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L.A. County Gets a Mixed Checkup From Health Dept.

Illness: State report cites heart disease and diabetes as problems. But the area's lung cancer rate is lower, and AIDS is decreasing throughout California.


Deaths from heart disease, diabetes and homicide occur at much higher rates in Los Angeles County than elsewhere in the state, but lung cancer death rates are lower, according to an annual report released Monday by the state Department of Health Services.

The report also shows that most of California is experiencing a decrease in the incidence of AIDS.

Experts attribute California's 45.4% decrease in the AIDS rate since the mid-1990s to the introduction of drug cocktails to treat the disease.

"California has made AIDS drugs universally available to everyone," said Michael Montgomery, chief of the office of AIDS. "People who are insured and uninsured have access through the AIDS drug program. It's exciting news, but it doesn't mean there is a decrease in HIV infection."

Health officials say Los Angeles County has high rates of deaths from diabetes and heart disease, in part because more than half of the county's residents are not exercising and many are not eating well.

Dr. Jonathan E. Fielding, the county's director of public health, said 60% of residents don't exercise at all, 52% are overweight and 17% are obese.

"The average coronary risk is significantly above where we would like it to be," he said.

Los Angeles County ranked fourth-highest among California's 58 counties in the rate of death from coronary disease. In 1999, there were 235 deaths caused by heart disease per 100,000 people in the county, compared with 204 statewide.

Surrounding counties did not fare so well, either. Ventura County, Riverside County and Orange County all were worse than the state average in heart disease deaths, and San Bernardino County ranked the worst in the state.

"Doing more exercise is not hard, but it takes will," Fielding said. "People can do things like park farther away from the office or walk to lunch. We're not saying you have to spend two hours at the gym every day."

According to the health report, most of which refers to the health status of counties in 1999, Los Angles County suffered 23.8 cases of diabetes per 100,000 people, compared with 20.5 statewide. Diabetes, like heart disease, is often linked to being overweight or obese.

Los Angeles County also had the second-highest homicide rate in the state--a situation that is drawing increasing attention not just from law enforcement but also from public health officials.

Approximately 9.4 people were murdered per 100,000 people in 1999, in comparison to six in California overall.

The report showed that Los Angeles County also had elevated rates of injuries from firearms, compared with the rest of the state.

"Handguns are much too ubiquitous," Fielding said. "Also, if you look at violent crimes, a significant amount are associated with substance abuse."

Another problem area was sexually transmitted diseases. Los Angeles County ranked fifth worst in the rate of chlamydia and fourth worst in the rate of syphilis.

However, Los Angeles County had less cancer than the statewide average, and in particular reduced its rate of lung cancer. Fielding said the combination of higher tobacco prices, more education and a ban on smoking in many public areas explains the 19% decrease in the number of lung cancer cases diagnosed over the last decade.

Los Angeles County had 42.5 cases of lung cancer per 100,000, compared with 44.9 statewide in 1999.

The incidence of tuberculosis dropped from 18.5 per 100,000 in 1995 to 12.8 in 1999. Fielding said the county has aggressively fought TB, sometimes sending county workers to supervise patients taking medicine in their homes or workplaces.

Ventura County mothers had the highest rate of early prenatal care in the state, according to the report. Forty-four other counties also improved prenatal care. About 10% of Ventura County's children were living in poverty, compared with 18% statewide and 22% in Los Angeles County.

But the infant mortality rate among Latino babies in Ventura County was more than seven for every 1,000 births, higher than the state average. Overall infant mortality was in line with the statewide average.


Times staff writer Margaret Talev contributed to this story.

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