usc state of the neighborhood report 2015

USC STATE OF THE NEIGHBORHOOD REPORT

April 2015

HORTENSIA AMARO, PH.D.Associate Vice Provost for Community Research Initiatives,

Deans 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,

Deans Professor of Social Work and

Professor of Preventive Medicine, Keck School of Medicine of USC

University of Southern California

and

ADVANCEMENT PROJECT

usc_son_intro_1i.indd 1 4/8/15 12:02 PM

USC State of the Neighborhood Report

Copyright 2015 by the University of Southern Californias 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

[email protected]

(213) 821-6462

(213) 821-5567 (assistant)


TABLE OF CONTENTSACKNOWLEDGMENTS ..................................................................................................................................................................vii

EXECUTIVE SUMMARY ...................................................................................................................................................................ix

INTRODUCTION ...................................................................................................................................................................................1

RESEARCH APPROACH .................................................................................................................................................................. 5

UNIVERSITY PARK CAMPUSCommunity History and Demographics ..................................................................................................................................................... 17

Community Conditions ................................................................................................................................................................................19

n Economic Stability ...............................................................................................................................................................................19

n Education ........................................................................................................................................................................................... 30n Health and Health Care ....................................................................................................................................................................... 36n Neighborhood and Built Environment ................................................................................................................................................. 43

n Social Capital ...................................................................................................................................................................................... 50Community Resources .................................................................................................................................................................................55

Recommendations ....................................................................................................................................................................................... 59

HEALTH SCIENCES CAMPUSCommunity History and Demographics .................................................................................................................................................... 69

Community Conditions ................................................................................................................................................................................71

n Economic Stability ...............................................................................................................................................................................71

n Education ............................................................................................................................................................................................81n Health and Health Care ....................................................................................................................................................................... 88n Neighborhood and Built Environment ................................................................................................................................................. 95

n Social Capital .....................................................................................................................................................................................103Community Resources .............................................................................................................................................................................. 109

Recommendations .......................................................................................................................................................................................112

CONCLUSION .....................................................................................................................................................................................121

APPENDICESAppendix 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

TABLESTable 1: Families with Children in Poverty as a Percentage of all Families with Children ...................................................................................19

Table 2: Unemployed Persons Ages 2564 as a Percentage of the Civilian Noninstitutional Labor Force by College Education, 20082012 .... 21

Table 3: Job-to-Worker Ratio by Monthly Earnings Level, Years 2002 and 2011.............................................................................................. 23

Table 4: Median Rent in Unadjusted Dollars, 20082012 ................................................................................................................................25

Table 5: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, 20082012 .................................25

Table 6: Banks per 10,000 Persons ................................................................................................................................................................27

Table 7: Percentage of Children Ages 05 with a Licensed Child Care Seat ..................................................................................................... 31

Table 8: Third-graders Scoring Proficient or Advanced on English Language Arts Exam, 20122013 ................................................................33

Table 9: High School Graduation Rate, 20112012 .......................................................................................................................................... 34

Table 10: Middle School Truancy Rate, 20102011 ......................................................................................................................................... 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 20082012 .....73

Table 21: Job-to-Worker Ratio by Monthly Earnings, 2002 and 2011 ...............................................................................................................75

Table 22: Median Rent in Unadjusted Dollars, 20082012 ............................................................................................................................. 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 05 with a Licensed Child Care Seat .................................................................................................. 83

Table 26: Third-graders Scoring Proficient or Advanced on English Language Arts Exam, 20122013 ............................................................. 84

Table 27: High School Graduation Rate, 20112012 ........................................................................................................................................ 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 20102011 .......................................................................................................................................... 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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MAPSMap 1: University Park Campus Study Area .....................................................................................................................................................18

Map 2: Families with Children in Poverty as a Percentage of all Families with Children, 20082012 ................................................................ 20

Map 3: Employment Rate with No College Education, 20082012...................................................................................................................22

Map 4: Median Rent in Unadjusted Dollars, 20082012 ................................................................................................................................. 24

Map 5: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, 20082012 .................................. 26

Map 6: Banks per 10,000 Persons, 2014 ........................................................................................................................................................ 28

Map 7: Children 05 with Licensed Child Care Seats, 2013 ..............................................................................................................................32

Map 8: Percentage of Population without Health Insurance, 20082012 ........................................................................................................ 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, 20082012 ...............................................................72

Map 19: Employment Rate with No College Education, 20082012 ................................................................................................................ 74

Map 20: Median Rent in Unadjusted Dollars, 20082012 ............................................................................................................................... 76

Map 21: Rental Units Protected under the Rent Stabilization Ordinance as a Percentage of all Rental Units, 20082012 .................................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, 20082012 ......................................................................................................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, 20102011 .................................................................................................................................... 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

FIGURESFigure 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, 20082012 ................................................................................................................. 51

