Los Angeles — A Tale of Two Cities

When I first started my project on mental healthcare disparities, I was quite surprised to learn the big difference in the access to services between urban and rural areas. In my Hello World blog post, I wrote about the story of Shariah Vroman-Nagy, a teenage girl living in a small city in Northern California, and her frustrating journey of getting the care she needed. Despite of her severe depression and attempt to commit suicide, Vroman-Nagy had a hard time to get treatment due to the lack of mental health specialists in her area. As an individual who lives in the urban part of Southern California, I compared the healthcare resources available to myself with that to Vroman-Nagy — the difference is day and night. Granted, California is a big state (not as big as Texas, but still), but did you know that you could see such healthcare disparities just within the city of Los Angeles? Upon learning the facts, my feeling was beyond shock —

Life expectancy is 72.8 years in South Los Angeles/Boyle Heights/Watts, and 84.7 years in Bel Air/Brentwood (that’s almost 12 years of difference!);
Diabetes mortality rate is 43 per 100,000 in South Los Angeles, and 14 in West Los Angeles;
Child obesity rate is 30 percent in South and East Los Angeles, and less than 12 percent in West Los Angeles;
Less than 10 percent of adults in South Los Angeles are eating the recommended servings of fruits and vegetables every day;
South Los Angeles has less than half of park space than West Los Angeles does;
The list could go on and on…

Really, when we are talking about Los Angeles, we are talking about a tale of two cities. When admiring the urban revitalization and gentrification at Downtown (the breathtaking skyline!), and roaming amongst the fancy hippie shops, bars, and eateries sprouting out of Silver Lake, we should always remind ourselves of the not-so-glorious part of the city, and of course, the people living there, who deserve far more than what they are getting.

As a lifelong urban dweller, I am well aware of the many different forms of inequalities that could manifest just within the boundary of a tiny city — be it the access to healthcare services, unemployment rate, annual income, and even public policies. Perhaps, the most important thing here is not to merely acknowledge the facts, but rather to figure out the complex reasons behind and seek for possible solutions. To put things into perspective, California has a state law that mandates hospitals to spend some portion of their profit on community benefits. The idea is to relocate resources from the wealthiest parts of the system to the underserved segments. The same principle is adapted in some other models such as wellness trust fund, where a pool of money collected from insurers goes to public preventive health service programs. However, whether or not the money is actually doing any good, and how the wealthy insurers and large health plans respond to such reformations, are some other things policymakers need to think about.

Despite of the ever worsening situation, I do believe there is a comprehensive solution to the problem of healthcare disparities. Don’t get me wrong, I love Los Angeles with every fiber of my being, but it is only half as good when only half of the city is getting love and care. And zip code really should not be a predictor for life expectancy.

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