders as a share of all third-graders than the district as a whole.

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Table 26: Third-graders Scoring Proficient or Advanced on English Language Arts Exam, 2012–2013 Multnomah Street Elementary

55%

Evergreen Avenue Elementary

25%

Los Angeles Unified School District

40%

Breed Street Elementary

23%

Gates Street Elementary

39%

23%

First Street Elementary

36%

Farmdale Elementary Extera Public†

Second Street Elementary

36%

Sheridan Street Elementary

23%

Utah Street Elementary

34%

William R. Anton Elementary

21%

Griffin Avenue Elementary

33%

Robert F. Kennedy Elementary

20%

Murchison Street Elementary

30%

Belvedere Elementary

19%

Malabar Street Elementary

30%

Bridge Street Elementary

11%

Harrison Street Elementary

26%

Academia Semillas del Pueblo†

7%

Euclid Avenue Elementary

25%

23%

This table shows the percentage of third-graders scoring proficient or advanced on the English language arts exam (California Standards Tests) for schools in the UPC study area and LAUSD overall. Schools in red are in the USC Family of Schools. Schools with crosses have addresses in the study area; schools without crosses have 20% or more of attendance boundaries in the study area. Source: California Department of Education (2012–13).

This pattern remained the same when comparing test data for the 2003–04 school year. Overall, higher-performing elementary schools were located north of the 10 Freeway. Portions of El Sereno, Lincoln Heights and Boyle Heights had more third-graders scoring proficient or advanced than the rest of study area. It is noteworthy that the data show a promising upward trend. The district and all but one school in the study area improved by this measure between 2004 and 2013. Among the focus groups, parents acknowledged a lack of involvement in their child’s education and the importance of additional engagement. They cited language barriers and competing work- and family-related demands on time.

ACADEMIC ACHIEVEMENT Residents voiced a strong desire for more workforce development and vocational training for high school graduates. The California Department of Education defines high school dropouts as students who “leave the 9-12 instructional system without a high school diploma, GED, or special education certificate of completion and do not remain enrolled after the end of the 4th year.”37 Risk factors for dropout are characteristics that increase the likelihood a student will become a dropout and not graduate from high school. One such risk factor, the truancy rate, is defined by the department as the percentage of students missing more than 30 minutes of instruction without an excuse three times during a school year.38 Researchers have found truancy particularly useful because it also functions as a risk factor for substance abuse, poor health, gang involvement and criminal activity.39, 40

Educational attainment, defined as the “years or level of overall schooling a person has,” affects an individual’s ability to obtain a well-paying job and factors significantly into their health outcomes.41 Additionally, studies have shown that higher educational

attainment is linked to longer life expectancy.41 With this in mind, various measures of academic achievement were identified to explore the interplay between education and well-being in the study area. One such variable was the high school graduation rate, because it is the most common measure of academic achievement used by researchers to understand the link between education and health.42 “High school graduates live longer, are less likely to be teen parents, produce healthier and better educated children, and

rely less on social services.”43 Dropping out of high school exacts a toll on society and the individual. Economic effects include lost individual earnings and tax revenue loss due to unemployment and low-wage employment, as well as costs associated with higher crime rates.44 Seventy-five percent of state prison inmates and 59% of federal prison inmates did not complete high school.44

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For all of these reasons, this analysis examined high school graduation rates and middle school truancy rates as one risk factor for dropping out of high school. Public high schools in and around the HSC study area had better high school graduation rates than district schools, as demonstrated in the data on high school graduation in Table 27. During 2011–2012, high schools in the HSC study area generally graduated more students as a percentage of all students enrolled than the district as a whole. Among 19 area schools with grades 9 through 12, all but two high schools reported graduation rates above the Los Angeles Unified School District graduation rate of 66.6% Table 27: High School Graduation Rate, 2011–2012 Francisco Bravo Medical Magnet High†

94.3%

Academy of Medical & Health Sciences at Roosevelt High

89.8 %

Anahuacalmecac International University Preparatory High†

89.5 %

Academy of Environment & Social Policy at Roosevelt High

89.1 %

Math, Science, & Technology Magnet Academy at Roosevelt High†

88.2 %

James A. Garfield Senior High

84.7 %

Engineering and Technology Academy at Esteban E. Torres High No. 3

83.3 %

E. Los Angeles Performing Arts Academy at Esteban E. Torres High No. 1

81.2 %

School of Science, Technology, Engineering and Math at Roosevelt High

79.2 %

Woodrow Wilson Senior High

78.5 %

Abraham Lincoln Senior High

75.7 %

School of Engineering and Technology

75.0 %

Humanitas Academy of Art and Technology at Esteban E. Torres High No. 4

74.4 %

E. Los Angeles Renaissance Academy at Esteban E. Torres High No. 2

73.3 %

Social Justice Leadership Academy at Esteban E. Torres High No. 5

72.6 %

Humanitas Art School at Roosevelt High

69.8 %

School of Law & Government at Roosevelt High

68.9 %

Los Angeles Unified School District

66.6 %

Theodore Roosevelt Senior High

53.4 %

Felicitas and Gonzalo Mendez High

48.6 %

This table shows high school graduation rates for schools in the HSC study area and the Los Angeles Unified School District. The four-year adjusted cohort high school graduation rate is calculated by dividing the number of students in the four-year adjusted cohort who graduate in four years or less with either a traditional high school diploma or an adult education high school diploma or have passed the California High School Proficiency Exam by the number of students who form the adjusted cohort for that graduating class. Schools in red are in the USC Family of Schools. Schools with crosses have addresses within the study area; schools without crosses have 20% or more of attendance boundaries in the study area. Source: California Department of Education (2011–12).

This information from the California Department of Education surprised most focus group participants, who said they felt that area schools were not doing well in terms of graduation rates. The discord here could be due to under-reporting of student outcomes based on mobile students or a gap between perceptions and the actual situation. Disparities in graduation rates between types of students, such as English learners and native English speakers, could also be a source of local parental perceptions. This analysis is an overview and did not examine that level of detail, which could be an area for future research. The two high schools that had lower graduation rates than the district, Roosevelt High School and Mendez Learning Center for Mathematics and Science, are in the Boyle Heights neighborhood. In recent years, these high schools split into smaller, more specialized magnet schools. The state graduation rate formula changed in 2009, making data trending difficult for previous years.

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Although 55% of the population older than 25 had some college education or more at the city level, the figure was less than half that amount (25%) in the study area (see Table 28). This is a significantly (p < .01) smaller proportion of residents with this level of educational attainment than in the city as a whole. Stakeholders felt that this reflected a gap between high school preparedness and barriers to postsecondary employment and college education options. Participants across all study area focus groups said they felt that local universities and community colleges play a key part in achieving this vision, helping to support and expand postsecondary workforce options, readiness and training that allow for higher educational attainment. Table 28: Persons Age 25 or Older Attaining Some College or More as a Percentage of all Persons Aged 25 or Older year(s) area

2000 2008–12

Study Area

17.3%

25.1%

City of Los Angeles

49.2%

55%

Source: U.S. Census 2000 Table QT-P20, American Community Survey 2012 5-Year Estimates Table B15003.

Despite the positive comparison to the district and positive trends, participants voiced the sentiment that graduation rates were still too low and contributed to difficulties finding employment after high school. Residents also strongly recommended changes to the alternative school system, which is meant to help those who do not graduate. Focus group participants were concerned with post-high school education and training. Community-based organization staff members stated that there is no education safety net after high school and graduates are unprepared to enter the workforce. Focus group participants also expressed concern that a lack of vocational training and limited access to community colleges, due to overcrowding and cost, have limited opportunities for economic self-sufficiency for recent high school graduates. One Spanish-speaking parent stated, I have a 19-year-old in [community] college and sometimes he can’t get classes because they are full or are not being offered. He sometimes comes back to me and tells me that he is just going to look for a job and start working. I don’t let him. Real and perceived limited opportunities create an environment in which students lose motivation or incentives to increase levels of educational attainment, including postsecondary education. Although focus group participants did not specify the HSC as an education resource, there are clearly opportunities for strengthening postsecondary resources and support to youths in the study area. Participants also spoke of the need for culturally relevant educators who can better work with students and parents for whom English is not a native language. Other challenges discussed included the need for more youth programming, safer schools and highly qualified teachers. Spanish-speaking residents also requested more adult English as a Second Language courses, so they can be more involved in their children’s education and improve their employment options. There are clear opportunities to convene local community-based organizations to work together on developing strategies to bolster career and college readiness. Another education indicator, school truancy, is a marker of school connectedness and an early indicator of whether a student will graduate or drop out of school. The California Department of Education reports middle school truancy rates for schools in and

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around the study area. It defines a truant student as “a pupil subject to compulsory full-time education or to compulsory continuation education who is absent from school without a valid excuse three full days in one school year or tardy or absent for more than a 30-minute period during the school day without a valid excuse on three occasions in one school year, or any combination

thereof.”38 Truancy rates are associated with school connectedness and are often an early warning sign of low academic achievement and dropout. Middle schools in the study area have outperformed the Los Angeles Unified School District in terms of truancy rates. Fourteen of the 18 schools in and around the study area offering sixth, seventh or eighth grades had lower reported truancy rates than the district (see Table 29). Table 29: Middle School Truancy Rate, 2010–2011 Xinaxcalmecac Academia Semillas del Pueblo† 1.1

Evergreen Avenue Elementary

23.8

Murchison Street Elementary

Robert F. Kennedy Elementary

24.0

11.8 † Ramona Opportunity High 14.0

Breed Street Elementary

24.6

Utah Street Elementary

30.8

Malabar Street Elementary

15.8

Los Angeles Unified School District

43.9

Second Street Elementary

17.8

El Sereno Middle

61.9

William R. Anton Elementary

18.3

Hollenbeck Middle

64.0

Sheridan Street Elementary

19.3

Belvedere Middle

Huntington Drive Elementary

19.9

66.1 † Central Juvenile Hall 180.3

Harrison Street Elementary

21.7

Extera Public† -

11.2

First Street Elementary

This table shows the truancy rate for schools in the HSC study area and the Los Angeles Unified School District. The data includes only schools that offer sixth, seventh or eighth grades. Schools in red are in the USC Family of Schools. Schools with crosses have addresses in the study area; schools without crosses have 20% or more of attendance boundaries in the study area. Source: California Department of Education (2010–11).

Perhaps echoing this finding, local parents did not express concern about this issue. In the study area, no real geographic pattern emerged; the four schools with higher truancy rates were not clustered. It should be noted that the district-wide rate, with more than two in five students being truant, does not serve as a gold standard and is presented for comparison only.

RESOURCES On HealthyCity.org Based on a search conducted using 211 data and other sources via www.HealthCity.org, there were approximately 86 education resources located in the study area. They were mostly located on the west side of the community, with the northeastern area having the fewest resources. The resources ranged from schools, colleges and universities, child care centers, arts and cultural agencies, youth development agencies, and occupational and professional associations. See Appendix 5 for a detailed description of the categories used to identify education resources. Focus group findings suggest that residents were not aware of all of the local education resources available.

USC Community Programs The following are select examples of USC community education programs. For a more complete list, see Appendix 10. The USC Penny Harvest, implemented by Civic Engagement’s Health Sciences Campus Community Partnerships fosters in elementary students the personal qualities that prepare them to be civically-engaged members of society. While it supplements core classroom lessons in areas such as persuasive writing, oral presentation and mathematics, The USC Penny Harvest also integrates concepts of empathy, leadership and advocacy. Through the combination

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and refinement of these attributes, more than 2,200 students in elementary schools in Boyle Heights and South Los Angeles are taught to contribute to their community’s greater dialogue on addressing its most pressing needs. The USC Health and Science Fair is an annual program through which 350 fifth-grade students from Griffin, Murchison and Sheridan Street elementary schools learn science and health concepts from graduate students in USC’s Keck School of Medicine and Pharmacy. The fifth-graders are not only exposed to advanced health and science topics, but the mentorship of USC students also provides them with insight and guidance about setting academic and career goals in pursuit of these fields.

Identified by Focus Group Members Focus group participants identified 15 education resources, with 12 within or along the study area boundary. Tellingly, none of the focus groups identified the HSC as an education resource. Most education resources were identified south of the 10 Freeway and none was identified near the northeastern part of the boundary in the El Sereno neighborhood. The resources that were identified included high schools, a community college, community organizations and centers, and public libraries. The number of education resources identified by focus groups participants is much smaller than those actually available, indicating the need for effective approaches to dissemination of such information to local residents.

HEALTH AND HEALTH CARE Health is an important issue for the HSC study area and was defined in a comprehensive way that included health care but also the relationships between health and a series of other existing factors. For example, we considered the relationship between issues such as access to healthy foods, safe outdoor activity space, the built environment and economic factors, and explored the barriers and opportunities created by the interplay of all these issues and its impact on positive health outcomes. Despite the paradoxical situation in which one of the neighborhoods in the

study area had the highest rate of childhood obesity in the city,11 the HSC area is nonetheless rich in health-related resources, with a high rate of federally qualified health centers (FQHCs) and several major hospitals. The answer to the paradox may very well lie in the concerted efforts by various community agents to make the necessary connections between these existing resources and the needs identified in the community.

ACCESS TO HEALTH CARE High rates of uninsured, limited health literacy, lack of awareness of health resources and the unique needs of undocumented community members arose as prominent local health-related issues. Increased access to health care is associated with less disease, disability and deaths; and better physical, social and mental outcomes, including longer life expectancies.45 For this study, we examined access to health care using three measures: FQHCs per 10,000

residents, uninsured persons and the preventable hospitalization rate per 1,000 persons. Having health insurance is the first step to accessing health care. People without insurance are less likely to have access to basic care and have a 25% higher mortality rate than

insured persons.46 This means that conditions go undetected and untreated longer than experienced by insured individuals, one consequence being a preventable hospitalization. There is evidence that FQHCs are effective at providing care in underserved areas and to populations who might otherwise not have access. “Patients in underserved areas served by Health Centers [including federally funded Federally Qualified Health Centers and non-federally funded clinics] had 5.8 fewer preventable hospitalizations per 1,000 people over three years than those in areas not served by a Health Center.” 47

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There was a high rate of residents in the HSC study area who are more likely to experience a lack of health insurance compared to residents in the city of Los Angeles (see Table 30). Table 30: Percentage of Persons without Health Insurance years area

2008–12

Study Area

33.7%

City of Los Angeles

25.8%

There is no comparable 2000 census table. Source: American Community Survey 2012 5-Year Estimates Table S2701.

