How Place, Racism, and Poverty Matter for Health in Alameda County
How Place, Racism, and Poverty Matter for Health in Alameda CountyMatter for Health in Alameda CountyMatter for Health in Alameda County
Our local dataOur local data on health and social
inequitiesq
An update since our 2008 reportour 2008 report
“Life and Death from Unnatural Causes”
The Community Assessment, Planning, Education, and Evaluation (CAPE) Unit of the Alameda County Public Health
Department (ACPHD)
Our Vision of Health Equity
Everyone in Alameda County –no matter who you are, where you live,
h h khow much money you make, or the color of your skin –has opportunities to leadhas opportunities to lead
a healthy, fulfilling, and productive life.
Purpose of this PresentationTo walk you through our latest data on health and social inequities in Alameda County and our interpretations of the data so you can:
1. Increase understanding of what factors need to be addressed t i t iti f h lth th h t C tto improve opportunities for health throughout our County
2. Use the data in your work to advance health and social equity
bl f
3. Spark critical dialogue and collective thinking about solutions
Possible Uses for Data Writing a grant where you must establish need Advocating for change in particular neighborhood conditions Using a health equity lens to frame a social or policy issue Assessing whether your current program or policy work is helping to
improve health equity Talking with somebody who doesn’t understand how place, racism,
and neighborhood poverty matter for health in our County
Health Inequities by PlaceLife Expectancy by Census Tract
Life Expectancy in Oakland by Region
Just a few miles = Over a decade difference in LE
Compared to a White child born in the affluent Oakland Hills…
OEAST OAKLANDLIFE EXPECTANCY 70LIFE EXPECTANCY 70
O S 8OOAKLAND HILLSLIFE EXPECTANCY 85
…an African American child born in East Oakland can expect to live 15 fewer years.
Photo Source: The California Endowment, Health Happens Here
Source: Alameda County Vital Statistics files, 2010‐2012
Why Does Place Matter for Health?
Communities of Opportunity Disinvested Communities
Good Health Status
• Parks• Safe/Walkable Streets• Grocery Stores and
• Limited/Unsafe Parks• Crime• Fast Food Restaurants
Healthy Foods• Good Schools• Clean AirQ lit H i
• Liquor Stores• Poor Performing Schools• Pollution and Toxic E• Quality Housing
• Public Transportation• Good Jobs• Strong Local Businesses
Poor Health St t
Exposures• Transportation Barriers• Absence of High Quality Financial Institutions• Strong Local Businesses
• Financial InstitutionsStatus
• Predatory Lenders
STRUCTURAL RACISM
Key Determinants of Health InequitySTRUCTURAL RACISM
Inequitable
Concentrated and Persistent Poor and
Inequitable Economic Conditions
and Persistent Poverty
Poor and Inequitable Health
Outcomes in Inequitable Psycho‐Social Conditions
Racial Residential Segregation
Low‐Income Communities
of Color
Conditions
Inequitable SegregationBuilt
Environment Conditions
Historical Roots of Racial Residential Historical Roots of Racial Residential Segregation and Persistent Poverty
Discriminatory mortgage underwriting by the
/
Disinvestment andconcentrated poverty
b
