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Social will can add years to our lives

Working for what's right — overturning the Bells and getting nutritious food to children, for example — is good medicine.

August 01, 2010|Cathleen Decker, Los Angeles Times

The last week brought a surfeit of bad news to one part of Los Angeles County — the part that lays waste to the palm tree image of the place.

County health officials unveiled a new study of how long people here live — and found death to be riddled with disparity, even as the length of time the average person lives has continued to creep upward.

In the industrial suburbs along the 710 corridor from the coast and up through downtown, people die years earlier than the 80.3-year county average. In the richer parts of the county, life expectancies were heightened. From La Cañada Flintridge's 87.8 years, the numbers spiraled downward to Compton's 75.7 years.

In the same stressed section of the county, the exaggerated salaries of the public servants of Bell bubbled into a national disgrace. Investigations were underway into exactly how the administrator of a tiny town came to make almost twice as much as the president of the United States, but the bottom line appeared to be that officials dipped into the till because no one was stopping them.

Lesson learned, last week the residents whose taxes have been financing the municipal feeding frenzy were at the gates of the castle, bearing not pitchforks but rather insistent demands that the funny business stop.

That, health analysts say, is not a bad model for how people in the most troubled parts of Los Angeles might manage to extend their lives.

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The life-expectancy study came out the same day county officials acknowledged that budget problems may soon force them to invoke layoffs and sharply cut the number of patients served by publicly funded hospitals and clinics.

Since those services go most often to the neighborhoods where people already are dying young, the combination of news might seem to have been enough to send health officialdom over the edge. But other things, they believe, are actually more important to needy communities than healthcare, important though it is.

"Healthcare is important but it's not the major determinate" of who dies prematurely, according to the county's public health director, Dr. Jonathan E. Fielding. "Family resources, income, social support, education attainment — those are really major determinants."

E. Richard Brown, director of the UCLA Center for Health Policy Research, seconded Fielding's assertions.

"Within L.A. we have a lot of inequality in the kinds of support and in the communities people live in, and that gets reflected in our health, and the number of years we can expect to live, and the quality of our lives," he said.

The fact that the solutions are myriad is both good news and bad — good in that many solutions are simpler to accomplish than healthcare, if the recent national debate is any hint, and bad, because there is no one magic bullet to solve the problem.

Health officials say the means to a longer life are evident: Curtailing drugs, tobacco and alcohol. Exercise. Eating healthful food, such as fresh fruits and vegetables; cutting back on junk food. All of which is easier said than done in some parts of town.

"This is a really simple example. But we are really worried right now about the obesity crisis, which you address with diet and exercise," said Manuel Pastor, director of USC's Program for Environmental and Regional Equity.

"But if you live in places that are food deserts — no grocery stores — it's hard to get high-quality food. If the place is plagued with crime, people get scared to let their kids out to play. If you live in places with environmental hazards, it discourages physical activity. You have the end point — obesity — but the factors that help people maintain fitness are quite varied."

Fielding acknowledged that some of his preferred solutions, such as developing more parks and places for recreation, may conjure objections in this economically fraught time. But other solutions shouldn't — such as changing the foods kids are served in school.

"It's not all a question of money," he said. "It's a question of social will."

Social will can be a hard currency to spend in California, where the DNA still carries fragments of go-it-alone western spunk. So it is that, while the chaos in Bell has been chattered about on talk radio and news outlets nationwide, it's been left to the citizens of Southeast Los Angeles to clean up the mess.

There are powerful reasons to hope they succeed, according to Pastor. Research done by him and others suggests that regions like Los Angeles, home to the wildly wealthy and the dispossessed, to the La Cañada Flintridges and the Comptons, have lasting problems.

Pastor sees reasons for optimism, in community groups working to chip away at the regions' problems and in the citizens of Bell and their neighbors, who rushed City Hall once they were alerted to its excesses.

"We've got big problems, but we've got some really soulful people with great heart," he said. "Big problems, big hope. But we only have one future. We'd better figure out how to stitch it together."

cathleen.decker@latimes.com.

Each Sunday, The Week examines implications of major stories. It is archived at latimes.com/theweek

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