In much of the community, more than one in five residents did not have health insurance (see Map 24). In the four neighborhoods that overlap the study area boundaries (El Sereno, Lincoln Heights, Boyle Heights and East Los Angeles), portions of Boyle Heights and East Los Angeles had higher percentages of residents without health insurance compared to the study area as a whole. The Affordable Care Act promises to improve access to health care48 and potentially to a regular source of care,49 an essential step

toward improving quality and use of preventative health services.50 Important parts of the health care infrastructure, including

providers, clinics, hospitals, nonprofits and others, will need to increase capacities to serve additional patients. Some populations may remain uninsured, however, including homeless, unemployed, undocumented and linguistically isolated populations. People working part-time, seasonally or in small businesses also may not gain insurance. Although the timing of this report did not allow us to assess how the Affordable Care Act has affected access to care among study area residents, there is reason to suspect that the Affordable Care Act’s efforts to insure the uninsured may not have equitable uptake in the HSC study area. First, recent reports have indicated that California is well behind other states in enrolling residents in health care

coverage, particularly among Hispanics.51 Second, Hispanics, who constitute the largest percentage of study area residents, have historically had the highest rates uninsured populations. Our data, which indicated high percentages of uninsured persons in the study area prior to the Affordable Care Act, suggest that the number of uninsured may remain high even after Affordable Care Act implementation. Further assessment of the impact of the Affordable Care Act on local residents’ access to health insurance is needed to inform future targets for health insurance outreach efforts by foundations and other health equity organizations. Within this policy context, HSC study area residents would be a prime beneficiary of enrollment because of persistently low rates of coverage. This is critical considering that small businesses have a strong presence in this community and serve as primary sources of employment. Noting that available estimates of the uninsured may be an underestimate, one Spanish-speaking resident stated, “I did a community survey and found that a lot, over 50% of people I surveyed, did not have any type of health care access and services. That is too much.” If the number of uninsured remains high in this community, outreach efforts by foundations and health equity organizations will be needed. More generally, focus group residents regarded the implementation of the Affordable Care Act somewhat skeptically due to the lack of coverage for undocumented persons. They expressed a desire for increased health literacy programs and better coordination of care delivery. In terms of quality of care, residents spoke of a need for better coordination among health care providers. Shortages of providers in surrounding areas and changes due to the Affordable Care Act have resulted in a need for improved coordination, increased funding and more culturally relevant programming. Participants said they felt that even residents who access local health services are still not receiving quality care.

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0

10.8

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Map 24: Percentage of Population without Health Insurance, 2008–12

Health Science Community

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The map shows uninsured persons as a percent of the total population by census tract. The census tracts with darker colors had higher percentages of persons without health insurance. To create this map, Los Angeles County census tracts were grouped into even fifths based on rates of uninsured. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

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FEDERALLY QUALIFIED HEALTH CENTERS A second indicator of access to care is availability of federally qualified health centers. Focus group data showed that both community-based organization staff members and residents identified lack of clinics and hospitals in the area as another important indicator, but data showed five hospitals and more than twice as many FQHCs per capita than in the city (see Table 31). However, HSC faculty and staff members described a lack of culturally relevant health care services, a perceived shortage of health care services and a lack of quality care in the area. Table 31: Federally Qualified Health Centers per 1,000 Persons

years

area 2008–12 Study Area

6.9

City of Los Angeles

3

Source: Department of Health & Human Services (2012), population estimates from Esri (2012).

As community-based and patient-directed health care delivery sites, these centers serve populations with limited access to health care, including low-income populations, the uninsured, those with limited English proficiency, migrant and seasonal farmworkers, individuals and families experiencing homelessness, and those living in public housing. In essence, FQHCs are designed to serve the type of demographic found in the HSC study area. In the community, Lincoln Heights appeared to have less coverage by FQHCs than other parts of the study area. This may simply be a result of Lincoln Heights having more residential and fewer commercial areas. Ultimately, these data do not indicate the capacity of health centers to respond to residents’ needs or how accessible they may be to residents based on opening hours, languages spoken and other capacities. We cannot assess the level of awareness residents have of the clinics other than whether or not they were identified by focus groups. However, the perceived lack of health care resources and the call for more access to health care raised across focus groups indicate one or more of these issues may be at play. Related to concerns about quality and access of care is a concern regarding undocumented community residents, who are excluded from insurance coverage through the Affordable Care Act and are particularly likely to be unaware of resources. Focus group participants reported a need for more culturally competent health care, which would benefit this predominantly Latino and Spanish-speaking community. Additionally, concerns arose regarding a worsening shortage of health care options due to a perception that the Affordable Care Act will decrease funding for clinics and hospitals based on an assumption of less demand for safety-net health services as more people gain health insurance. The decrease in funding could limit the quantity and quality of health care options for undocumented residents and others who remain uninsured. However, this study area likely has more residents who will remain uninsured and so local FQHCs and other safety-net services will likely continue to see high demand.

PREVENTABLE HOSPITALIZATIONS A third indicator of access to health care is the rate of preventable hospitalizations. Access to health care also includes preventive and outpatient care through which chronic and other conditions are managed. The preventable hospitalization rate provides a measure of access and use of preventive care. In this report, we set the parameter for preventable hospitalizations to include admissions for several

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.71

Health Sciences Campus study area

14.59

W Avenue 28

Health Science Commu-

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ue Fig

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N H iss unt ion ing Rd ton

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Map 25: Federally Qualified Health Centers per 10,000 Persons, 2012 The map shows the number of FQHCs per 10,000 residents by zip code. Zip codes with darker colors had a higher number of FQHCs per 10,000 residents. To create this map, Los Angeles County zip codes were grouped into even fifths based on FQHC rates. Markers showing the locations of the hospitals in the area were added to the map. Source: FQHC data from the U.S. Department of Health & Human Services (2012), population data from ESRI (2012), hospital data from Office of Statewide Health Planning and Development (2012).

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usc_son_hsc_1e.indd 92

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conditions, such as diabetes with short-term and long-term complications, asthma, hypertension and other routinely treatable conditions.52 On a national level, there are disparities across race and ethnicity in rates of preventable hospitalizations. A report published

by the Centers for Disease Control and Prevention in 2011 demonstrated that the rate of preventable hospitalizations is higher among African-Americans and Latinos than non-Latino Whites.53 In the study area, which features a predominantly Latino population, the rate of preventable hospitalizations was 12.81 per 1,000 residents—slightly higher than the city’s preventable hospitalization rate of 12.22 per 1,000 residents (see Table 32). Table 32: Preventable Hospitalizations per 1,000 Adults

year

area

2011 2012

Study Area

14.4

12.8

City of Los Angeles

12.8

12.2

Source: Office of Statewide Health Planning and Development (2012), population estimates from Nielsen Claritas (2011) and ESRI (2012).

As Map 26 illustrates, the Boyle Heights neighborhood had a higher incidence of preventable hospitalizations than surrounding areas. This is particularly notable because this area houses several medical centers. When presented with this data, an Englishspeaking resident and campus faculty and staff members described low usage of preventive care and unique barriers to access for undocumented residents.

RESOURCES On HealthyCity.org A review of service data from 211 and other sources via www.HealthyCity.org showed approximately 57 health resources available in the study area boundary, which suggests a lack of knowledge of many of these resources among community residents. These resources included eldercare and mental health services, government agencies (e.g., health department divisions for aging adults and HIV/AIDS programs), hospitals, health care centers and public health agencies. The resources were evenly scattered in all areas of the boundary, with the exception of the northeastern corner (north of the 10 Freeway), which had very few health resources.

USC Community Programs USC HSC has the availability of health professionals and renowned researchers from multiple disciples. As a result, USC HSC offers an extensive list of health related programs. Provided below are only a few examples. Please see Appendix 10 for a more complete list. Keck Medicine of USC has launched NortheastLAHealth! (www.nelahealth.com) a program of the Dean’s Community Leadership Council. This program is a network of local clinics, including FQHCs and community clinics in My Health LA to improve access for communities around USC’s HSCs to free and low-cost high quality health care, including for those who don’t qualify for Covered California. The Ramona Gardens Women’s Health initiative launched in 2014, provides culturally-tailored, evidence-based health education and health care access to 350 women and their families in the Ramona Gardens area. Classes are taught by promotoras/lay health advisors, providing information on cancer, heart disease and diabetes, and community members are linked to local health providers in the North East Los Angeles Health program, including prevention

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Map 26: Preventable Hospitalization Rates per 1,000 Adults, 2012

k Community

Health Science Community

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d

The map shows the number of preventable hospitalizations for people age 18 or older per 1,000 residents age 18 or older by zip code. Preventable hospitalizations included admissions for one of the following conditions: diabetes-related conditions, chronic obstructive pulmonary disease, asthma, hypertension, heart failure, angina without a cardiac procedure, dehydration, bacterial pneumonia or urinary tract infection. Persons hospitalized with more than one of these conditions were counted once per hospitalization. The zip codes with darker colors had more preventable hospitalizations per 1,000 residents. To create this map, Los Angeles County zip codes were grouped into even fifths based on rates of preventable hospitalizations. Markers showing the locations of the hospitals in the area were added to the map. Source: Office of Statewide Health Planning and Development (2012). ple

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resources such USC’s Fit Families exercise program and programs at the LAC+USC Wellness Center, in addition to finding ways to utilize the built environment to improve health such as walking paths at Hazard and Lincoln parks. The Good Neighbors Campaign funds Proyecto Jardín to establish a community garden at the LAC-USC Wellness Center in 2013 in collaboration with USC Norris Comprehensive Cancer Center. The program is part of a larger food justice collaborative for Boyle Heights, Lincoln Heights and El Sereno in partnership with the California Endowment and USC HSC Community Partnerships in Civic Engagement. The program also created “Agricorps” to support the establishment of other community gardens in the community and advocate for healthy foods options.

Identified by Focus Group Members Focus area group participants identified 15 health resources, 12 of them within or along study area boundaries. Most of these resources were located very close to the HSC and most of the area’s hospitals. The northeastern and southern portions of the study area did not have any health resources identified by focus groups, which supports the sense of focus group participants that there was a lack of awareness of health resources in the study area. As mentioned, this study area does have substantial health care resources, with five hospitals within its borders: USC University Hospital, USC Kenneth Norris Jr. Cancer Hospital, LAC+USC Medical Center, White Memorial Medical Center and Promise Hospital of East Los Angeles. Although there are many health resources available in the study area, focus group participants still described a lack of health care access and information. The community-based organization focus group identified LAC+USC and White Memorial medical centers as health resources, whereas English-speaking residents identified only White Memorial Medical Center as a resource. The fact that more groups did not consider more of the hospitals as health resources could be due to the significant population of uninsured residents and a lack of awareness of the services offered. See the Appendix 5 for a detailed list of the categories used to identify health resources.

NEIGHBORHOOD AND BUILT ENVIRONMENT Our findings on neighborhood and safety factors in the HSC study area revealed a mixed picture. The violent crime rate has dropped in recent years and residents generally described feeling safe in their neighborhood, a contrast with perceptions among focus group members that outsiders perceive the area as dangerous. There is a strong desire for healthier neighborhood resources because residents said they want a community that supports and promotes health. At the same time, there is little opportunity for outdoor physical activity, residents face a poor food environment and there are concerning trends in the area of child welfare. In collaboration with partners across sectors, there is an opportunity to leverage the positive neighborhood and built environment factors to combat and eliminate negative conditions.

EXPOSURE TO COMMUNITY VIOLENCE Residents said they feel safe in their community but worry about the effects of outside perceptions that their community is unsafe. The Federal Bureau of Investigation’s Uniform Crime Reporting Program defines violent crime as crimes that involve force or threat of

force.54 It includes the following offenses: murder and nonnegligent manslaughter, forcible rape, robbery and aggravated assault.54 More than 18,000 law enforcement agencies across the country share this definition and use it for crime reporting at the federal level.54

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Exposure to crime, violence and social disorder is a social determinant of health that influences a person’s health and welfare.55 Exposure to violence as a perpetrator, victim or witness makes it more likely that an individual will exhibit mental health issues, including depression or risk of suicide, aggressive or violent behavior disorders, and post-traumatic stress disorder. The effects of exposure to violent crime reach beyond health alone and into education and social support. Prevention Institute research has shown that children exposed to violence score significantly lower on IQ and reading ability tests.56 In addition, exposure to violence puts

children at higher risk of neglect.56, 57 Neighborhoods with high levels of violence are also linked with less social contact or support.57

In the portions of the study area served by the Los Angeles Police Department, the violent crime rate was 3.8 per 1,000 residents, which was lower than in Los Angeles overall (4 per 1,000 residents). In the East Los Angeles portion of the study area served by the Los Angeles County Sheriff ’s Department, the violent crime rate was 4.5 per 1,000. Overall, the study area was about as safe as the city of Los Angeles in terms of violent crime. This confirmed focus group findings, as illustrated by a community-based organization staff member who stated, “There exists a narrative of the [other] communities feeling that this one is dangerous, but I don’t feel unsafe.” According to Figure 5, the study area and city of Los Angeles have experienced an improvement in violent crime rates in recent years. Figure 5: Violent Crime per 1,000 Persons, 2007 and 2011 2007

2011

5.3

5.1

4.5 3.8

Health Sciences L.A. Police Department

Health Sciences L.A. Sheriff’s Department

5.0 4.0

Los Angeles City L.A. Police Department

This chart shows the number of violent crime incidents per 1,000 residents. The rate is calculated in two parts. The western part of the HSC Study Area is served by the Los Angeles Police Department (LAPD), whereas the eastern portion is covered by the Los Angeles County Sheriff’s Department (LACSD). Please note the LACSD data included additional violent crimes that were not included in the LAPD dataset. Therefore, the LACSD rates may appear somewhat artificially higher in comparison to the LAPD rates. Source: Crime data from LAPD (2011) and LACSD (2011), population data from Nielsen Claritas (2007) and the U.S. Census (2010).

Focus group participants expressed concerns about park safety. Gangs, drugs and transient populations were cited as barriers to park usage. Despite safety issues mentioned in focus groups, residents said they feel that the area is generally safe and expressed concern that outsiders perceive the community as unsafe. Faculty and staff and community-based organization focus group participants felt that the negative perception of safety adversely affects local investment in small business, schools and infrastructure. Focus group participants also questioned the accountability and responsiveness of police. Police were not perceived to be an asset and community members said they are reluctant to express these police-related concerns to law enforcement directly. Focus group participants stated they felt that increased investments in programming and resources rather than policing would help improve community conditions. One organizational staff member offered, “Clearly more cops does not make the neighborhood a safer place.”

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ta

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Child Abuse per 1,000 er B

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Map 28: Child Abuse Allegations per 1,000 Children, 2012 t Bl vd

The map shows the number of child abuse allegations per 1,000 children by census tract. Tracts with darker colors had higher percentages of such units. To create this map, Los Angeles County census tracts were grouped into even fifths based on the percentage of rent-stabilized units. Source: California Department of Social Services and University of California Berkeley Child Welfare Dynamic Report System (2012). W

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Table 33 shows that child abuse allegation rates increased between 2010 and 2012 in both the HSC study area and Los Angeles between 2007 and 2011. In addition, the study area child abuse allegation rate was 30% higher than the city rate in 2012. It is also important to note that this gap has widened in recent years. Geographically, the areas around the HSC and along the 10 Freeway had higher rates of child abuse allegations than other parts of the study area. Although the topic of child abuse (or domestic violence) more generally did not surface in focus group discussions, the high rate of child abuse allegations warrants more detailed study regarding the precursors and conditions that contribute to the high rate. Table 33: Child Abuse Allegations per 1,000 Children

year

area

2010 2012

Study Area

60.4

74.6

City of Los Angeles

50.3

56.9

These data include all allegation referrals, not only those later substantiated. Source: California Department of Social Services and University of California Berkeley Child Welfare Dynamic Report System (2010 and 2012).