Redlining practicesby banks and home Middle class and white
FHA/VA in urban centers
by banks and homeinsurance agents
Racial steering Displacement caused
flight to the suburbs
Racial steeringand block‐busting
practices by real estate agents
Displacement caused by federal highway
construction and other urban renewal projectsreal estate agents urban renewal projects
Racial Redlining in Alameda County
Concentrated
Poor and Inequitable
Concentrated and Persistent
Poverty
Health Outcomes in Low‐Income CommunitiesCommunities
of Color
Definitions of Poverty
Individual Poverty 2013
A single person living alone has a household income of less than $11,490
Individual Poverty, 2013
$ ,
A family of four has a household income of less than $23 550
Neighborhood Poverty
less than $23,550
30%+ are living in poverty
Defined by the percentage of residents living in poverty
Very High Poverty 30%+ are living in povertyVery High Poverty
20‐29.9% are living in povertyHigh Poverty
Affluent <10% are living in poverty
Neighborhood Poverty Level by Census Tract
Very high poverty neighborhoods
High poverty neighborhoods
AffluentAffluent neighborhoods
Persistent Neighborhood Poverty
Definitions of Poverty (continued)
Persistent Neighborhood Poverty
Neighborhood with high poverty
Defined by the number of decades of high neighborhood poverty
Neighborhood with high poverty for 5 decades (1970‐2010)
Persistent High Poverty
hb h d h h hNeighborhood with high poverty for 3‐4 decades
Frequent High Poverty
Neighborhood with high poverty for 2 decades
Intermittent High Poverty
Neighborhood with high poverty for 1 decade
Infrequent High Poverty
Neighborhood with high poverty for 0 decades
No High Poverty
Persistence of Neighborhood Poverty by Census Tract
Life Expectancy by Neighborhood Poverty Level:A Social Gradient in Health
8384
867 year difference in life expectancy
83
8080
82
84
(in Years)
7876
76
78
80
pectan
cy
72
74
Life Exp
<10% 10‐20% 20‐30 30%+
Neighborhood Poverty Level(Very High Poverty)
(Affluent)
Source: Alameda County Vital Statistics files, 2008‐2010
% of residents living in poverty
5 Leading Causes of Death in Alameda County, 2008‐2010
1. Cancer24%24%
2. Diseases of the Heart5 the Heart
23%3. Stroke
6%4. Chronic
5. Unintentional
Injuries 4% 6%Lower
Respiratory Diseases
4%
Top 5 account for 62%
Source: Alameda County Vital Statistics files, 2008‐2010
5% of total deaths
5 Leading Causes of Death by Neighborhood Poverty Level, 2000‐2010
<10% Poverty (Affluent)
1 Cancer 26%
10‐20% Poverty
1 Cancer 24%2 Diseases of Heart 23%3 Stroke 6%4 CLRD 5%
2 Diseases of Heart 23%3 Stroke 6%4 CLRD 5%
5 Alzheimer's Disease 4%Top 5 account for 63% of deaths
5 Unintentional Injuries 4%Top 5 account for 62% of deaths
20‐30% Poverty
1 Cancer 21%
30%+ Poverty (Very High Poverty)
1 Cancer 22%2 Diseases of Heart 20%3 Stroke 7%4 CLRD 5%
2 Diseases of Heart 22%3 Stroke 7%4 Homicide 5%
5 Unintentional Injuries 5%Top 5 account for 58% of deaths
5 Unintentional Injuries 4%Top 5 account for 61% of deaths
Source: Alameda County Vital Statistics files, 2008‐2010
Social Gradients in MortalityRates of Death from the Top 5 Leading Causes of Death
250
by Neighborhood Poverty Level
150
200
r 100,000
100
150
Rate per
0
50
N i hb h d
0Cancer Diseases of
