California Endowment. - Twenty years of life: why the poor die earlier and how to challenge inequity

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Copyright 2018 Suzanne Bohan

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Keywords: California Endowment, community development, health disparities, neighborhood revitalization, philanthropy, public health, Dr. Robert Ross, school reform, trauma-informed schools, violence prevention

For Glenn

There had never been a rally quite like this one in front of Los Angeles City Hall or, for that matter, at any city hall in the United States. On December 10, 2013, nearly two hundred people assembled, displaying photos of loved ones whose lives were cut short by sickness and holding signs with the words, Where you live should not determine how long you live. They shared stories of their relatives early deaths, a few fighting tears.

Yvette Fuentes, who has lived in poverty-ridden South Central Los Angeles all her life, held a photo of her mother, who died at age fifty-seven, a few years after she was diagnosed with hypertension and diabetes. Every year on her mothers birthday, Yvette takes the day off to visit her mothers grave and to go on outingsa trip to the mall, seeing a moviethat they would have done together had her mother not died prematurely. Fuentes father had also died prematurely, of lung cancer at age fifty-seven.

Sabrina Coffey-Smith, who lives in the same area as Fuentes, held a sign with a photo of her brother, who suffered a fatal heart attack at fifty-three. Hed left her a voice message shortly before he died, saying, This is your big bro. I really need to talk to you so call me back. I love you, so call me back. Coffey-Smith didnt get the message until after he died.

Another protester, Liliana Reyes, who lives in another low-income LA community, held a photo of her twin sister, a nonsmoker who died at twenty-four from lung cancer. Reyess sister remained undiagnosed and untreated for several months after the first symptoms appearedheavy coughing and back painbecause she was uninsured. Reyes still feels adrift after that loss nine years earlier.

Stories like these abound in poorer areas. Although tragically early deaths occur in all types of neighborhoods, theyre far more prevalent in those with high poverty rates and a dearth of the basic resources that support health, like parks, good schools, and grocery stores.

In fact, the 2013 rally was prompted by a first-of-its kind report from Los Angeless Public Health Department, which revealed a startling twelve-year difference in life expectancy between the wealthier, verdant areas on the citys west side and its far poorer neighborhoods in the inner parts of the vast city.

Theres nothing in the water in Los Angeles that creates that. This is a problem of our own making, Dave Regan, a Service Employees International Union leader, told the crowd. A walk from the west side to Central LA is really a journey from the First World to the Third World.

Many of the workers Regans union represents, who labor as hospital technicians and in-home caregivers, among other health care occupations, live in South LA. They showed up to pressure the regions nonprofit hospitals to set aside more money to benefit low-income communities. These nonprofit hospitals are required to do so given their generous tax breaks, but many do not, and theres little enforcement of the requirement. The protesters wanted to see more of that moneytens of millions of dollars annuallyactually collected and then spent on neighborhood amenities in their home turf that would make their lives healthier and easier, the same kind of amenities that wealthier areas take for granted.

Consider Pacific Palisades, an affluent enclave on the western edge of Los Angeles in zip code 90272. There, the afternoon sun bathes spacious ocean-facing homes in a golden glow, while beachgoers enjoy the sand and surf of the communitys beaches and bikers and hikers travel to the nearby Santa Monica Mountains. Shops, restaurants, and cafes keep the sidewalks busy in its attractive downtown. Most businesses are locally owned, and residents let fast-food restaurants know theyre not welcome, beating back an attempt years ago by one burger chain to open one; no fast-food outlet has tried since then. Although its actually part of the City of Los Angeles, the neighborhood picks an honorary mayor to represent its interests at City Hall. Kevin Nealon, a longtime cast member of the TV show Saturday Night Live, currently holds the honorary position; a few of his famous predecessors include Sugar Ray Leonard, Anthony Hopkins, and Chevy Chase.

Pacific Palisades is called the Mayberry of Los Angeles for its small-town, friendly atmosphere, and people living here not only enjoy the good life, they get to do so for longer. Average life expectancy in the Palisades is eighty-five years. Its the highest in Los Angeles, a distinction shared with adjacent Brentwood and Bel Air.

If you travel inland over the LA basin, though, life expectancy steadily declines as you cross into middle-class neighborhoods and then into progressively poorer ones. By the time you reach zip code 90059 in South Los Angeles, where the 1965 Watts riots and the 1992 Los Angeles riots both ignited, life expectancy plunges twelve years to seventy-three, the same as someone born in Samoa.