Los Angeles County's death rate has dropped significantly in recent years, according to a report released this week by the county's Department of Public Health. The drop, 22% countywide from 1998 to 2007, came as fewer county residents died from many chronic illnesses. Still, significant disparities persist among racial, ethnic and socioeconomic groups.
"There's a lot of good news here," said Gerald Kominski, associate director of the UCLA Center for Health Policy Research. "There's a lot of reasons to think Los Angeles County would be doing worse than other areas — we have a high proportion of uninsured residents and a high percentage of people in poverty. But despite that, we continue to improve."
The news comes about a week after public health officials reported the county's average life expectancy increased to 80.3 years in 2006, up from 75.8 years in 1991 when the department started tracking it.
The 2007 data, the most recent year available, shows decreases in death rates for many lethal diseases, including heart disease, stroke, lung cancer and pneumonia/flu.
Although death rates dropped for all ethnicities during the decade, Asians still had the lowest rates and blacks, particularly black men, had the highest.
Black women died from breast cancer at more than twice the rate of Latinas and Asian women, the report showed, while black men died at more than twice the rate of Latinos from colorectal cancer. Blacks were still dying from diabetes at more than twice the rate of whites, just as they were in 1998.
Dr. Jonathan Fielding, the county's director of public health, called the higher mortality for blacks "disgraceful."
"We need to continue to work on that as a community and a country," he said.
Lack of access to quality healthcare may contribute to higher mortality for blacks in Los Angeles County, Fielding said, but he noted that Latinos — many of whom are low income and uninsured — saw lower mortality than both blacks and whites.
The phenomenon, observed in other public health studies, has been dubbed "the Latino paradox." What may account for the paradox is that Latinos smoke less than those other ethnic groups, and recent Latino immigrants tend to eat more healthfully, Fielding said. But healthful eating habits tend to erode with successive generations, he said.
"I'm afraid that for the second- and third-generation Latinos, we're not going to have a paradox," he said.
Another concern: the number of Alzheimer's deaths in Los Angeles County rose 300% between 1998 and 2007 as the population aged and doctors made better diagnoses of the disease. There were 1,780 deaths countywide from Alzheimer's in 2007, making it the seventh leading cause of death.
"The aging of the population is going to make this a very serious social problem," Fielding said.