HeartStroke CLRD Unintentional
Injury
Source: Alameda County Vital Statistics files, 2008‐2010
Neighborhood Poverty Level
<10% 10‐20% 20‐30% 30%+(Very High Poverty)
(Affluent)
Social Gradients in MorbidityRates of Visits to the Emergency Department for S l C di i b i hb h d l*
5,000Select Conditions by Neighborhood Poverty Level*
3,000
4,000
000
2,000
te per 100,0
0
1,000Rat
Neighborhood Poverty Level
0Diabetes Asthma Obesity Assault
<10% 10%‐20% 20%+
Source: Alameda County OSHPD files, 2009‐2011
Poverty Level
*ED rates and neighborhood poverty are at the zip code level
(High Poverty)(Affluent)
Neighborhood Poverty Impacts Health Over the Life Course
160 14 000
30%+ Poverty
<10% Poverty
(Very High Poverty Neighborhoods)
(Affluent Neighborhoods)
120
140
160
y Ra
te
10 000
12,000
14,000
ality
Rate
80
100
use Mortality
6 000
8,000
10,000
Cause Morta
40
60
All‐C
au
2 000
4,000
6,000
All‐C
0
20
<5 5‐24 25‐440
2,000
45‐64 65‐84 85+
Source: Alameda County Vital Statistics files, 2006‐2010
Age Group Age Group
Leading Causes of Death by Age Groupin Very High Poverty Neighborhoods
Ages 5‐24 % of Deaths1 Homicide 59%1. Homicide 59%2. Unintentional Injuries 22%
Ages 25 44
81% of deaths
Ages 25‐441. Homicide 25%2. Unintentional Injuries 16%3 Cancer 14%
65% of deaths3. Cancer 14%4. Diseases of Heart 10%
Ages 45 64Ages 45‐641. Cancer 24%2. Diseases of Heart 23%3 Unintentional Injuries 7% 60% of deaths3. Unintentional Injuries 7%4. Stroke 6%
Source: Alameda County Vital Statistics files, 2006‐2010
Poor and Inequitable Health
Outcomes in Low‐Income CommunitiesCommunities
of ColorRacial Residential SegregationSegregation
Who Lives in Neighborhoods of Varying Poverty Levels by Race/Ethnicity
100%
17%
12%6%
17%27% 31%
5% 5% 6% 5% 5%
80%
90%
100%
All Other Races
29%
22%26%
31%
60%
70%
dents (%
)
Black/AfrAmer
L i /Hi i
25%
29%
22%
36%
40%40%
50%
entage of R
esi Latino/Hispanic
Asian
35%42%
29%
16%
14%20%
30%Perce
White
29%17%
9%
14%
0%
10%
Alameda <10% 10‐20% 20‐30% 30%+(Very High Poverty)
(Affluent)Alameda County
<10% 10 20% 20 30% 30%+
Neighborhood Poverty LevelSource: American Community Survey, 2006‐2010 and Census, 2010
Proportion Living in a High Poverty Neighborhood (where >20% of residents are poor) by Race/Ethnicity
1 in 15 White residents live in high‐poverty neighborhoods, compared to:
1 in 9 Asians
i i
1 in 4 Latinos
1 in 3 Blacks
Source: American Community Survey, 2006‐2010 and Census, 2010
Proportion of Poor People Living in an Affluent Neighborhood (where <10% of residents are poor) by Race/Ethnicity
1 in 2 poor White residents live in affluent neighborhoods, compared to:
1 in 3 poor Asians
1 in 6 poor Blacks
1 in 7 poor Latinos
Source: American Community Survey, 2006‐2010 and Census, 2010
Racial Gaps in HealthLife Expectancy at Birth by Race 1960‐2010Life Expectancy at Birth by Race, 1960‐2010
6 6 yrs85
s) 6.6 yrs
Black
White
75
80
irth (in
Years
4.0 yrsBlack
70
75
ectancy at Bi
60
65
Life Expe
1960
1965
1970
1975
1980
1985
1990
1995
2000
2005
2010
Source: Alameda County Vital Statistics files, 1960‐2010
Racism (Not Race) Harms Health
Percentage of Low Birth Weight Babies by Mother's Race/Ethnicity and Place of Birth
US born Foreign born
12%12%
14%
US‐born Foreign‐born
8%7%
10%
