Examining gaps in knowledge of social determinants of health at the community level to inform policy, system, and environmental-change strategies seeking to ameliorate chronic disease risk in underserved populations, Los Angeles County, 2013

Introduction: Recent policy, system, and environmental (PSE) change strategies have focused primarily on improving the food and built environment. Less is known about other determinants of health such as neighborhood violence or related social factors (e.g., mental health status) that can influence how target populations receive PSE benefits. The present study examines these gaps.

Methods: An internet panel survey conducted by a contracted online survey firm was administered to adult residents living in Los Angeles County. Eligible participants (i.e., residents age 18+ years who met selected demographic quotas) completed a self-administered survey that included validated questions on social environment/neighborhood collective efficacy/neighborhood violence and depression – latter via the MHI-5 screener.

Results: A total of 1,000 participants completed the health department-sponsored survey. About 13% reported experiencing violence against themselves or a member of their household in the past 12 months. Prevalence of ‘often/sometimes’ experiencing the following in their neighborhood in the last 6 months were: fighting (23%); arguments (27%); gang violence (17%); assault (11%); muggings (23%); and harassment/unjustified use of force by policy officers (20%). Approximately 20% met criteria for a mental health disorder. Over 20% reported drinking >1 soda/day and 27% reported visiting a park a few times a year or less. Additional analyses are planned to examine associations between these neighborhood characteristics and health behaviors.

Discussion: Local health data that provide information on neighborhood characteristics including violence can add rich context and inform PSE strategies that target health behaviors in the community.