Figure 5: Violent Crime per 1,000 Persons, 2007 and 2011 ............................................................................................................................ 97

Figure 6: Year Householder Moved into Housing Unit, 20082012 ...............................................................................................................105

Figure 7: Elements of an Authentic Partnership ............................................................................................................................................ 122

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ACKNOWLEDGMENTSThe University of Southern Californias 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 Projects 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 SUMMARYThe 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 neigh-borhoods surrounding the University of Southern Californias (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 communityuniversity partnerships to guide activities in priority areas in civic engage-ment, 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 conceptual-ized 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 Projects 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 stake-holders 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 commu-nity 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, commu-nity 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 RECOMMENDATIONSThe 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 African-American (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 Projects Community Advisory Board and Faculty Task Force.

Economic Stability

The proportion of families with children under age 18 living in poverty from 20082012 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 20082012 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 citys Rent Stabilization Ordinance between 2000 (82%) and 20082012 (79.8%) and increased student housing demand were noted by commu-nity 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-in-come 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 20102013 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 20082012) than for residents in the UPC study area (from 22.9% in 2000 to 28.8% in 20082012).

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 gradu-ates 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 20082012, 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 underen-rollment. 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 AdamsNormandie 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 accessabout 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 childrens 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 environ-ment 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 afford-able 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 organiza-tions 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 strat-egies 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 commu-nity 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 RECOMMENDATIONSThe 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 Projects Community Advisory Board and Faculty Task Force.

Economic Stability

Estimates from 20082012 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 (2564 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 20082012 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).

Focus 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 Stabiliza-tion 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 05 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 20122013 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 20112012 graduation rates (LAUSD gradu-ated 66.6% of students). The two high schools with lower graduation rates than the district were in Boyle Heights.

In 20082012, 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 20102011 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 educa-tors 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.


The HSC study area had a high rate of residents without health insurance. Data from 20082012 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 20082012 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.


x v i i

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 hospital-izations 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-


x v i i i

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 collab-orative 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 indica-tors 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.


x i x

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.

CONCLUSIONSThis 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 collabora-tions. Focus group participants and members of the community advisory board and faculty task force noted opportunities for strength-ening 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 USCs 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 USCs 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 Projects 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 USCs 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 communitycampus partnerships and innovation in advancing equity and economic inclusion.


1

INTRODUCTIONHISTORYIn 1992, the University of Southern California (USC) launched five community initiatives that set the foundation for USCs 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 universitys various academic units and departments.

The initiatives were:1. Successful Schools2. Healthy Families3. Connecting Campus and Community4. Thriving Businesses5. 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 Deans 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.

GOALSThe 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


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

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

STAKEHOLDER INPUT AND COLLABORATIONAt 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 studys geographic boundaries for both University Park Campus study area and Health Sciences Campus study area;

Secondary data indicators for:1. Demographics2. Economic Stability3. Education4. Health and Health Care5. Neighborhood and Built Environment6. 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.


I N T R O D U C T I O N 3

ORGANIZATION OF THE REPORTThis 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 subsec-tions 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.



ENDNOTES1List 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



RESEARCH APPROACHCONCEPTUAL FRAMEWORKIn the process of creating the research approach for this project, the following three frameworks were explored:

Social Determinants of Health CommunityCampus 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 communitycampus 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 condi-tions; 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 individuals ability to acquire safe housing and purchase fresh fruits and vegetables on an ongoing basis; quality of education may affect a persons 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 Projects 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 nations 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



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

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: Availability 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 Availability 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: Economic stability: poverty, employment status, access to employment, housing stability (e.g.,

homelessness, foreclosure)

STRUCTURAL DETERMINANTSSOCIAL DETERMINANTS OF

HEALTH INEQUITIES

SOCIOECONOMICAND POLITICAL

CONTEXT

Governance

MacroeconomicPolicies

Social PoliciesLabour Market,Housing, Land

Public PoliciesEducation, Health,Societal Protection

Culture andSocietal Values

SocioeconomicPosition

Social ClassGender

Ethnicity (Racism)

Education

Occupation

Income

INTERMEDIARY DETERMINANTSSOCIAL DETERMINANTS OF

HEALTH

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

Behaviors andBiological Factors

Psychosocial Factors

Social Cohesion & Social Capital

Health System

IMPACT ONEQUITY IN

HEALTH ANDWELL-BEING



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 MATTERSRobert 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 Amaros 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 popula-tion-level interventions to improve health.

Further, in a recent report, Bell and Lee12 found that an individuals address makes a significant difference in that persons health outcomes. For instance:



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 FRAMEWORKThe 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 frame-work 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

APPROACHThe 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, communitycampus 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

SocialDeterminants

of Health

Neighborhood and Built

Environment


Social andCommunity

Capital

EconomicStability

Education



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 79 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 DATA1. 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

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 individ

usc state of the neighborhood report 2015

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