OPPORTUNITIES FOR PHYSICAL ACTIVITY The study area is a “walking mecca,” but limited open space and concerns about park safety and programming were prevalent. The American Heart Association defines physical activity as “anything that makes you move your body and burn calories,” which

includes climbing stairs, walking, jogging and stretching.58 Approaches targeting individuals in an effort to increase physical activity have been met with minimal success.59 Scholars have increasingly recognized that environmental factors play a key role in levels of

physical activity.60 This review focused on different environmental factors contributing to increased opportunities for physical activity, such as walkable environments and access to park space. Physical activity is critical to health. According to the Centers for Disease Control and Prevention, physically active people have longer life expectancies and a reduced risk of stroke, heart disease, type 2 diabetes, depression and certain types of cancers.61 Additionally, regular physical activity can also help with weight control and is linked to improvements in academic achievement outcomes for

students.61 In terms of disparities in environmental incentives or barriers to physical activity, neighborhoods with lower socioeco-

nomic status have fewer resources available for physical activity.59 Scholars have identified inequality in recreational facilities and park space as contributing factors to disparities in physical activity levels and obesity and overweight outcomes by race and class.62 Studies also have shown the importance of available open and green space in the community, and that proximity to park space increases the likelihood of park usage, which increases rates of physical activity and improves overall health. One study of park usage in Los Angeles showed that, “people who lived within 1 mile of the park were 4 times as likely to visit the park once a week or more,” and that “living within 1 mile of a park was positively associated with leisure exercise.”60

The study area had few open spaces. In fact, one of the three larger spaces was a cemetery. Much of the green space fell within the USC and California State University, Los Angeles campuses, and therefore was not identified as a resource by residents. There were three additional smaller green spaces in the community, but open public green space was insufficient according to both residents and secondary data. Focus group participants identified only Hazard Park as an asset. Compounded by what group participants identified

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Map 29: Modified Retail Food Environment Index, 2011

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The map shows food retailers considered healthy as a percentage of the total number of food retailers by census tract. Census tracts with darker colors had higher percentages of healthy food retailers. To create this map, Los Angeles County census tracts were grouped into even fifths based on Modified Retail Food Environment Index scores. Source: Centers for Disease Control and Prevention (2011). le mp Te

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as a lack of adequate park safety, this lack of green space means that residents are less likely to go outdoors for recreational and physical activities on a regular basis. Secondary data showed that Los Angeles overall had roughly 3.5 times the amount of open space per capita than the study area (see Table 34). This discrepancy is large and even more severe because Los Angeles ranks last in open space per capita of major cities in the

United States.63 Residents’ vision for their community included more green space for physical activity and social interaction. The areas north of Valley and Mission boulevards had more open space than other regions in the HSC study area. Table 34: Square Miles of Open Space per 1,000 Persons year area

2010 2012

Study Area

0.4

0.4

City of Los Angeles

1.4

1.4

Source: GreenInfo California Protected Areas Database (2010 and 2013).

The community-based organizations focus group participants said they felt very strongly that the study area has a high level of walkability, referring to it as a “walking mecca.” The Los Angeles Health Atlas supported this finding and reported that the Boyle

Heights Community Plan Area outlines one of the top 10 most walkable areas in Los Angeles.11 However, focus group participants said they found local opportunities and space for physical activity insufficient due to safety concerns about parks, a lack of programming at public parks and the unaffordability of gym memberships. A Spanish-speaking resident and focus group participant described the consequences this way: “If our parks, streets or [recreation] centers are not safe, then our children cannot be active and healthy.” Other focus group participants stated that park programming had declined over the years and that what remains is not tailored to the needs of this community.

ACCESS TO HEALTHY FOODS The study area was home to a high and disproportionate number of fast food restaurants and liquor stores. Faculty and staff members and residents expressed a desire for more healthy food venue options. One way to assess access to healthy foods is to define the appearance of a food desert, or a lack of access. These areas “lack convenient access to affordable and healthy food. Instead of supermarkets or grocery stores, these communities often have an abundance of fast-food restaurants and convenience stores. In addition, stores in low-income communities may stock fewer and lower quality healthy foods. When available, the cost of fresh foods in low-income areas can be high. Public transportation to supermarkets is often lacking, and long distances separate home and supermarkets in many rural communities and American Indian reser-

vations.”64 For this report, we considered access to healthy foods based on distance, affordability, availability and prevalence in relation to unhealthy food options. Increasing access to healthy food resources arose as a major theme across focus groups. A community-based organization staff member used the term “food desert” when referring to the study area. Participants in all focus groups expressed a desire for more affordable fresh food options. Research has established that access to affordable healthy foods is a contributing factor to maintaining a healthy

weight and a lack of access is related to health conditions such as diabetes and heart disease.64 , 65 As stated previously in the Health and Health Care section, researchers have concluded that approximately one in three adults and one in three children (between ages

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2 to 19) are overweight or obese.64 , 65 Heart disease, diabetes, cancers, hypertension, stroke, liver and gallbladder disease, respiratory problems, osteoarthritis and gynecological problems are among the health consequences of the obesity epidemic. Several factors contribute to why low-income and minority neighborhoods are more likely to feature food deserts than other areas.68 Residents of these communities are less likely to own cars, making it difficult to access healthy food outlets, which might not be

located in their communities and be far away.69 Roughly 20% of African-American children and 25% of Mexican-American children are obese, compared to 10% of White children.69 There are opportunities in the HSC study area to promote affordable healthy food

options and programs, which residents noted as missing resources. In fact, one Spanish-speaking resident said her local grocery store features poor-quality produce and high prices. Another Spanish-speaking resident said, “People, to save money, opt to buy unhealthy food.” USC faculty and staff focus group participants also said they felt there were too many fast food restaurants and liquor stores and not enough sit-down restaurants in the study area. In fact, the Boyle Heights Community Plan Area has the second highest rate of off-sale (for consumption elsewhere) liquor outlets in the city.11

As a whole, secondary data showed that the study area had about the same ratio of healthy to unhealthy food options as the city of Los Angeles. However, Map 29 reveals that in the study area, healthy food access was unevenly distributed. Areas around the HSC and the East Los Angeles portion of the study area had higher Modified Retail Food Environment Index scores, indicating the presence of many more fast food restaurants than healthy food retailers compared to other parts of the community. The Modified Retail Food Environment Index does not allow for data aggregations at the study area and city geographic levels, so can only be mapped by census tract.

RESOURCES On HealthyCity.org In contrast, a search of services listed with 211 and other sources via www.HealthyCity.org revealed approximately 99 neighborhood and built environment resources located in the study area. These resources included organizations such as food resources, transportation, police and fire departments, nonprofit environmental agencies, parks and recreation areas, safety education programs and graffiti-removal agencies. Most of the resources were clustered on the west side of the community and a few were located south of the 10 Freeway. See Appendix 5 for a detailed list of the categories used to identify neighborhood and built environment resources.

USC Community Programs Community safety has been a top priority for USC. The university has invested in efficient and effective community safety programs. Below are a few examples of USC Community Program. Please see Appendix 10 for a more complete list. The USC Good Neighbors Campaign funds a number of programs that address neighborhood and built environment features. Below are some examples. Promotoras Contra La Violencia housed in the Wellness Center empowers women who are at risk of living with intimate partner violence. Good Neighbors Domestic Violence Healthy project assists women and children to heal from trauma of domestic violence through gardening and food cultivation. Safe Streets – CHLA prevention program addresses pedestrian safety in local schools.

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Lincoln Heights Certified Farmers Market is set to be launched in 2015 to provide health food options for residents of Lincoln Heights, Boyle Heights and El Sereno. Legacy LA and Preventive Medicine will develop a youth development curriculum using a community-based participatory process. The outcomes of this program will include a curriculum for youth development and an infrastructure to engage youth in development of the Ramona Gardens neighborhood. The following USC sponsored civic engagement efforts are additional examples. Keck School of Medicine in collaboration with the USC HSC Community Partnerships in Civic Engagement and the Clinical Science Translational Institute are collaborating with the Variety Boys and Girls Club in Boyle Heights to build capacity around child abuse prevention through use of evidence-based programs. The goal of this effort is to develop a sustainable initiative for the areas around HSC. The USC HSC Community Partnerships in Civic Engagement and Keck Medicine supports the annual Mariachi Festival organized by the Mariachi Foundation in Boyle Heights and Casa 1010 theater. The goal of this program is to leverage arts and cultural assets for community education, health screening and access to health services, many of which have been provided by Keck Medicine of USC and HSC CP. In 2014, over 2,000 people participated in this program.

Identified by Focus Group Members Focus group participants identified only eight neighborhood and built environment resources. All but one were located in the center of the study area. Resources identified included food resources (e.g., grocery stores and farmers markets), a police station, a local Girl Scouts troop and a park. The contrast between existing resources and identification of such resources among focus group participants suggests that residents are unaware of many services and programs that may be helpful if used.

SOCIAL CAPITAL The HSC study area has a strong sense of cohesiveness that connects directly to issues of social capital. Community members highlighted elements such as a significant population of long-term, multigenerational families and an active grassroots community as particular strengths that help build social capital, because the sense of connection to place and investment in the community is high in the study area. Working to bridge these strengths with identified barriers such as an underdeveloped nonprofit infrastructure and connecting community members to such resources can help to bolster the social capital in the study area.

SOCIAL CAPITAL Residents, community-based organization staff members, and USC faculty and staff members said they perceive that “there’s a real sense of community here,” but also a sense of disempowerment among local residents with regard to their ability to influence the availability of resources or the level of investment by relevant stakeholders and institutions in their community. Social capital refers to the institutions, relationships and norms that shape the quality and quantity of a society’s social interactions and the social networks and norms of reciprocity and trustworthiness that arise from them.70, 71 The social capital of local communities

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represent “mutually supportive institutions within a neighborhood that residents can turn to when the going gets rough” and “features of

social organization such as networks, norms, and social trust that facilitate coordination and cooperation for mutual benefit.”72 , 73 Trust

between neighbors, along with the willingness of neighbors “to intervene on behalf of the common good, is linked to reduced violence.”74 We faced a major challenge when assessing social capital because there were no data sources with census track measures of social capital indicators such as sense of trust in neighbors, sense of mutual support, social networks and social norms. Thus, in this section we identified several proxies of social capital: length of residency in the neighborhood and number of nonprofit organizations per 1,000 residents. These are imperfect but the best available proxy indicators of social capital that we could identify.

LENGTH OF RESIDENCY Residents in the focus groups expressed pride in their community and engaged in enthusiastic conversations about assets already present in the study area. Cultural attributes such as family cohesiveness were also considered to be an asset and a resource for stakeholders. The study area is known for its long history of being active in community affairs, and faculty and staff members noted that there is a “strong grassroots community.” Yet enthusiasm about the possibilities for the study area was tempered by feelings of disempowerment due to a sense that residents were unable to effect positive change. As one community-based organization staff member put it, “A lot of people that really care about this community are so engaged in it … [but] at the same time there is a lot of bureaucracy.” A needs assessment conducted by the Los Angeles mayor’s Gang Reduction and Youth Development program also found that residents “frequently identify human and physical capital in their community which begs for development.”3

Specifically, disparities in social capital exist by age, race and ethnicity, and population density. Putnam found that generations following the World War II generation are less likely to participate in civic, religious, workplace and informal institutions, and rural

and suburban areas have generally higher participation rates in these institutions compared to urban areas.7 1 Additionally, neighborhoods with less stability are less likely to have supportive networks of friends and neighbors and more likely to have lower involvement in civic organizations. Yet to build networks within a community, cross-group or bridging social capital has a stronger influence on

Latino participatory behaviors than within-group or bonded social capital.75 Considering that the HSC study area is overwhelmingly Latino and relatively stable, this point is particularly relevant. As expressed in the call for more civic engagement, residents said they are seeking more communication and collaboration with law enforcement, elected officials, community members, schools and institutions of higher education such as USC. Residents said they felt discouraged by limited communication and interactions with institutions of power and key decision makers. Their disillusion with institutions of power was evident with regard to their participation in this project. Participants wanted some assurance that their participation would get results. One resident stated, “It’s nice to come and get informed but I have a question: How much will our voice have an impact and be heard?” Another resident emphasized it in this way: “I don’t want to be a statistic. I want to know that all the information you are collecting will make a difference.” As a result, they called for more civic engagement opportunities and capacity-building and empowerment programs. Focus group participants said they recognized that language and cultural differences created limitations for civic engagement and called for culturally relevant outreach and education, with one Spanish-speaking resident referring to it as “guidance.” Participants in the faculty and staff focus group suggested the use of the promotores modeli to build on the cultural norms of the study area population.

i Promotores or promotoras (feminine) is the Spanish term used for community health workers. They are typically members of the local community who are familiar with local conditions, norms, culture and institutions. Their knowledge of the community and network of relationships are deemed to be critical elements in their work in communities as grassroots educators, organizers and agents of change. As such, they can serve as a cultural bridge between the community and institutions and agencies. There is a long tradition of the promotores model in Latino communities inside and outside the United States. The community health worker model more generally has been employed worldwide.

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Limited by the lack of direct measures of social capital that could be specified at the census tract level, the first proxy measure of social capital we present is the proportion of long-term residents. The study area had roughly 1.5 times the proportion of long-term residents than the city of Los Angeles, referring to individuals who moved there prior to 1980 (see Figure 6). This may indicate strong social bonds in the community and a sense of stability and safety. Focus group participants mentioned homeownership in the community as an asset. A community-based organization staff member echoed this idea and said, “We look out for each other.” The Gang Reduction and Youth Development needs assessment found that residents reported neighbors and families with close ties and a “willingness to get involved and work together in order to address common problems” in the community. However, the percentage of long-term residents dropped by roughly half in the study area and Los Angeles between 2000 and 2012. Related to this idea of community stability, focus group participants decried the lack of investment in social capital and services in the study area and called for programs and financing options to increase and support homeownership by local residents. They attributed the lack of investment to a perception held by people who live outside the community that the study area is unsafe or violent. Some residents stated a belief that the media plays a role in creating that perception. They said they strongly felt the study area was safe and many of them expressed a desire to work to change the outside image of the community by promoting the assets of the community, such as its extreme walkability, high rate of homeownership and strong community feeling. Figure 6: Year Householder Moved into Housing Unit, 2008–2012 pre-1980 pre-1980

1980’s

1990’s

2000’s

1980’s

1990’s

13%

8%

2010-12

2010-12

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52%

18%

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52%

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18% 9%

Health Sciences

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19% 9% 13% 7%

13%

Los Angeles City

Health Sciences Los Angeles City The chart shows the percentage of householders who moved into their current housing unit during specific time periods as a percentage of all householders. Source: U.S. Census Bureau American Community Survey 5-Year Estimates (2008–2012).

NONPROFIT ORGANIZATIONS Next, we examined a second proxy for social capital: prevalence of nonprofit organizations. Nonprofit organizations foster civic engagement and build social capital for affiliated individuals.76 Additionally, they provide an “organizational vehicle for citizens to volunteer and participate in their communities” and can promote social ties, thriving communities, political engagement and effective gover-

nance.77, 78 Some researchers have found that “the number and type of nonprofits also make counties more resilient to unemploy-

ment,”79 which is critical in the study area, where residents struggle to find steady employment. Study area residents said they believe

that nonprofit organizations could provide training, programs and opportunities. However, residents said they felt that local nonprofit organizations lack the capacity to provide such assets. There is a perceived “resource drain,” which community-based organizations and faculty and staff focus group participants attributed to the lack of coordination between programs and lack of continuity in funding. The secondary data demonstrated a potential lack of nonprofit organizations in general. Table 35 shows that the HSC study area had roughly half the number of nonprofits per capita as the city of Los Angeles.

