Low-cost methods for community health assessments

We conducted an analytic and field study of childhood overweight rates among the communities of Los Angeles County to assess the impact of socioeconomic status and built environment. We adapted several tools using standard office software. The methods could be applied by community groups to assess environmental and social components of health issues. Basic data were obtained from web resources including the U.S. Census 2000 and California Center for Public Health Advocacy. Geographical information systems have substantial capability for displaying spatial relationships, although at the cost of acquiring software and user training. As an alternative we adapted the method of choropleth mapping to depict childhood overweight rates. Patterns emerged suggesting the overweight problem has regional aspects beyond individual communities. A proximity analysis provided a quantitative measure of the visual patterns. Using linear regression we found a high negative association between median family income and childhood overweight. We included ethnicity using multiple regression in the development of a predictive model based on ongoing ethnic and demographic shifts in the county. We visited two cities with high childhood overweight rates and two with lower rates to assess the built environment. By using tools as a simple as a bicycle, odometer, and digital camera we collected data to create maps of the built environment including restaurants, grocery stores, and health-related establishments. We found intriguing associations between the built environment and childhood overweight. We will present examples of these low-cost tools, and suggestions on how they could be applied to other community health assessments.