12%
6% 6%
7% 7%
5%
7%6%
8%
2%
4%
Source: Alameda County Vital Statistics files, 2008‐2010
0%AfrAm Asian Latino White
i bl
Poor and Inequitable
Inequitable Economic Conditions
Health Outcomes in Low‐Income Communities
• Employment• Job Wages
Communities of Color
• Household Income• Wealth
Access to Employment:Unemployment Rate by Neighborhood Poverty Levelp y y g y
15%
20%%)
2.1X Higher
10%
14%15%
12%
16%
nt Rate (%
7%
10%
8%
mploymen
0%
4%
Une
m
0%<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level(Very High Poverty)
(Affluent)
Source: American Community Survey, 2007‐2011
g y(% of Residents Living in Poverty)
Access to Jobs that Pay Adequate Wages:Top 5 Occupations by Neighborhood Poverty Level
<10% Poverty (Affluent)
Occupation 1. Management(14% of civilian
2. Office & Ad i S
3. Sales & l d
4. Computer & h
5. Business & i i l
pCategory
(14% of civilian employed pop
age 16+)
Admin Support (13%)
Related (11%)
& Math (7%)
Financial (7%)
Median $91 324 $39 497 $44 887 $94 361 $70 869Income $91,324 $39,497 $44,887 $94,361 $70,869
Alameda County Self‐Sufficiency Standard for 1 Adult in 2011 = $27,456
30%+ Poverty (Very High Poverty)2 F d
for 1 Adult in 2011 = $27,456
Occupation Category
1. Office & Admin Support
(11%)
2. Food Preparation & Serving
(11%)
3. Construction & Extraction
(10%)
4. Sales & Related(9%)
5. Building & Maintenance
(8%)
Source: American Community Survey, 2007‐2011
Median Income $28,920 $16,135 $29,495 $23,877 $20,967
Access to Income: Average Annual Household Income by Neighborhood Poverty Level
$110,436$120,000
e
$76,591 $73,439$80,000
old Incom
2.4 Fold Difference
$46,598$40,000e
Hou
seho
$40,000
Average
$0<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level(Very High
)(Affluent)
Source: American Community Survey, 2007‐2011
Neighborhood Poverty Level(% of Residents Living in Poverty)
Poverty)
Access to Wealth: Rates of Foreclosure by Neighborhood Poverty Level
31% 32%35%
e
2.4X Higher
21%20%
25%
30%
efau
lt Ra
te
13%
10%
15%
20%
tice of De
0%
5%
<10% 10‐20% 20‐30% 30%+
4‐Yr Not
(Very High Poverty)
(Affluent)
<10% 10 20% 20 30% 30%+Neighborhood Poverty Level(% of Residents Living in Poverty)
Source: CAPE, with data from HUD and from First American Title via Urban Strategies Council, 2006‐2009
Poor and Inequitable Health
Outcomes in Low‐Income
Inequitable Psycho‐SocialConditionsLow Income
Communities of Color
Conditions
• Educational Attainment• School Quality• School Attendance• Crime and Violence• Criminal Justice• Criminal Justice• Stress and Mental Health
Access to Education and Quality Schools:Educational Attainment by Neighborhood Poverty Level
40%e 3.8X Higher
25%
34%
30%
HS Degree 3.8X Higher
9%
18%20%
Less th
an H
9%
0%
10%
% with
L
<10% 10‐20% 20‐30% 30%+Neighborhood Poverty Level(% of Residents Living in Poverty)
(Very High Poverty)
(Affluent)
Source: American Community Survey, 2007‐2011
Academic Performance by Neighborhood Poverty LevelOakland Public School Students3rd Grade English‐Language Arts3 G ade g s a guage ts
72%80%
y
2.4‐fold difference
48%50%
60%
70%
roficiency
48%
31% 30%30%
40%
50%
r Abo
ve P
10%
20%
30%
% At o
r
(Very High )
(Affluent)
0%<10% 10‐20% 20‐30% 30%+
N i hb h d P L l
Source: OUSD , 2011‐12