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Map 30: Nonprofit Organizations per 1,000 Residents, 2011

W

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The map shows the number of nonprofit organizations per 1,000 residents by census tract. Census tracts with darker colors had more nonprofit organizations per 1,000 residents. To create this map, Los Angeles County census tracts were grouped into even fifths based on rates of the number of nonprofit organizations per 1,000 residents. Source: Nonprofit data from Internal Revenue Service (2011), population data from the U.S. Census (2010). le mp Te

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Macarthur Park

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Table 35: Nonprofits per 1,000 Persons

year

area

2011

Study Area

1.4

City of Los Angeles

3.0

Source: Nonprofit data from Internal Revenue Service (2011), population data from the U.S. Census (2010).

When this disparity is paired with the focus group comments, the dearth of nonprofit capacity becomes clear. In the study area, nonprofits were concentrated in the area around the HSC and Boyle Heights neighborhood. The freeways also create boundaries that inhibited residents and especially youths from accessing services, programs and organizations (Map 30). Spanish-speaking resident focus group participants in particular identified distinct areas in which to increase social capital. The Spanish-speaking residents spoke about the interactions between foreign-born parents and their native-born children and the resources needed for parents to support youths. Stress placed on families due to the lack of jobs, limited English capacity and scarcity of child care limited their time, money and involvement. They expressed interest in free English language classes for parents to “get more involved and be more responsible for their kids.” Cultural differences were also noted as sources of tension in the Latino community. This is significant to note in relation to the requested outreach and communication resources, because there were distinct perceptions and views among Latino residents. Faculty and staff focus group participants also provided unique insights from their position at USC. Specifically with regard to nonprofit organizations, faculty and staff members highlighted the need for better coordination and communication among community-based organizations. Similarly, USC faculty and staff saw the opportunity for improved collaboration between the university and local community agencies in applying for external funding. This would help to develop trust and avoid smaller organizations feeling that they are placed at a disadvantage in competing with the USC resources. Faculty and staff members also mentioned specific place-based (regional) programs with distinct aims of community empowerment, such as the California Endowment’s Building Health Communities program, as important initiatives addressing community needs. Additionally, they also cited a need for political awareness among residents and community leaders to leverage the strong grassroots community to influence politicians.

RESOURCES On HealthyCity.org A search of service data listed with 211 and other sources via www.HealthyCity.org revealed approximately 92 social capital resources in or along the study area boundary. Even more resources were clustered in the northern part of the study area. These resources included advocacy organizations and programs, social and spiritual groups and organizations, arts and cultural venues, community centers, political organizations, philanthropic and volunteering organizations, youth development initiatives and capacity-building organizations. See Appendix 5 for a detailed list of the categories used to identify social capital resources.

USC Community Programs USC’s commitment to strengthen the campus-community partnership and enhance the opportunity for bidirectional learning has guided the development of the following social capital programs. For a more complete list, see Appendix 10.

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USC Health Sciences Campus Master Plan outreach efforts have engaged communities in Boyle Heights, Lincoln Heights and El Sereno to increase participation in community development efforts around the HSC. Through 25 community presentations, including discussions at Neighborhood Council meetings and with community organization leaders, USC has enabled the community’s voice in the development efforts. Community gaps were also identified in this area and efforts toward addressing them are underway. USC Health Sciences Campus Master Plan outreach efforts will continue in 2015–2016 to further engage communities in the above identified neighborhoods. (http://communities.usc.edu/about/our-neighborhoods/health-sciences/hsc-calendar-of-events/) The Good Neighbors Grants program holds community informational session to coach organizations on how to apply for USC’s neighborhood grants using best practices while addressing infrastructure needs.

Identified by Focus Group Members Social capital resources were most often identified by focus group participants. They identified 17 resources in total, with 13 of them located within or along the study area boundary. All but two were located in the city of Los Angeles and a majority of them was concentrated south of the 10 Freeway. The resources identified included a restaurant, a high school, nonprofit organizations, community centers, and the local city hall. Thus, focus group participants were not familiar with the majority of the 92 social capital resources in or along the study area.

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COMMUNITY RESOURCES Focus group participants identified 59 resources in the HSC study area. LAC+USC Medical Center was the only USC facility among them. Only seven of the resources were identified by more than one group, as shown in Map 31. This again, points out the need for improved methods of information dissemination about available community resources. This indicates that awareness of resources varied across groups (e.g., residents were aware of resources that USC faculty and staff members were not aware of and vice versa). Legacy LA, a community-based nonprofit organization focused on youth development, was identified by all four focus groups. Other resources, including Weingart East Los Angeles YMCA, AltaMed Medical Group, Boyle Heights Technology Youth Center, Clinica Romero, East Los Angeles Community Corporation and White Memorial Medical Center, were also identified by more than one focus group. Moreover, the participants acknowledged there were likely many more resources of which they were not aware. A search for resources using service listings from 211 and other sources via www.HealthyCity. org found approximately 360 resources. As Map 32 shows, the number and type of resources identified depended on the type of focus group. Map 32 shows that community-based organization representatives had the most knowledge of resources in the area, followed by USC faculty and staff members. The faculty and staff member focus group inset map does show, however, that their knowledge was mostly limited to the area immediately surrounding the HSC and to health- and education-related resources. Community residents identified social capital-related resources most frequently, whereas community-based organization staff members mainly identified health-related resources. Maps representing the residents focus group have significantly fewer resources identified, particularly that of the Spanishspeaking residents group. This discrepancy is at least partially explained by the fact that any resource with an associated cost was not considered a resource by the Spanish-speaking residents. One community-based organization staff member summed up the resource landscape this way: “I think there are a lot of resources, but a lot of barriers,� including economic, citizenship and child care barriers. Geographically speaking, several patterns emerged. The southeastern portion of the study area, which is not part of the city of Los Angeles, had fewer resources than the rest of the study area. The USC faculty and staff member map shows a cluster around the HSC. This is not surprising given that these participants likely spend most of their time on or near campus. The English-speaking residents map has a cluster in the southwestern part of the study area, whereas the Spanish-speaking residents and community-based organizations maps are more evenly distributed. On all four maps, the northeastern part of the community is lacking in resources. This could be because that area, covering the El Sereno neighborhood, is mainly residential. The focus group participants explained that freeways impose community borders and divisions, restricting access to resources. For example, resources in Boyle Heights and Lincoln Heights may be inaccessible to residents of East Los Angeles and El Sereno.

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RECOMMENDATIONS This section outlines community conditions identified via our analysis of primary and secondary data for the HSC study area, along with recommendations meant to draw on strengths and address gaps. The recommendations originated during discussions with resident and organizational focus group participants and from input garnered during meetings of the community advisory board, faculty task force and the study team. The focus groups and engagement with the community and faculty advisory boards also included a discussion of opportunities regarding the role that the University of Southern California and other stakeholders could play in addressing many of the community’s conditions.

ECONOMIC STABILITY Although small businesses are seen as key resources in the community in terms of services and employment, low financial literacy and lack of access to credit has hindered small business growth. Contributing to challenges for small businesses and small business initiatives by local residents is the lack of banks per capita, resulting in residents experiencing difficulty accessing financial services. An important asset in the study area is that several large employers are located within the study area, including the LAC+USC Medical Center and other medical centers. However, lack of requisite training among community members may contribute to lack of fit with current employment options and high unemployment. Overall economic concerns were voiced as high priority issues in the community. The community benefits from a relatively large base of long-term residents and residents expressed a high desire for increased opportunities for home ownership. Those who rent find housing unaffordable with concomitant overcrowding and poor housing conditions. The high walkability of the community and access to mass transit are strengths that could be leveraged to contribute to physical health and access to employment, respectively. Recommendation 1. Elected officials, community organizations, institutions of higher education and business leaders should jointly (a) identify effective and systematic strategies to disseminate information about existing financial literacy and capacity-building programs, (b) assess training program needs, and (c) develop such programs. Recommendation 2. Local chambers of commerce should continue to work in collaboration with local employers to promote hiring of local residents, particularly in labor market areas with expected growth, and policies to prioritize training. Recommendation 3. Elected officials and financial business institutions should (a) implement strategies to attract banks to the communities surrounding the HSC and (b) develop community-based strategies to increase access to credit and lending to promote home ownership and foster financial literacy among local residents.

EDUCATION Local parents expressed a strong desire to become more involved in their children’s education and were familiar with available educational resources in the local community. Yet cultural and linguistic differences and work-related time demands act as barriers between

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parents and schools. Fostering parent involvement during the early school years is important, especially considering that local elementary school students have fallen behind the district in third-grade reading skills. At the high school level, local public schools have outperformed the district in high school graduation and middle school truancy rates. Yet residents said they felt that students often graduate high school without the practical skills to find employment or the resources and support to pursue higher education. Residents would like to see initiatives to further improve high school graduation rates and increase student motivation and avenues for higher education. Recommendation 4. Local high schools and community colleges should continue to develop adult education programs that improve employment readiness and employment options among local residents. This includes English as a Second Language courses, vocational training and workforce development programs that could be linked to small businesses and large employers. Recommendation 5. Local public schools and parents should join efforts to increase grade-level reading and literacy. Recommendation 6. Local foundations, elected officials and institutions of higher education should forge an alliance to create more pathways and support for low-income residents to access higher education. Recommendation 7. In collaboration with community stakeholders, USC should continue efforts to (a) inform and engage community members in existing USC education service programs to increase participation among local residents and their children and (b) support programs that enhance engagement with recent high school graduates and link them to fulfilling education and employment options with a focus on career development.

HEALTH AND HEALTH CARE The community benefits from a wealth of major health-related academic institutions, medical groups and clinics, including LAC+USC Medical Center, Keck Hospital, AltaMed Medical Group, ClĂ­nica Romero, and others. The community has five hospitals and more than twice as many federally qualified health centers per capita than Los Angeles. Yet barriers to health care are significant. One in three residents lacked health insurance and there is concern that heath care providers need to become more familiar with the needs of community residents and that care needs to be more culturally relevant, effective and of higher quality. Residents who participated in focus groups seemed unfamiliar with the wealth of services available. Concern was also expressed about potential funding cuts to local safety net clinics after the implementation of the Affordable Care Act and its lack of coverage for those who are undocumented, employed part-time or work in small businesses. The newly approved My Health LA program is designed to benefit the estimated 400,000 to 700,000 unauthorized immigrants in the county without insurance. Ensuring that local residents are informed of and take advantage of this program will be important. Recommendation 8. Community stakeholders along with elected officials, local foundations and policymakers should explore health impact bond opportunities to improve population health in the local area. Such programs pay back investors through the savings that the government accrues should a preventive program succeed in its goals of reducing a specific costly and pernicious health condition.

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Recommendation 9. Institutions of higher education, community organizations and health care entities should conduct research to (a) better understand the impact of the Affordable Care Act on health insurance status among local community residents, (b) identify cost and quality barriers faced by residents in accessing health insurance and health care under the Affordable Care Act, and (c) identify strategies for improving access and use of preventive health care services.

NEIGHBORHOOD AND BUILT ENVIRONMENT Community strengths related to the neighborhood and built environment include the community’s high walkability and interest in physical activity and social interaction. Although the community has few parks, there is a park located near the HSC that could serve as a place for residents and university faculty and staff members to interact. Overall, the crime rate in the area was lower in the study area than the city of Los Angeles. Outside of some specific areas, residents described feeling safe in the neighborhood but were concerned that perceptions by outsiders stigmatize the community as dangerous. There are various areas of significant need. Most striking are the rates of child maltreatment, which were higher than in Los Angeles overall and have increased over time. Residents’ concerns focused on the excessive number of liquor stores, low availability of affordable high-quality fresh produce, lack of trust in the police, and a sense that police are not responsive to the community’s needs. Other aspects of the environment that concerned residents were street litter, poor lighting and pollution from freeways, which detract from the quality of the built environment. Further, freeways act as barriers separating some residents from services. Recommendation 10. USC can serve as the nexus of research to (a) identify the underlying conditions fueling the high rates of child abuse allegations and (b) test preventive evidence-based strategies that can be taken to scale in the community. Recommendation 11. Community agencies, residents, law enforcement and elected officials should collaborate to develop initiatives to (a) improve relationships between the community and local law enforcement, (b) further increase access, safety, programming and use of existing local parks such as Hazard Park, and (c) develop new green spaces. Recommendation 12. Stakeholders from health agencies, organizations and foundations should develop collaborative efforts with the new Wellness Center at the Historic General Hospital and other community-based health programs to implement multipronged strategies for increasing consumption of healthy foods, decreasing consumption of unhealthy foods and increasing physical activity among local residents. Such approaches should combine policy strategies, evidence-based community and family education programs, and availability of outlets for purchase of affordable healthy food options and physical activity programs and facilities. Recommendation 13. Local responsible agencies should (a) improve city services related to trash collection and clean up, (b) develop programs to encourage community resident participation in community clean up, (c) implement approaches to mitigate pollution, and (d) implement strategies that reduce the impact of freeways as barriers to residents’ access to community resources.

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SOCIAL CAPITAL There is a feeling of civic engagement and community in this area. The community has a rich set of social capital resources. Almost 60 social capital resources were identified across all focus groups and more than 350 were identified through www.HeathyCity.org. Residents generally said they feel safe in their neighborhood and law enforcement data support these perceptions. However, focus group members expressed feelings of disempowerment and a desire for more leadership and engagement from elected officials. There is a dearth of data on social capital in the study area beyond the focus group data collected via this research, and more focused research that collected primary data on traditional markers of social capital would be most useful. Focus group members felt that citizenship status and lack of child care have limited the use of available community resources. Spanish-speaking residents in particular do not identify services with an associated cost as resources, because these services are not accessible to them. Focus group participants said they felt that outsiders to the community perceive the area as dangerous despite the lower crime rate compared to the city of Los Angeles and that this perception hinders investment in the local community, stymying local economic development. Recommendation 14. USC should encourage faculty members to conduct research to assess social capital indicators in the local community to inform community-led strategic approaches to strengthening social capital. Recommendation 15. USC, in collaboration with community members, should develop strategies to increase mutual trust between the university and the community and improve coordination and collaboration on the various USC community engagement initiatives and programs, as well as between USC and local organizations. Recommendation 16. Community stakeholders and local residents should build on the rich cultural history of the study area by developing it as a culture and arts destination and economic opportunity for local residents.

ADDITIONAL RECOMMENDATIONS FOR USC During discussions in focus groups and meetings of the community advisory board and faculty task force, members identified additional recommendations related to the university’s role in improving community conditions and addressing community needs. The recommendations fall under four major themes. Widen access to community members. Community members and stakeholders said they would like to see increased access to university programs, services and higher education for local youths. Suggestions included increasing accessibility of the HSC green space, meeting spaces and other programs and resources for local residents and community-based organizations. Access can also be improved through better communication and dissemination of available services and programs so that community members and local agencies can take advantage of these resources. Related to this was the suggestion that the university develops a systematic way to document all community engagement and programs sponsored by the university so that faculty members across campus, community members and community stakeholders can be aware of these services. Specifically, it was suggested that such an effort be tied to the Digital University Initiative, using software such as SalesForce or a partnership with the Viterbi School of Engineering to facilitate the development of a useful tool for this purpose. Further, participants described a need for a staff person who is a neutral partner and responsible for keeping track of university-based programs.

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Stakeholders felt that the university could make an important contribution by creating a nonprofit capacity-building center in the new HSC Wellness Center that would assist organizations with training and collaboration on grant writing, marketing, data collection and program development. Increase university involvement and partnerships in the community. Stakeholders expressed interest in having the university further strengthen and deepen partnerships with local organizations so that local organizations can offer their own programs with support from the university and other funders. An example provided was the USC Marshall School of Business collaborating with the Boyle Heights Chamber of Commerce to provide support for small businesses. Stakeholders also cited an opportunity to expand current university projects and programs in local schools that provide tutoring, internships, mentoring, job training and scholarships for local youths. Plan a future for the neighborhood together. Stakeholders recommended that the university develop a mechanism to work with the community to co-create an agenda, set priorities and leverage its position as a major local institution to promote these priorities on an ongoing basis. This includes creating a process and specific roles for community organizations and residents to be involved in guiding community initiative investments in the study area, such as those made through the Good Neighbors Campaign and the Keck Hospital Foundation. There is a need to build trust between the university and the local community. Participants felt that this could be achieved through collaboration with local organizations that have the trust of local families and by having a transparent and accessible process for community engagement and shared planning. Stakeholders also felt that university leaders can be powerful partners in the community because they can help engage elected and public officials in addressing policy issues to improve community conditions. Prioritize workforce development. Of particular interest are programs that enhance workforce development. Stakeholders felt that with USC’s leadership, local institutions should work to increase investment in jobs, training, workforce development and the local economy. Large local employers such as USC can create entry-level pathways for community residents at varying educational levels to better access jobs, including those at the university, and develop programs that train residents in developing small businesses and increasing financial literacy (for businesses and personal finance).  

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CONCLUSION This report identified specific areas of strength, challenges, and need in the communities surrounding UPC and HSC. Addressing these challenges and needs is the responsibility of a broad spectrum of local stakeholders. Community-based organizations, the faith community, elected officials, residents, policymakers, educational institutions, foundations, and other public and private funders share this civic responsibility. As a major anchor institution and employer in the city of Los Angeles and a neighbor in the communities surrounding the UPC and HSC study areas, USC can play an important role as a convener, agent of change, and leader to form mutually beneficial transformative collaborations. Focus group participants and members of the community advisory board and faculty task force noted opportunities for strengthening the relationship between the university and the communities surrounding the UPC and HSC study areas. These include continued efforts to improve dissemination of information and widen access to USC community programs and services; increase and strengthen university involvement and partnerships in the community, including strategies to plan a future for the neighborhood together; and prioritization of workforce development among community residents and building of community social capital. One of the goals of this report was to assess whether the priority areas set forth in 1992 for USC’s community engagement and programs are still relevant. Overall, findings from the report provide support for a continued focus on the five current priority areas: successful schools, healthy families, connecting campus and community, thriving businesses, and safe streets. In some of these areas, progress has been made but continued effort is still needed. In other areas, additional effort may be needed to more directly target goals for improvement. Our findings indicate the need to expand USC’s priority areas to include three additional priorities. The first additional priority is building a vibrant local workforce through collaborative programs with local community partners that create a training pipeline to prepare local community residents for jobs, including those at USC. The second additional priority is strengthening community social capital through programs that enhance mutual trust and promote civic engagement and community action. The third additional priority is prevention of child abuse and neglect, which fits under the existing priority of healthy families. The recommendations put forth in this report provide an initial guide to the development of action steps, which can lift community conditions to a level that offers residents the promise of a better future. The recommendations presented are aligned with the goals of

community-campus partnerships and strategies highlighted in a recent report by Policy Link.1 Community–campus partnerships have the following strategic goals2 :

• Leverage the knowledge, wisdom, and experience of communities and academic institutions to solve pressing health, social, environmental, and economic challenges • Ensure that community-driven social change is central to the work of community–academic partnerships • Build the capacity of communities and academic institutions to engage each other in partnerships that balance power, share resources, and work toward systems change

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Figure 7 identifies four elements that “represent a synthesis of the experiences of seasoned community and academic partners engaged in partnerships and on the extensive work of Community-Campus Partnerships for Health (CCPH) since its first set of principles were released on 1998.”2

Figure 7. Elements of an Authentic Partnership

Guiding Principles of Partnerships

Transformative Experiences

Authentic Partnerships

Quality Practices

Meaningful Outcomes

These elements provide a useful framework to guide the next steps in the process of implementation of the recommendations in this report. The history of community–campus partnerships has shown that to be credible and effective, authentic partnerships need to be established and nourished consistently and with a long-term commitment to achieving meaningful outcomes. Inherent in the impetus for the State of the Neighborhood Project is USC’s commitment to long-term investment in its neighboring communities. The conclusion of this first step in the State of the Neighborhood Initiative presents an opportunity to assess and refresh the university’s approach to civic engagement in this time of considerable development and growth. It is useful to consider the strategies for leveraging anchor institutions for economic inclusion outlined in the recent Policy Link

report1 to identify specific approaches consistent with recommendations in this report. Although these strategies need to be tailored to the communities surrounding the University Park and Health Science campuses, they are highly relevant to the zeitgeist of civic engagement in institutions of higher education, including USC’s mission to develop human beings and society as a whole through the cultivation and enrichment of the human mind and spirit. These strategies include1 :

1. I nvesting in local neighborhood development (i.e., align land and transportation planning to maximize business growth and economic inclusion potential near anchors in a manner that meets the needs of local residents and does not lead to displacement; work with neighborhood business development efforts) 2. B uilding an equitable economy while fostering innovation (e.g., spur new business development and jobs in growing industries using an equity lens to ensure that historically disenfranchised communities directly benefit from economic growth) 3. Contract with targeted businesses for procurement (e.g., obtain commitment by anchor leadership to increase procurement to local businesses and support efforts to prepare small local businesses to take advantage of these opportunities)

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4. Provide workforce training, hiring incentives, and career development (e.g., develop internal hiring provisions and policies that create job and career opportunities for local residents, particularly for those who have faced barriers to employment) By engaging key anchors in the local economy, USC and other key stakeholders can make a business case to adopt economic inclusion strategies, address institutional and structural barriers to equity, and set realistic steps and measurable goals to track progress toward improving economic and social conditions in the local communities. The significant scholarly, research, and practice expertise among USC’s units and faculty members represents a wealth of resources to inform our approaches and advance our understanding of how to bring about and document community change that benefits all partners. As an anchor institution along with other key stakeholders, USC is poised to provide national leadership, impactful scholarship, and innovative student learning approaches that will serve as an exemplar of community–campus partnerships and innovation in advancing equity and economic inclusion.

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ENDNOTES 1 Schildt, C., & Rubin, V. (2015). Leveraging anchor institutions for economic inclusion. Oakland, CA: PolicyLink. http://www.policylink.org/sites/default/files/pl_brief_ anchor_012315_a.pdf 2

Community-Campus Partnerships for Health. (2013). Position statement on authentic partnerships. Retrieved from https://ccph.memberclicks.net/principles-of-partnership

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APPENDIX 1 ACKNOWLEDGMENT OF STATE OF THE NEIGHBORHOOD PROJECT FACULTY TASK FORCE AND COMMUNITY ADVISORY BOARD MEMBERS Faculty Task Force Members

Community Advisory Board Members

Lourdes Baezconde-Gabernati Keck School of Medicine,

Rachelle Pastor Arizmendi Pacific Asian Consortium

USC Institute for Prevention Research

in Employment

Sandra Ball-Rokeach Annenberg School of Communication and Journalism, Communication and Journalism

Daniel Balderrama Interim Principal of Sheridan Elementary Michael Banner Los Angeles LDC

Brent Blair, School of Dramatic Arts, Performance

Ralph Carmona Barrio Planners

Marlon Boarnet Price School of Public Policy, Graduate Programs

Connie Castro El Sereno Neighborhood Council

in Urban Planning

Victor Dominguez Weingart East Los Angeles YMCA

Steven Chen School of Pharmacy, Titus Family Department

Adam Freer South LA Best Start Community

of Clinical Pharmacy and Pharmaceutical Economics &

Lark Galloway-Gilliam Community Health Councils

Policy Faculty

Grace Gonzalez Volunteers of East LA

Brian Finch Dana and David Dornsife College of Letters, Arts and Sciences, Sociology

Lila Guirguis Magnolia Place Community Initiative Veronica Hahni Los Angeles Neighborhood Initiative

Tamika Gilreath School of Social Work, Health

Alicia Maldonado Boyle Heights Chamber of Commerce

Geoffrey Joyce School of Pharmacy, Titus Family Department

Sandra McNeil Trust South LA

of Clinical Pharmacy and Pharmaceutical Economics &

Tammy Membreno Barrio Action Youth and Family

Policy Faculty

Walter Pittman Los Angeles Urban League

Michelle Kipke Keck School of Medicine, Pediatrics and Preventive Medicine

Eddie Padilla Boyle Heights Neighborhood Council Tiffany Rodriguez Los Angeles Child Guidance Clinic

LaVona Blair Lewis Price School of Public Policy, Public Policy Julie Marsh Rossier School of Education, Education Roseanne Mulligan Ostrow School of Dentistry, Geriatric Dentistry & Community Dentistry

Nolan Rollins Los Angeles Urban League Nancy Rosas Lincoln Heights Neighborhood Walter Pittman Los Angeles Urban League Cynthia Sanchez Proyecto Pastoral

Michelle Povinelli, Viterbi School of Engineering, Electrical Engineering

Krithika Santhanam Legacy LA Bennie Torres CDTech

Robert Rueda Rossier School of Education, Education

Jackie DuPont Walker Ward Economic Development Corporation

Avelardo Valdez School of Social Work, Social Development

Craig Weber Los Angeles Department of City Planning

and Policy

Jennifer Ybarra Boyle Heights Communities

Adlai Wertman Marshall School of Business, Lloyd Greif Center for Entrepreneurial Studies

Senior Advisors

Kathleen Wilber Davis School of Gerontology, Gerontology

Brian Finch Director, Population Research Center

John Wilson Dana & David Dornsife College of Letters,

Manuel Pastor Director, Program for Environmental and Regional Equity, Co-Director, Center for the Study of Immigrant Integration

Arts & Sciences, Sociology

William Vega Director, Edward R. Roybal Institute on Aging John Wilson Director, Spatial Sciences Institute

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APPENDIX 2 OVERVIEW OF STATE OF THE NEIGHBORHOOD RESEARCH DESIGN BACKGROUND As indicated in the Research Approach section, to identify the framework best suited for this project, the team reviewed three conceptual frames, including their key tenets and best practices. The three frames considered were: • Social Determinants of Health • Community–Campus Partnerships • Community-based Participatory Research Ultimately, the social determinants of health framework was selected as the primary guide for the research design and the implementation that followed. The remaining two frameworks were used as references throughout the project.

Community–Campus Partnerships Campus–community partnerships are entities that value the connection of the diverse strengths of communities and universities and build on the assets and capacities of each. Community–Campus Partnerships for Health, a community partner, believes such partner-

ships can improve local services, research, education and community health.1 They can focus on a variety of issue areas important to the

university and community; for example, access to health care, environmental justice and economic development.1 Effective partnerships

include meaningful outcomes, processes that are transparent, trust building and transformation at the personal, institutional, community, university and policy levels.1

Various universities have developed community–campus partnerships. Such partnerships are distinctly different than other types of approaches to community engagement that may include university-sponsored community research, programs or services. Community–campus partnerships take varied forms but generally they include agreed-upon missions, values and goals; clear, open communication, process roles and norms; shared credit

and responsibility; feedback and evaluation processes; and shared dissemination of research for impact.2 Here are some examples of such partnerships. Campus Partnerships for Health sponsored by the Centers for Disease Control and Prevention (https://ccph. memberclicks.net). University of California, San Francisco’s University Community Partnership Program, which promotes civic

engagement, community health and well-being2 to enhance the environment for education, research, employment and patient care. (http://partnerships.ucsf.edu) Brown University, Providence Community Partnerships-Swearer Center was established in 1986 to connect the capacities at Brown University with those of Providence communities to address inequality and promote both student learning and community impact. Members engage in bidirectional learning through the alliance among the institution and long-term community partnerships (http://www.brown.edu/academics/college/special-programs/ public-service/community-partnerships). Duke University, Office of Durham and Regional Affairs is a facilitator supporting the advancement of Durham public schools, youth-oriented nonprofits and economic development of the local neighborhood (https://web.duke. edu/community/5yearreport.pdf ).

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Stanford University, Haas Center for Public Service emphasizes collaborative partnerships among multiple sectors applied through six public service pathways: (a) direct service, (b) community-engaged scholarship, (c) activism, (d) philanthropy, (e) policy and politics, and (f ) social entrepreneurship (https://studentaffairs.stanford. edu/haas/about/strategicplan/pathways).

Community-Based Participatory Action Research There are many definitions of research centered on a community-based approach,3 and we explored some of them in the context of community-based participatory action research (CBPAR). CBPAR is an applied research process that values community collaboration with researchers or community members engaging in all aspects of the research process, which could include4 establishing research

questions, developing data collection tools, and analyzing and disseminating findings.4 , 5 Key components of the CBPAR framework

include a desire to change issues communities care about, shared ownership of research and findings, long-term relationships and capacity building, and participation in a collaborative learning process with community members and researchers.4 , 6, 7 This figure highlights the overall flow and interplay between the stages of the CBPAR process.4 Community Based Participatory Action Research Project Process Model step 1

step 2

step 3

step 4

step 5

Project Design &

Partner

Data Collection

Data Analysis

Reporting

Implementation

Engagement

Identify research

Identify research

Choose and imple-

Analyze the results

Report the results

topic, questions,

partners and invite

ment the research

goal and geographic

them to collaborate

and data collection

focus

methodology Documentation, communication and evaluation throughout process

The benefits of a CBPAR approach can include higher-quality research, systems change based on a long-term commitment, and the implementation of research, community asset development and a collaborative, trustful relationship among partners.4  

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APPENDIX 3 FOCUS GROUP DISCUSSION OUTLINE This discussion outline describes the specific activities and discussion questions used to facilitate each focus group. Activity

Description

Discussion Questions

Icebreaker

Participants were asked questions

Facilitator: Ask each person to introduce themselves and share

(10 min.)

throughout the session to develop an under-

their response to this question:

standing of their vision of the community and what could be done to realize this vision, including during the icebreaker.

1. “To make sure this community is a safe, healthy and good place to live, I would like to see less/more _____________________________?

Data Gallery

Part 1: Participants were prompted to reflect

Discussion

upon secondary data and data visualiza-

(45 min.)

tions, or data gallery, that represented the

Facilitator: In the icebreaker, we heard about some of the issues in

five different community condition domains

the community that are important to you. In this exercise, we are

used in this study: Economic, Education,

going to look at some data and information about this community.