Poverty)Neighborhood Poverty Level(% of Residents Living in Poverty)
Chronic Absenteeism Rate (% of Students Absent for 10%+ of Enrolled School Days) by Neighborhood Poverty Level
18%20% Over 2X Higher
14%
18% 17%
15%
Absent
8%10%
ronically A
5%% Chr
(Very High )
(Affluent)
0%<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level
Source: OUSD, 2011‐12
Poverty)g y
(% of Residents Living in Poverty)
Crime and Violence:Homicide Death Rate by Neighborhood Poverty Level
35 7.9X Higher
21
30
25
30
0,00
0
11
21
15
20
te per 100
4
0
5
10Rat
0<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level(Very High Poverty)
(Affluent)Neighborhood Poverty Level(% of Residents Living in Poverty)
Poverty)
Source: Alameda County Vital Statistics files, 2008‐2010
Mass Incarceration:Youth Incarceration Rate by Neighborhood Poverty Level
3.0%5.4X Higher 1 out of 40 youth
incarcerated
2.3%2.5%
2 0%
2.5%
ges 10
‐17
rcerated
1.1%1.5%
2.0%
f You
th Ag
o are Inca
1 out of 200 youthincarcerated
0.5%0.5%
1.0%
% of
who incarcerated
0.0%<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level (Very High (Affluent)
Source: CAPE with data from Urban Strategies Council & the Alameda County Probation Department, 2010 (Aug) ‐2011 (June)
Neighborhood Poverty Level(% of Residents Living in Poverty)
( y gPoverty)
( )
Hypertension:Hypertension Hospitalization Rates by Neighborhood Poverty Level*yp p y g y
1 7691,8902,000
1.7X Higher
1 084
1,769,
1,500
2,000
0,00
0
1,0841,000
te per 100
0
500Rat
<10% 10‐20% 20%+Neighborhood Poverty Level(% of Residents Living in Poverty)
(High Poverty)(Affluent)
*Includes hospitalizations with hypertension as a primary or top 4 associated diagnosisHospitalization rates and neighborhood poverty are at the zip code level
Source: Alameda County OSHPD files, 2009‐2011
Hypertension:Hypertension Hospitalization Rates by Race/Ethnicityyp p y / y
3,500
2,500
3,000
00
1,500
2,000
per 1
00,00
BlackWhite
i
500
1,000
Rate p Latino
API
0<10% 10‐19.9% 20+%
Neighborhood Poverty LevelNeighborhood Poverty Level(% of Residents Living in Poverty)
Source: Alameda County OSHPD files, 2009‐2011
Mental Health:Rate of Visits to the Emergency Department for Severe Mental Illness*
5656002.7X Higher
436
400
500
0,000
212200
300
Rate per 100
0
100
R
(High Poverty)(Affluent)
* I l d i i i h l di d i 4 i d di i
<10% 10‐19.9% 20%+Neighborhood Poverty Level(% of Residents Living in Poverty)
Source: Alameda County OSHPD files, 2009‐2011 with input from Alameda County Behavioral Health Care Services
* Includes ED visits with severe mental disorders as primary or top 4 associated diagnosisED rates and neighborhood poverty are at the zip code level
Poor and Inequitable Health
Outcomes in Low‐IncomeLow Income Communities
of Color
InequitableBuilt
Environment ConditionsConditions
• Housing Quality and AffordabilityT it D d• Transit Dependence
• Street Safety• Supermarkets and Healthy Foods• Clean Air and Water
Access to Quality Housing:Age of Housing by Neighborhood Poverty LevelAge of Housing by Neighborhood Poverty Level
60% Over 2X Higher
35%
49% 49%
40%
50%
ng Units
%)
21%
35%
20%
30%
of Hou
sin
lt <195
0 (
0%
10%
20%
Percen
t Bu
i
0%<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level(Very High Poverty)
(Affluent)