Health, Environment and Safety (represented

We want to know what this information means to you and how

in this report as Neighborhood and Built

you would like to see this picture of the community change. We

Environment), and Community Interaction

have placed this information in different categories or areas that

and Involvement (represented in this report

are important to a community’s health: Economic, Education,

as Social Capital). Participants reflected on

Health, Environment and Safety, and Community Interaction and

this information, discussed their reflections of

Involvement. After reviewing the data for one category:

these data, and indicated whether or not the data were an accurate representation of their and other community members’ experiences. Part 2: Participants were asked questions throughout the session to develop an understanding of their vision of the community and what could be done to realize this vision. After generating responses for each data gallery category, or community condition, facilitators led a discussion about how participants would like to see the picture presented by the data

Part 1. Review and discuss community conditions using data gallery

1. How do these data reflect the issues or conditions our community experiences? 2. What stands out as really powerful? 3. Are you surprised by the data? 4. Is there anything or anyone missing from this picture?

Part 2. Discuss changes, challenges and barriers Facilitator: Now we want to talk about how you would like to see the picture of this community and the issues we just discussed change. 5. How would you like to see this picture change in five years? Ten years? 6. What do you think needs to be done to make this picture come about? 7. W hat are the barriers or challenges to making this picture come about?

and their responses change in the next five or 10 years, as well as the barriers and opportunities to bringing it about.

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Activity

Description

Discussion Questions

Community

Participants were asked to identify and share

Part I. Map community resources

Resources

their knowledge about local community

Mapping

resources and assets that addressed the

Facilitator: We’ve placed a map in front of you titled “What are the

and Vision

community conditions discussed above. During

different resources in this community?” We’re going to talk about

Discussion

this phase, facilitators led the participants

the resources in this community that you are involved in or that you

(55 min.)

in community-engaged mapping, performed

know of that are helping to address the issues we discussed in the

using table-sized maps of the particular focus

last activity.

area. Using a set of stickers color-coded by each of the five domains, participants identified organizations, associations and groups that they or people they knew are involved in and that addressed the discussed conditions, with the goal of using their collective responses to identify the most used and effective assets and strengths of the two target communities. Once completed, participants discussed their observations of the maps, reflecting on which

1. Residents: What organizations and programs exist in this area (point to area on the map) that you or someone you know are involved in that address the issues we discussed? For instance, if “jobs” was identified as an issue, ask: What organizations work on the issue of jobs or offer jobs or job training programs? 2. Organizations: What organizations and programs exist in this area that you know of (yours included) that are addressing the issues we discussed?

Part II. Discuss community resources, vision and opportunities, and barriers to achieving this vision Facilitator: Take a look at the map … 1. What do you notice?

domains were represented most or least,

2. Which categories do you see more of on the map? What would you say that means?

particular spatial concentrations of resources

3. Which categories do you see less of? What would you say that means?

and resources that appeared to be missing.

4. Are there any positive places, organizations and programs that do not currently exist that you would like to see in this community? What needs to be done to make this possible?

Participants were asked questions throughout

5. What are the barriers or challenges to developing these missing resources?

the session to develop an understanding of their vision of the community and what

Facilitator: For the remainder of the time for discussion, we will

could be done to realize this vision. After

focus on your general ideas about the issues, resources and vision

resource mapping, they identified specific

that we’ve discussed. We also want to gather your reflections about

ways that different community partners (such

the role that you think USC can play as an educational institution.

as community-based organizations, elected officials, USC, or community members) could play a role in achieving this vision.

6. What are some SPECIFIC ways that you think community partners can begin or continue working together to achieve the vision we discussed in the first exercise? a. Community-based organizations: b. Community agencies: c. Community members: d. Elected officials: e. Funders: f. USC: 7. H ow can organizations and institutions like USC strengthen the capacity of residents, associations and organizations? 8. A s an educational institution, are there specific roles you think USC can play in supporting the community to work toward its vision?

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APPENDIX 4 UPRE

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U S C S TA T E O F T H E N E I G H B O R H O O D R E P O R T

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S Hoover St

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4/6/15 7:25 PM

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The maps show resources identified by the Resident, Community-Based ashinEgWtoa nshBiln E 37Th St vgdto Organization and Faculty & Staff focus groups. Each resource is only displayed n Bl E 37Th St vd once, no matter how many times it was identified.

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usc_son_appendix_1e.indd 131

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Resources Iden Resources Id

Health Health Community Interaction & Community Involvement Interaction & Involvement

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APPENDIX 5 RESOURCE CATEGORIES USED TO DEFINE RESOURCES ON HEALTHYCITY.ORG A search for local services around the UPC and USC area was done using healthycity.org. Below is a list of resources identified among the two campus areas.

ECONOMIC

category

subcategory

Food

Utilities

Housing and Shelter

Consumer Services

Tax Organizations and

Money

Services

specific category

Basic Needs

Income Support and Employment (includes Social Services Departments) All subcategories included Organizational, Community and

Community Groups

Occupational and

International Services

and Government and

Professional Associations

Community Economic Development

Administration Offices

(Business Associations;

and Finance

(Administrative Entities,

includes Chambers of

Administrative and

Commerce)

Support Services Offices; includes Social Services) Neighborhood and Community Banks (includes Credit Unions) Nonprofit Headquarters Employment, Job-related

132

Housing, Shelter

U S C S TA T E O F T H E N E I G H B O R H O O D R E P O R T

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EDUCATION

category

subcategory

Arts, Culture and

Youth Development

specific category

Education All subcategories included Neighborhood and Community Child Care Centers Nonprofit Headquarters Educational Institutions

Humanities (includes theatre, dance, visual arts institutions, cultural foundation, galleries and museums) Organizational, Community and International Services Occupational and Professional Associations

Arts and Culture

(Education Associations)

(includes libraries, museums, parks)

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HEALTH

category

subcategory

specific category

Mental Health, Crisis

Disease, Disorders,

Medical Research

Intervention

Medical Disciplines

Environmental and Public Health and Safety Public Health Individual and Family Life Individual and Family Support Services (Adult Day Programs) (includes elderly care facilities and social services) Mental Health and Substance Abuse All subcategories included Nonprofit Headquarters Health Care

Organizational, Community and International Services Community Groups and Government and Administrative Offices (Categorical Program Administrative Units; includes L.A. County Department of Health Divisions of Aging and HIV/AIDS and the Los Angeles Unified School District Health & Human Services Division)

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NEIGHBORHOOD AND BUILT

category

subcategory

specific category

Donor Services

Information Services

ENVIRONMENT Basic Needs Transportation Food (Food Outlets; includes Farmers Markets) Environmental and Public Health and Safety Environmental Protection and Improvement

Public Safety (includes

(includes Police Department, environmental

fire departments,

protection agencies and organizations)

Department of Water & Power, Family Source Centers, Sheriff’s Department)

Individual and Family Life Leisure Activities (Parks and Recreation Areas, Recreational Activities and Sports, Physical Fitness) Organizational, Community and International Services Community Planning and Public Works

Disaster Services

Neighborhood and Community Grocery Stores Nonprofit Headquarters All subcategories included

usc_son_appendix_1e.indd 135

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SOCIAL CAPITAL

category

subcategory

Law Enforcement Services (Gang Programs,

Legal Assistance

Legal Services

Missing Persons Location Assistance)

Modalities (Advocacy,

specific category

Criminal Justice and Legal Services

Legal Counseling) Individual and Family Life Individual and Family Support Services

Leisure Activities

Mutual Support

Social Development and Enrichment

Spiritual Enrichment

Volunteer Opportunities

Volunteer Development

Arts and Culture (includes libraries,

Community Facilitates

Community Groups

Social Development and

museums, parks)

and Centers

and Government and

Enrichment

Organizational, Community and International Services

Administrative Offices (Community Action, Social Advocacy, Planning, Coordinating and Advisory Groups) Occupational and Professional Associations

Political Organizations

(Child Care Provider Associations, Child

and Participation

Welfare and Family Services Associations, Disability Associations, Home Care and Hospice Associations, Labor Organizations) Nonprofit Headquarters Arts, Culture and Humanities (includes

Civil Rights, Social

theatre, dance, visual arts institutions,

Action, Advocacy

Crime, Legal-related

Human Services

cultural foundation, galleries and museums) International, Foreign Affairs & National

Recreation, Sports,

Religion, Spiritual

Mutual and Membership

Security

Leisure, Athletics

Development

Benefit Organizations, Other

Philanthropy, Voluntarism and Grantmaking

Public Safety, Disaster

Public, Society Benefit

Youth Development

Preparedness and Relief Community Improvement, Capacity Building

136

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APPENDIX 6 TECHNICAL NOTES ON BOUNDARY SELECTION PROCESS Campus Study Area Boundary Selection Process We gathered input from both the community advisory board and the faculty task force on how the original boundaries (Nexus Study boundaries for University Park Campus study area and Good Neighbors Campaign for Health Sciences Campus study area) should either expand or contract around: 1. areas that they saw as cohesive, meaning they identify it as a community or neighborhood; 2. areas that USC serves; and 3. areas where they saw opportunities for USC and the community to work together. In general, we considered the following criteria to decide whether to adopt a recommendation or not: 1. agreement with other feedback (e.g., if recommendations were opposed to one another, we had to make a choice); 2. consistency with project goals (e.g., recommended boundaries should not extend well beyond USC’s sphere of interest or influence); 3. confirmation with local perspective (e.g., community advisory board and HealthyCity staff members who reside in areas of interest could confirm a recommendation); and 4. applicability (e.g., is the recommendation clear in how it can be applied?). Note on the interpretation of the boundaries: There are two main ways of thinking of the project boundaries. One is to think of the boundaries as a cutoff point for analysis, meaning if a building falls outside the boundary, it should not be considered in the analysis. The second option, our recommendation and the method used in this analysis, is to look at the communities inside the boundaries as connected to areas outside the boundaries. For instance, Lincoln High School’s mailing address is within project boundaries, but the actual building falls outside them. We still included the school in the analysis based on feedback from the community advisory board and faculty task force and because a significant portion of the population it serves lives within the project area.

Census Tract Selection Process To calculate estimates for the campus study areas based on census tract figures, we selected census tracts with centers inside study area boundaries. For the HSC study area, three additional census tracts were included based on recommendations from the faculty task force and community advisory board.

Zip Code Selection Process For campus study areas and the city of Los Angeles, zip codes with their centers within the boundaries were included. Zip codes that had at least 30% of their population within the boundaries were also included.

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APPENDIX 7 SECONDARY DATA METHODOLOGY American Community Survey Data Census tract estimates were aggregated and margins of error calculated for the campus and community boundaries using formulas in the U.S. Census Bureau’s A Compass for Understanding and Using American Community Survey Data. The same formulas were used to aggregate categories of data, such as the population with some college or more, which included individuals with some college, a college degree, a master’s degree, or professional and advanced degrees. The American Community Survey is an annual nationwide survey that collects data on age, sex, race and ethnicity, family and relationships, employment, housing and other important information. The 2005–2009 American Community Survey 5-year estimates are based on data collected between January 2005 and December 2009. These estimates represent the average characteristics during the 5-year period and are published for small geographic areas. When comparing estimates for different areas, the same period should be used for each estimate. For example, a 5-year estimate should not be compared to a 1-year estimate. Note: Focus group participants often reacted to 5-year estimates and may have based commentary on present-day conceptions of indicators like unemployment and home ownership. Visit http://www.census.gov/acs/www/index.html for more detailed information on comparing American Community Survey estimates. In this report, figures regarding uninsured persons, families in poverty, housing characteristics, employment characteristics, and demographic characteristics like race and ethnicity, language, age and educational attainment are American Community Survey estimates or derivations of them.

Bank Data Bank data were sourced from the DeLorme StreetAtlas 2014 using the following Yellow Pages keywords: Banks, Banks Commercial, Banks Commercial Savings, Banks Consulting Services, Banks Federal Savings, Banks Financial Planning, Banks Industrial, Banks Loans and Mortgage, Banks Savings, Banks Savings and Loan, Foreign Bank & Branches & Agencies, National Commercial Banks and State Commercial Banks. The resulting list was cleaned to exclude duplicates and any nonbank businesses that were erroneously included, such as check-cashing locations. The cleaned list was grouped by zip code to calculate the number of banks per zip code. Finally, the totals by zip code (2012 and 2014) were combined with Esri 2014 population data to calculate rates. DeLorme is a worldwide company that focuses on mapping, GPSm and digital data technologies (http://www.delorme.com/default.aspx).

Child Abuse and Neglect Data Figures regarding the number of children younger than 18 with a child abuse allegation referral per 1,000 children younger than 18 were derived from the California Department of Social Services and University of California, Berkeley Child Welfare Dynamic Reporting System.

Federally Qualified Health Center Data Only federally qualified health centers (FQHCs) coded as service delivery sites or as both a joint administrative and service delivery site were included in this analysis. Sites coded as simply administrative sites were excluded. In addition, FQHCs categorized as domestic violence, hospital, tribal or all other clinic types were included, whereas those categorized as school were filtered out. The

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resulting FQHCs were then grouped to obtain the total number per zip code. The zip code statistics were aggregated to create study area and city-level statistics. Finally, these data were combined with population data from Esri to calculate rates.

Job-to-Worker Ratio Data Job counts by income bracket were downloaded from the U.S. Census Bureau’s Longitudinal Employer-Household Dynamics data (http://lehd.ces.census.gov/) at the census tract level based on home address of employees and again based on the address of the employer. The job counts based on the employer addresses were then divided by job counts based on the employee addresses to create the job-to-worker ratios. The Longitudinal Employer-Household Dynamics program is part of the Center for Economic Studies at the U.S. Census Bureau. It produces new, cost-effective, public-use information combining federal, state and U.S. Census Bureau data on employers and employees under the Local Employment Dynamics Partnership. Under this partnership, states agree to share data on unemployment insurance earnings, employment and wages data with the U.S. Census Bureau. The Longitudinal Employer-Household Dynamics program combines these administrative data, additional administrative data, and data from censuses and surveys. From these data, the program creates statistics on employment, earnings and job flows at detailed levels of geography and industry and for different demographic groups. In addition, the program uses these data to create partially synthetic data on workers’ residential patterns.

Licensed Child Care Data California Department of Social Services Community Care Licensing Division data were geocoded using Esri ArcGIS 10 geographic information systems software. The 2011 child care providers were grouped by zip code and combined with census 2010 population data to calculate the 2011 rate. The 2013 child care providers were grouped by zip code and combined with Esri 2012 population estimates to calculate the 2013 rate. The Community Care Licensing Division (http://www.ccld.ca.gov/) promotes the health, safety and quality of life of each person in community care through the administration of an effective collaborative regulatory enforcement system.

Los Angeles County Sheriff’s Department Data Violent crimes include aggravated assault, homicide and robbery. Violent crime rates for 2007 were calculated with 2007 Nielsen Claritas population estimates. Rates for 2011 violent crime data were calculated using census 2010 population data. See http://www. lasd.org for more on the Sheriff ’s Department.

Los Angeles Police Department Data Violent crimes include aggravated assault, homicide and robbery. However, the rates in this report do not include certain particularly sensitive crimes typically included because the data were withheld from the Advancement Project. The crimes withheld included rape, child abuse, and domestic abuse, among other less common crimes. The Los Angeles Police Department-wide rate includes only crimes reported in Los Angeles city boundaries. The violent crime rate for 2007 was calculated with Nielsen Claritas population estimates for 2007. The rate for 2011 was calculated using census 2010 population data. See http://www.lapdonline.org/ for more details.

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Modified Retail Food Environment Index Modified Retail Food Environment Index data used in this report are from the Centers for Disease Control and Prevention (http:// www.cdc.gov/), one of the major operating components of the U.S. Department of Health & Human Services. The organization collaborates to create the expertise, information and tools that people and communities need to protect their health through health promotion, prevention of disease, injury and disability, and preparedness for new health threats.

Nonprofit Organization Data Internal Revenue Service address data for all nonprofits in California were geocoded using Esri ArcGIS 10 software. The number of nonprofit organizations in the campus community and Los Angeles city boundaries were totaled and combined with census 2010 population data to calculate rates. The Internal Revenue Service (http://www.irs.gov/) is the nation’s tax collection agency and administers the Internal Revenue Code enacted by Congress.

Open Space Data Greeninfo data were filtered and only open spaces categorized as open access were included in the calculations, whereas those with access categorized as no access, restricted access or unknown access were excluded. Area was calculated for the portion of each open space that fell within a campus community or city of Los Angeles boundaries. All open space areas in each of those boundaries were totaled and combined with population data to calculate the rate (Nielsen Claritas for 2009 data and Esri for 2014 data). These data are from the California Protected Areas Database, a geographic information systems inventory of all protected open space lands in the state of California, created by the GreenInfo Network (see http://calands.org/).

Preventable Hospitalizations Preventable hospitalization data are from the Office of Statewide Health Planning and Development (http://www.oshpd.ca.gov/), one of the 13 departments in the California Health and Human Services Agency. Its hospital discharge data record hospitalizations by disease or injury by the geographic area containing the patient’s home address.

School Data School third-grade reading, middle school truancy and high school graduation statistics are reported in this assessment. Schools had to meet one of two criteria to be included in community-level statistics: (a) located within a community boundary or (b) 20% or more of the school attendance boundary within the campus community boundary. The grades offered at each school determined its inclusion in the community-level measure calculations. Any school that offered third grade was included in the third-grade reading score calculations. Any school that offered sixth, seventh or eighth grade was included in the middle school truancy rate calculations. Any school that offered 12th grade was included in the high school graduation rate calculations. Data on schools in this report are from the California Department of Education (http://www.cde.ca.gov/index.asp).

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APPENDIX 8 STABILITY OF SECONDARY DATA ESTIMATES AND MARGINS OF ERROR Secondary data for this work come from 100% counts of people and from surveys that estimate true population values. All surveys are subject to sampling error, and it is important to communicate the strength of data used to guide important decisions. To communicate the strength of data in the report, we did the following. First, we displayed margins of error with all estimates and calculated margins of error whenever we derived estimates from other data. Estimates such as 33.7% of Health Sciences Campus community members are without health insurance are presented with a +/- 1.4% margin of error. This margin reflects a 90% confidence interval, meaning there is a 10% chance that the true estimate falls outside the interval.8

Second, we tested the strength of estimates based on the coefficient of variation. Some researchers categorize coefficients of variation9 as follows: Less than 12%: high reliability 12%–40%: medium reliability More than 40%: low reliability All University Park and Health Sciences campus overall study area estimates are high- or medium-reliability estimates. Calculated coefficient of variation for all indicators in both campus study areas where found to have reliable or acceptable estimates. For census tract specific data, calculated coefficient of variation expressed variability due to smaller units of analysis. Third, we visualized the strength of estimates so it is known what portions of campus communities are subject to more or less error. The maps can be viewed on the HealthyCity.org group page accompanying this report. Statistical methods cannot account for every type of secondary data error. Surveyors may not have been trained properly; survey respondents may not have understood questions they answered and responses could have been lost in processing. Knowing this, we sought to verify much of the data collected with residents, community-based organizations, faculty members and staff members in focus groups, thus collecting primary data on conditions so the report doesn’t rely on secondary data alone. Further information collected from previously completed reports of the area helped to triangulate data to increase the accuracy of our understanding of community conditions. Calculated coefficient of variation expressed variation in reliability due to smaller units of analysis.

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APPENDIX 9 SIGNIFICANCE OF THE DIFFERENCES BETWEEN USC STUDY AREAS AND CITY OF LOS ANGELES ESTIMATES WITH COEFFICIENTS OF VARIATION (CV) FOR SURVEY ESTIMATES UNINSURED POPULATION Health Sciences Campus

Estimate (%)

Margin of Error (+/-) Difference is significant at a 99% confidence level.

Study Area

33.7

1.4

CV (%)*

exists between the Health Campus Study

2.5

area and the city of Los Angeles.

Reliable Estimate

You can be 99% certain that a difference

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

37.5

1.1

You can be 99% certain that a difference

CV (%)*

exists between the University Park Campus

1.8

Study area and the city of Los Angeles.

Reliable Estimate

Los Angeles

Estimate (%)

Margin of Error (+/-)

25.8

0.2

CV (%)*

0.5

Reliable Estimate

LENGTH OF RESIDENCE: 1969 OR EARLIER Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 90% confidence level.

Study Area

8.3

0.9

You can be 90% certain that a difference exists

CV (%)*

between the Health Campus Study area and the

6.6

city of Los Angeles.

Reliable Estimate

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

6.1

0.7

You can be 99% certain that a difference exists

CV (%)*

between the UPC Study area and the city of

6.7

Los Angeles.

Reliable Estimate

Los Angeles

Estimate (%)

Margin of Error (+/-)

7.3

0.1

CV (%)*

0.8

142

Reliable Estimate

U S C S TA T E O F T H E N E I G H B O R H O O D R E P O R T

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LENGTH OF RESIDENCE: 1980 OR 1989 Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

8.3

0.9

You can be 90% certain that a difference exists

CV (%)*

between the Health Campus Study area and the

6.6

city of Los Angeles.

Reliable Estimate

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

6.1

0.7

You can be 99% certain that a difference exists

CV (%)*

between the UPC Study area and the city of

6.7

Los Angeles.

Reliable Estimate

Los Angeles

Estimate (%)

Margin of Error (+/-)

7.3

0.1

CV (%)*

0.8

Reliable Estimate

LENGTH OF RESIDENCE: 2000-2009 Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is not statistically significant.

Study Area 51.9 1.7

CV (%)*

2.0

Reliable Estimate

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

55.1

1.4

You can be 99% certain that a difference exists

CV (%)*

between the University Park Campus Study area

1.6

Reliable Estimate

and the city of Los Angeles.

Los Angeles

Estimate (%)

Margin of Error (+/-)

52.2

0.3

CV (%)*

0.3

Reliable Estimate

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FAMILIES IN POVERTY WITH RELATED CHILDREN Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

34.2

2.3

You can be 99% certain that a difference exists

CV (%)*

between Health Campus Study area and the city

4.1

Reliable Estimate

of Los Angeles.

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

47.3

2.2

You can be 99% certain that a difference exists

CV (%)*

between the University Park Campus Study area

2.8

Reliable Estimate

and the city of Los Angeles.

Los Angeles

Estimate (%)

Margin of Error (+/-)

25.2

0.5

CV (%)*

1.2

Reliable Estimate

UNEMPLOYMENT RATE WITH NO COLLEGE EDUCATION Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is not statistically significant.

Study Area 87.8 5.1

CV (%)*

3.5

Reliable Estimate

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is not statistically significant.

Study Area 88.7 4.5

CV (%)*

3.1

Reliable Estimate

Los Angeles

Estimate (%)

Margin of Error (+/-)

88.9

1.2

CV (%)*

0.8

144

Reliable Estimate

U S C S TA T E O F T H E N E I G H B O R H O O D R E P O R T

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MEDIAN GROSS RENT

Health Sciences Campus

Estimate ($)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

922

77

You can be 99% certain that a difference exists

CV (%)*

between the Health Campus Study area and the

5.1

Reliable Estimate

city of Los Angeles.

University Park Campus

Estimate ($)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

895

63

You can be 99% certain that a difference exists

CV (%)*

between the University Park Campus Study area

4.3

and the city of Los Angeles.

Reliable Estimate

Los Angeles

Estimate ($)

Margin of Error (+/-)

1156

5

CV (%)*

0.3

Reliable Estimate

RENT STABILIZED HOUSING

Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

81.1

2.9

You can be 99% certain that a difference exists

CV (%)*

between the Health Campus Study area and the

2.2

Reliable Estimate

city of Los Angeles.

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

79.8

2.1

You can be 99% certain that a difference exists

CV (%)*

between the University Park Campus Study area

1.6

and the city of Los Angeles.

Reliable Estimate

Los Angeles

Estimate (%)

Margin of Error (+/-)

75.9

0.5

CV (%)*

0.4

Reliable Estimate

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SOME COLLEGE OR MORE Health Sciences Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

25.1

1.4

You can be 99% certain that a difference exists

CV (%)*

between the Health Campus Study area and the

3.4

Reliable Estimate

city of Los Angeles.

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 99% confidence level.

Study Area

28.8

0.9

You can be 99% certain that a difference exists

CV (%)*

between the University Park Campus Study area

1.9

Reliable Estimate

and the City of Los Angeles.

Los Angeles

Estimate (%)

Margin of Error (+/-)

55.0

0.3

CV (%)*

0.3

LINGUISTIC ISOLATION Health Sciences Campus

Reliable Estimate

Estimate (%)

Margin of Error (+/-)

Difference is not statistically significant.

Study Area 25.6 9.0

CV (%)*

21.4

Acceptable Estimate

University Park Campus

Estimate (%)

Margin of Error (+/-)

Difference is significant at a 95% confidence level.

Study Area

28.8

8.6

You can be 95% certain that a difference exists

CV (%)*

between the University Park Campus Study area

18.3

Acceptable Estimate

and the City of Los Angeles.

Los Angeles

Estimate (%)

Margin of Error (+/-)

17.0

0.2

CV (%)*

0.9

146

Reliable Estimate

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APPENDIX 10 USC COMMUNITY PROGRAM LIST USC has a longstanding commitment to strengthening their neighboring community. Numerous USC funded programs contribute to the economic health, sustainability and stability of UPC and HSC areas. Provided below is an abbreviated list of community–university programs that address indicators addressed in the report.

UPC Community Programs ECONOMIC STABILITY The Los Angeles Minority Business Development Agency (MBDA) Business Center at USC is funded by the U.S. Department of Commerce and the center has been hosted at USC Civic Engagement and Economic Development since 1996. The program has provided business technical assistance services such as management consulting to small, minority-owned enterprises and helped them access over $200 million in loans and equity investments, as well as more than $500 million in procurement contracts. As a result of these services, USC has aided in the creation of thousands of jobs in the Los Angeles area. The MBDA is the only federal agency created specifically to foster the full participation and entrepreneurial parity of minority business enterprises in our national economy. https://communities.usc.edu/minority-business-development-agency-los-angeles/ phone: (213) 821-2542 The USC Bridges to Business Success program is a capacity building procurement training program with a focus to enable the small, minority-owned and veteran-owned enterprises to be contract-ready and to be prepared to secure and manage new contracting opportunities. In 2011, USC led the design of a new innovative public/private/nonprofit partnership between USC, the Los Angeles MBDA Business Center, the Southern California Supplier Development Council (SCMSDC), the U.S. Small Business Administration and the Mayor’s Office of Economic Development. As of December 2013, the USC Bridges Program had 100 graduates with outcomes that included 209 awarded contracts that total $11.2 million. As a whole, the program graduates created and retained 438 jobs in our communities and were able to successfully access $600,000 in financing. Currently, the program curriculum is designed for businesses in the real asset management industry such as construction contractors, plumbers, electricians, landscape architects and related fields. http://www.uscbridgesprogram.com/#!about/cjg9 phone: (213) 821-2542 email: info@uscbridgesprogram.com USC and Univision provide one of the largest financial resource fairs in the country. More than 5,999 Latinos attend Feria Financiera to gain information on college aid, home financing, stock investments, consumer protection and resources for small businesses. http://communities.usc.edu/univisions-feria-financiera/ Joint Educational Project is one of the oldest and largest service learning programs in the country, offering students at USC the unique opportunity to combine academic coursework with experiences in the community surrounding the campus. This program enables students to learn firsthand issues facing urban communities. https://communities.usc.edu/joint-educational-project-jep-service-learning/ usc contact: DJ Kast phone: (951) 818-4659 email: dkast@usc.edu

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The Network for Teaching Entrepreneurship (NFTE) Youth Entrepreneurship Initiative provides teens with an academically rigorous, hands-on entrepreneurship training program. With assistance from USC students, teens will gain job and college readiness skills through the completion of a business plan and related activities. http://uscfamilyofschools.com/nfte-usc-greif-center-youth-entrepreneurship-initiative/ usc contact: USC Marshall School of Business, Professor William H. Crookston phone: (213) 740-0649 email: bcrookston@verizon.net

EDUCATION The USC Neighborhood Academic Initiative is a seven year program offered in local middle and high schools structured to prepare low-income students for college admission, engage parents in their child’s education and provide ongoing support throughout the student’s collegiate years. https://communities.usc.edu/college-access/nai/ usc contact: Kim Thomas-Barrios phone: (213) 743-1594 email: thomasba@usc.edu USC School for Early Childhood Education provides comprehensive, high-quality Head Start and Early Head Start programs for more than 500 families in South Los Angeles. https://communities.usc.edu/school-for-early-childhood-education-sece/ usc contact: Phillipa Johnson phone: (213) 821-3133 email: johnsonp@usc.edu The Good Neighbors Campaign funds the Redeemer Community Partnership’s Family Learning Academy, which hosts parent learning days to assist parents with supporting their child’s academic achievement. http://www.redeemercp.org/#!about2/c3fa USC’s Kinder to College program enrolls kindergarten boys in an initiative that prepares them to be proficient in reading and writing by the end of the third grade. http://communities.usc.edu/kinder-2-college/ usc contact: Kim Thomas-Barrios phone: (213) 743-1594 email: thomasba@usc.edu The Norman Topping Student Aid Fund provides neighborhood youth with college access information and offers current first generation students critical support services while they are enrolled at USC. http://sait.usc.edu/ntsaf/index.asp usc contact: Christina L. Yokoyama phone: (213) 740-7575 email: cyokoyam@usc.edu , ntsaf@usc.edu

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HEALTH AND HEALTH CARE The USC Neighborhood Mobile Dental Van provides free dental services to thousands of South Los Angeles residents. http://dentistry.usc.edu/community-programs/mobile-clinics/ usc contact: Carlos Sanchez and Linda Brookman email: carlos.sanchez@usc.edu, lbrookman@usc.edu USC After School Sports Connection provides elementary school students with quality sports, fitness and general health programs in a cost-free, efficient and effective manner. http://sait.usc.edu/Recsports/programs/youth-programs/assc-page usc contact: Cynthia Brass phone: (213) 740-9252 email: brass@usc.edu The Fuente Initiative provides poison prevention education, appropriate drug use and self-management education, and general health education and screenings for diabetes, hypertension and obesity. http://uscfamilyofschools.com/fuente-initiative/ usc contact: Steve Chen phone: (323) 442-1394 email: chens@usc.edu The Trojan Health Volunteers gives pre-health students the opportunity to obtain volunteering experience in the Los Angeles area. The program is not only a community outreach program, but it also strives to be a forum for discussion about current bioethics topics and related health care issues. http://dornsife.usc.edu/trojan-health-volunteers usc contact: DJ Kast phone: (951) 818-4659 email: dkast@usc.edu