(% of Residents Living in Poverty)
Source: American Community Survey, 2007‐2011
Household Overcrowding by Neighborhood Poverty Level
12%
16%
olds
Over 4X Higher
11%
14%
8%
12%
f Hou
seho
7%
11%
4%
Percen
t of
3%
0%<10% 10‐20% 20‐30% 30%+
P
( i h( ffl ) Neighborhood Poverty Level(% of Residents Living in Poverty)
O d d S l O d d
(Very High Poverty)
(Affluent)
Overcrowded (1.01‐1.5 per room)
Severely Overcrowded (1.51+ per room)
Source: American Community Survey, 2007‐2011
Access to Affordable Housing:Rental Housing Cost Burden by Neighborhood Poverty Level
59% 61%60%
70% 1.5X Higher
42%49%
35% 36%40%
50%
Reside
nts
1.9X Higher
19%25%
20%
30%
rcen
t of R
0%
10%
<10% 10‐20% 20‐30% 30%+
Pe
<10% 10‐20% 20‐30% 30%+Neighborhood Poverty Level(% of Residents Living in Poverty)
(Very High Poverty)
(Affluent)
Housing cost burden (30%+ of income on rent)
Severe housing cost burden (50%+ of income on rent)
Source: American Community Survey, 2007‐2011
Access to Transportation:Zero Vehicle Households by Neighborhood Poverty Level
14%16% About 7X Higher
8%
12%
useh
olds
cles (%
)
5%
8%8%
ent o
f Hou
Zero Veh
i
2%4%
Perce
with
0%<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level(Very High
)(Affluent)
Neighborhood Poverty Level(% of Residents Living in Poverty)
Source: American Community Survey, 2007‐2011
Poverty)
Access to Safe StreetsAdjusted Rate of Pedestrian Injuries & Deaths
by Neighborhood Poverty Levelby Neighborhood Poverty Level
2 2 2 22.5 3.8X Higher
2.2 2.2
2.0
stria
n h Ra
te
1.4
1.0
1.5
sted
Ped
esan
d Deat
0.60.5Ad
jus
Injury
(Very High(Affluent)
0.0<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level
Source: CAPE with data from SWITRS, 2006‐2010
(Very High Poverty)
(Affluent) Neighborhood Poverty Level(% of Residents Living in Poverty)
Access to Supermarkets:Limited Supermarket Access (LSA) score
by Neighborhood Poverty Level
80Limited
Supermarket Access More Limited Supermarket Access
5967
60
70
core
3743
30
40
50
age LSA Sc
10
20
30
Avera
0<10% 10‐20% 20‐30% 30%+
N i hb h d P t L l
GreatestSupermarket Access
(Very High(Affluent) Neighborhood Poverty Level(% of Residents Living in Poverty)
Source: CAPE with data from the Reinvestment Fund, 2011
(Very High Poverty)
(Affluent)
Exposure to Liquor Stores:Off‐Sale Liquor Outlet Densityby Neighborhood Poverty Levelby Neighborhood Poverty Level
75801.7X Higher
66 6975
607080
Licenses
esiden
ts
43
304050
le Liquo
r 00
,000
Re
102030
Off‐Sa
per 1
0
0<10% 10‐19.9% 20‐29.9% 30%+
Neighborhood Poverty Level
Source: CAPE with data from Department of Alcohol Beverage Control, 2013
(% of Residents Living in Poverty)
Exposure to Clean Air:Location of Pollution Sources, including
Highways and Port of Oakland
Exposure to Toxic Chemicals and Fuels:Density of Industrial Chemical (SLIC)
and Fuel (LOP) Release Sites
4X Higher
239
332
250
300
350
mical and
s ,000
pop
)g
239
150
200
250
ndustrial Che
ml R
elease Site
sP sites per 100,
83
115
50
100
Den
sity of In
Fue
(# of SLIC/LO
0<10% 10‐20% 20‐30% 30%+
Neighborhood Poverty Level(% of residents living in poverty)(% of residents living in poverty)
Source: CAPE with data from Alameda County Environmental Health, 2005‐2013 (July)
Place, Racism, and Neighborhood Poverty: How do they Interact?
90Latino
Race and Social Gradients in Health
85
Birth
AsianLatino
75
80
ectancy at
n years)
Total
70
75
Life Expe (in
WhiteBlack
65<10% 10‐20% 20‐30% 30%+
Source: Alameda County Vital Statistics files, 2006‐2010
Neighborhood Poverty Level(% of residents living in poverty)
(Very High Poverty)
(Affluent)
Life Expectancy at Birth in Oakland Flats vs. Hills
90
Oakland Flats Oakland Hills
85.3 85.083.8
85.6 85.1 84.1
79 6
85
90
Birth
77.8 78.2
71 6
79.6
75
80
ctan
cy at B
n years)
71.6
65
70
Life Expec (in
60
65
All Races Asian Latino White Black
Source: Alameda County Vital Statistics files, 2008‐2010
OWEST OAKLANDLIFE EXPECTANCY 71LIFE EXPECTANCY 71
O S 8OOAKLAND HILLSLIFE EXPECTANCY 85
Photo Source: The California Endowment, Health Happens Here
Source: Alameda County Vital Statistics files, 2010‐2012
Compared to a White child in the affluent Oakland Hills, an African American child born in West Oakland is…
2 timesmore likely to be born low birth weight
13 timesmore likely to live in poverty
5 timesmore likelyto be unemployed
12 times less likely h h
4 times less likely to d d l l
3 timesmore likely d f kto have a mother
who graduated from college
read at grade level to die of stroke
INFANT CHILD ADULT
Cumulative impact:14 diff i lif t14 year difference in life expectancy
Source: Alameda County Death files, 2010‐2012; Alameda County Birth files, 2009‐2011; American Community Survey, 2007‐2011; California Dept of Education, 2012‐2013
Increasing Opportunities for Good Health
Communities of Opportunity Disinvested Communities
Good Health Status
• Parks• Safe/Walkable Streets• Grocery Stores and
• Limited/Unsafe Parks• Crime• Fast Food RestaurantsGrocery Stores and
Healthy Foods• Good Schools• Clean Air
Fast Food Restaurants• Liquor Stores• Poor Performing Schools• Pollution and Toxic
• Quality Housing• Public Transportation• Good JobsSt L l B i
Poor Health
Exposures• Transportation Barriers• Absence of High Quality Financial Institutions• Strong Local Businesses
• Financial InstitutionsStatus Financial Institutions
• Predatory Lenders
INCREASING ECONOMIC STABILITY & INCREASING ECONOMIC STABILITY & OPPORTUNITYOPPORTUNITY
Increasing Housing Stability & AffordabilityIncreasing Housing Stability & Affordabilityg g y yg g y y
3268 San Pablo Avenue Oakland, CA 94608(510) 763‐5877
Preventing ViolencePreventing Violence
16335 East 14th Street16335 East 14th StreetSan Leandro, CA 94578(510) 481-4500
Reducing Incarceration & RecidivismReducing Incarceration & Recidivismgg
1221 Preservation Park Way Oakland, CA 94612(510) 891‐0427( )
Acknowledgements:CAPE E id i l + TCAPE Epidemiology+ Team
Elaine BautistaSamantha Bell
Tammy LeeJane MartinSamantha Bell
Matt BeyersJanet Brown
Jane MartinChuck McKetneyRuvani FonsekaJanet Brown
Sangsook ChoRoxanna Guide
Ruvani FonsekaAviva LipkowitzKatherine SchaffRoza Tammer
Questions, Comments, or Ideas?
Please contact:Chuck McKetney
Director, Community Assessment Planning and l ( )Evaluation (CAPE) Unit
[email protected] or 510‐268‐8020
Tammy LeeCommunity EpidemiologistCommunity Epidemiologist
Alameda County Public Health Departmenttammy.lee@acgov or 510‐268‐2619tammy.lee@acgov or 510 268 2619