NEIGHBORHOOD AND BUILT ENVIRONMENT The Good Neighbors Campaign funds Peer Meditation USC UPC. This meditation program teaches elementary school children mediation and conflict resolution with the goal of reducing community conflict and violence. http://invla.org/ usc contact: Kim Thomas-Barrios phone: (213) 743-1594 email: thomasba@usc.edu Since 1996, USC Kid Watch has mobilized 800 volunteers each year to provide safe passage for more than 9,000 neighborhood children as they walk to and from school, local parks, museums and libraries, and other neighborhood areas. http://communities.usc.edu/health-and-safety/kid-watch/ usc contact: Kim Thomas-Barrios phone: (213) 743-1594 email: thomasba@usc.edu

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In partnership with USC Fire Safety and Emergency Planning, City of Los Angeles Emergency Management Department and City of Los Angeles Fire Department, Kid Watch conducts Community Emergency Response Training for contingencies such as earthquakes and fires by building teams among the groups of community members. http://create.usc.edu/2014/03/usc-create_and_community_leade.html phone: (213) 740-3863 email: create@usc.edu Norman Topping Student Aid Fund Safe Halloween provides an evening of tricks and treats to children in the community from 4 to 9 p.m. on Halloween day. The annual event is free and open to the public. https://studentaffairs.usc.edu/safe-halloween-promises-free-fun-for-local-kids/ usc contact: Christina Yokoyama phone: (213) 740-7575 email: cyokoyam@usc.edu Norman Topping Student Aid Fund (NTSAF) annual Eggster event. Eggster has grown into a nondenominational celebration of the rites of spring. Volunteers come together to plan and carry out a day filled with educational booths, inflatable rides, various performances and egg hunts for families of the local surrounding community. http://sait.usc.edu/ntsaf/programs.asp usc contact: Christina Yokoyama phone: (213) 740-7575 email: cyokoyam@usc.edu The After-Cool Theater Program is a free, after-school arts program that uses theatre as a tool to emphasize the importance of higher education. The program allows children and youth to develop a strong sense of self, learn to use creativity and imagination to problem solve, and have an outlet for the pressures of urban life. http://communities.usc.edu/about/community-programs-new/ usc contact: Brent Blair phone: (213) 740-7175 email: bblair@usc.edu

SOCIAL CAPITAL A Community Place is a student-run social service program providing meals, bus tokens, taxi vouchers and other resources to community residents. http://uscesa.com/a-community-place/ email: acommunityplace@gmail.com USC Galen Center Community Fund’s purpose is to provide a meeting and gathering space to local nonprofits and schools for events. usc contact: Carolina Castillo email: ccastill@usc.edu

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The USC Community House is open to anyone in the USC neighborhood who wishes to inquire about USC Civic Engagement Programs. phone: (213) 743-5262

HSC Community Programs ECONOMIC STABILITY The Health Sciences Campus Community Partnerships has launched a “Jobs at USC” awareness initiative, using a mobile computer technology van to link local residents in Boyle Heights, Lincoln Heights and El Sereno to employment opportunities at USC. In 2014, 145 job seekers were trained by USC’s Talent Management department to provide advice on entry-level pathways, conduct effective online job searches, set up an account to apply for jobs at USC and successfully complete job applications. https://communities. usc.edu/job-fair-in-lincoln-heights/ usc contact: Zul Surani email: zsurani@usc.edu In the 1970s, USC’s School of Medicine founded Medical Organizing, Counseling and Recruiting Programs which improves and nurtures the motivation, dedication and academic skills of 40 Latino, black and other under-represented students at Bravo High School who are interested in health-related careers, including medicine, nursing and allied health. http://medcor.usc.edu/ usc contact: Kerry Franco phone: (323) 442-1530 email: kfranco@usc.edu USC Concurrent Enrollment Program provides information on career opportunities in allied health occupations for high school students. This program offers certified nursing curriculum simultaneously with general education requirements while completing high school. usc contact: Dr. Theda Douglas email: Thedadou@usc.edu Engineering for Health Academy prepares high school students, including underrepresented minorities, for careers in biomedical engineering with firsthand laboratory experience. http://bmes-erc.usc.edu/outreach/engineering-for-health-academy-eha-at-bravo-medical-magnet-high-school.htm usc contact: Joe Cocozza email: cocozza@usc.edu

EDUCATION The USC Penny Harvest, implemented by Civic Engagement’s Health Sciences Campus Community Partnerships fosters in elementary students the personal qualities that prepare them to be civically-engaged members of society. While it supplements core classroom lessons in areas such as persuasive writing, oral presentation and mathematics, The USC Penny Harvest also integrates concepts of empathy, leadership and advocacy. Through the combination and refinement of these attributes, more than 2,200 students in elementary schools in Boyle Heights and South Los Angeles are taught to contribute to their community’s greater dialogue on addressing its most pressing needs. usc contact: Zul Surani email: zsurani@usc.edu

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The USC Health and Science Fair is an annual program through which 350 fifth-grade students from Griffin, Murchison and Sheridan Street elementary schools learn science and health concepts from graduate students in USC’s Keck School of Medicine and Pharmacy. The fifth-graders are not only exposed to advanced health and science topics, but the mentorship of USC students also provides them with insight and guidance about setting academic and career goals in pursuit of these fields. usc contact: Zul Surani email: zsurani@usc.edu The USC Science, Technology and Research (STAR) Program is a collaborative with Francisco Bravo Medical Magnet High School, linking high school students with a USC scientist providing mentorship and hands-on laboratory experience. usc contact: Dr. Roberta Diaz Brinton email: rbrinton@usc.edu phone: (323) 442-1430

HEALTH AND HEALTH CARE Keck Medicine of USC has launched NortheastLAHealth!, a program of the Dean’s Community Leadership Council. This program is a network of local clinics, including federally qualified health centers and community clinics in My Health LA to improve access for communities around USC’s HSC to free and low-cost, high quality health care, including for those who don’t qualify for Covered California. http://www.nelahealth.com The Ramona Gardens Women’s Health initiative launched in 2014, provides culturally-tailored, evidence-based health education and health care access to 350 women and their families in the Ramona Gardens area. Classes are taught by promotoras/lay health advisors, providing information on cancer, heart disease and diabetes, and community members are linked to local health providers in the North East Los Angeles Health program, including prevention resources such USC’s Fit Families exercise program and programs at the LAC+USC Wellness Center, in addition to finding ways to utilize the built environment to improve health such as walking paths at Hazard and Lincoln parks. usc contact: Zul Surani email: zsurani@usc.edu The Good Neighbors Campaign funds Proyecto Jardín to establish a community garden at the LAC+USC Wellness Center in 2013 in collaboration with USC Norris Comprehensive Cancer Center. The program is part of a larger food justice collaborative for Boyle Heights, Lincoln Heights and El Sereno in partnership with the California Endowment and USC HSC Community Partnerships in Civic Engagement. The program also created “Agricorps” to support the establishment of other community gardens in the community and advocate for healthy foods options. usc contact: Zul Surani email: zsurani@usc.edu The LAC+USC Breathmobile program serves nearly 100 locations throughout East Los Angeles and South Los Angeles. The program delivers asthma-specialty care to underserved children around the local community. http://www.labreathmobile.com/ phone: (323) 226-3813

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Fit Families, a program run by Herman Ostrow School of Dentistry of USC and the USC Division of Physical Therapy to provide pro bono preventive and wellness physical therapy services to neighborhood elementary-school-aged children. http://pt.usc.edu/fit_families/ phone: (323) 224-5592 email: uscfitfamilies@gmail.com The University of Southern California Maternal Child and Adolescent/Adult Center for Infectious Diseases and Virology provides comprehensive multidisciplinary care to HIV positive women, children and adolescents, and their families with special needs in a culturally sensitive environment. http://keck.usc.edu/Education/Academic_Department_and_Divisions/Department_of_Pediatrics/Clinical_Services/MCA/ About_MCA.aspx phone: (323) 226-2200

NEIGHBORHOOD AND BUILT ENVIRONMENT USC Department of Emergency Medicine and USC Center for Trauma, Violence and Injury Prevention have partnered with East Los Angeles Women’s Center to provide Promotoras Contra La Violencia. Promotoras Contra La Violencia, housed in the Wellness Center, received USC Good Neighbor’s funding to empower women who are at risk of living with intimate partner violence. usc contact: Dr. Deidre Anglin email: anglin@usc.edu Good Neighbors Domestic Violence Healthy project assists women and children to heal from trauma of domestic violence through gardening and food cultivation. http://www.1736familycrisiscenter.org/ USC Contact: Dr. Mellissa Withers email: mwithers@usc.edu Safe Streets – CHLA prevention program addresses pedestrian safety in local schools. usc contact: Dr. Jeffrey Upperman email: jupperman@chla.usc.edu Lincoln Heights Certified Farmers Market is set to be launched in 2015 to provide health food options for residents of Lincoln Heights, Boyle Heights and El Sereno. usc contact: Pauline Martinez email: Pauline.martinez@usc.edu Legacy LA and Preventive Medicine will develop a youth development curriculum using a community-based participatory process. The outcomes of this program will include a curriculum for youth development and an infrastructure to engage youth in development of the Ramona Gardens neighborhood. usc contact: Zul Surani email: zsurani@usc.edu

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Keck School of Medicine in collaboration with the USC HSC Community Partnerships in Civic Engagement and the Clinical Science Translational Institute are collaborating with the Variety Boys and Girls Club in Boyle Heights to build capacity around child abuse prevention through use of evidence-based programs. The goal of this effort is to develop a sustainable initiative for the areas around HSC. usc contact: Zul Surani email: zsurani@usc.edu The USC HSC Community Partnerships in Civic Engagement and Keck Medicine supports the annual Mariachi Festival organized by the Mariachi Foundation in Boyle Heights and Casa 1010 theater. The goal of this program is to leverage arts and cultural assets for community education, health screening and access to health services many of which have been provided by Keck Medicine of USC and HSC CP. In 2014, over 2,000 people participated in this program. usc contact: Zul Surani email: zsurani@usc.edu

SOCIAL CAPITAL USC Health Sciences Campus Master Plan outreach efforts have engaged communities in Boyle Heights, Lincoln Heights and El Sereno to increase participation in community development efforts around the HSC. Through 25 community presentations, including discussions at Neighborhood Council meetings and with community organization leaders, USC has enabled the community’s voice in the development efforts. Community gaps were also identified in this area and efforts toward addressing them are underway. USC Health Sciences Campus Master Plan outreach efforts will continue in 2015–2016 to further engage communities in the above identified neighborhoods. http://communities.usc.edu/about/our-neighborhoods/health-sciences/hsc-calendar-of-events/ usc contact: Zul Surani email: zsurani@usc.edu The Good Neighbors Grants program holds community informational sessions to coach organizations on how to apply for USC’s neighborhood grants using best practices while addressing infrastructure needs. https://goodneighbors.usc.edu/apply/ The Community Grants and Sponsorship Program is available to community organizations wishing to partner with USC to respond to identified community health needs. http://www.keckmedicine.org/community-benefit/ email: Benefitandoutreach@med.usc.edu

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ENDNOTES 1 Community-Campus Partnerships for Health. (n.d.). FAQ. Retrieved from https://ccph.memberclicks.net/index. php?option=com_content&view=article&id=41:faq&catid=23:about-us&Itemid=100 2 Wortis, N., Goldstein, E., Vargas, R. A., & Grumbach, K. (2006). Engaging a university in self-assessment and strategic planning to build partnership capacity: The UCSF experience. Journal of Higher Education Outreach and Engagement, 11, 121–138. 3 Schulz, A. J., Parker, E. A., Israel, B. A., Becker, A. B., Maciak, B. J., & Hollis, R. (1998). Conducting a participatory community-based survey for a community health intervention on Detroit’s East Side. Journal of Public Health Management Practice, 4(2), 10–24. 4

Advancement Project. (2011). A short guide to community based participatory action research. Retrieved from http://www.healthycity.org/toolbox

5

Office of Behavioral and Social Sciences Research. (n.d.). Community-based participatory research. Retrieved from http://obssr.od.nih.gov/scientific_areas/methodology/ community_based_participatory_research/index.aspx 6 Horowitz, C. R., Robinson, M., & Seifer, S. (2009). Community-based participatory research from the margin to the mainstream: Are researchers prepared? Circulation, 119, 2633–2642. doi:10.1161/CIRCULATIONAHA.107.729863 7

Minkler, M. (2000). Using participatory action research to build healthy communities. Public Health Reports, 15, 191–197.

8

U.S. Census Bureau. (2009). A compass for understanding and using American Community Survey data: What researchers need to know. Retrieved from http://www.census. gov/acs/www/Downloads/handbooks/ACSResearch.pdf 9 Esri. (n.d.). American Community Survey (ACS): Understanding margins of error. Retrieved from http://www.esri.com/software/american-community-survey/ understanding-margin-error

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THE UNIVERSITY OF SOUTHERN CALIFORNIA (USC) is an active member of Southern California’s economic, cultural and civic life. Our mission is to develop “human beings and society as a whole through the cultivation and enrichment of the human mind and spirit.” The principal means by which our mission is accomplished are teaching, research, artistic creation, professional practice and selected forms of public service. At the heart of our mission is a longstanding dedication to our local neighborhoods—a solid commitment to nurturing bonds that remain mutually beneficial. Each year, the university allocates nearly $6 million to support civic engagement, service learning and volunteer programs that are led by faculty members, staff members and our students. In our surrounding neighborhoods and around the globe, USC provides public leadership and public service in such diverse fields as health care, economic development, social welfare, scientific research, public policy and the arts. We also serve the public interest by being the largest private employer in the city of Los Angeles, as well as the city’s largest export industry in the private sector. THE STATE OF THE NEIGHBORHOOD PROJECT was initiated in 2013 with support from the USC Office of the Provost and Office of the Senior Vice President for University Relations to 1) examine conditions in the communities surrounding the University Park and Health Sciences campuses, 2) identify strategic priority areas for USC civic engagement efforts and opportunities for interdisciplinary faculty research and scholarship that could further inform community needs and assets and place-based research and interventions; 3) and serve as a resource and framework for university and community stakeholders in the areas of civic engagement, place-based research and student service learning. The Project’s work is informed by group of stakeholders comprised of a Community Advisory Board and Faculty Task Force. ADVANCEMENT PROJECT is a public policy change organization rooted in the civil rights movement. We engineer large-scale systems change to remedy inequality, expand opportunity and open paths to upward mobility. Our goal is that members of all communities have the safety, opportunity and health they need to thrive. The Healthy City program transforms how people access and use information about their communities. Healthy City is an information-plus-action resource that unites community voices, rigorous research and innovative technologies to solve the root causes of social inequity.

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