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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018

Due 6 March 2018, 9:30am
Attached to bcourses

In this assignment, you must use this form to answer all questions and you must attach a
map to this file. Your map can be pasted as a jpeg or image file or as a pdf, but it MUST be
attached to or embedded in his file for you to receive credit. Following directions is part of
this assignment.
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This homework has multiple steps. First, you must follow the instructions below and answer all
the questions using the web site, Community Commons (communitycommons.org). In order to
do this, you must use the ZIP CODE assigned to you and develop the Community Health Needs
Assessment (CHNA) report for your assigned zip code.
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Your puzzle is to help understand some of the place-based factors that might be contributing to
life expectancy in your zip code, and why it differs from the county and California Average life
expectancy.
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Please read and review the “Homework 3: Assignment Instructions” closely before you
attempt to answer any questions below. For more background on CHNAs please review:
https://www.cdc.gov/stltpublichealth/cha/plan.html
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Questions: PART 1:
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1. What is the definition of a zip code? [hints: http://proximityone.com/tracts_zips.htm, https://
newrepublic.com/article/112558/zip-code-history-how-they-define-us]
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ZIP codes are clusters of lines, prone to changing over time, that exist only where US mail
service is provided. They are groups of lines whose structural definition is not officially
established and are really functionally only a system of postal codes used by the United States
Postal Service since 1963.
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2. (a) Most health departments in California are county agencies. How does the scale of a zip-
code and census tract compare to the scale of a county? Are they the same size? Do they
overlap?
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Census tracts align coterminously to county boundaries and usually contain between 1,000
and 8,000 people with an optimum size of 4,000 people. Zip codes are only prevalent where
US mail service is provided, and there is no true uniformity in their distribution, whereas
census tracts (and are thus often smaller) and counties do. Their boundaries are delineated
with the intention of being stable for the course of decades, so they generally follow

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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018
Due 6 March 2018, 9:30am
Attached to bcourses

permanent visible features. The boundary of a state or county is always a census tract
boundary, so they are not the same size, but they do overlap in this sense of boundary-
formation.
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(b) What are the differences between a county and a census-tract and why might this matter
for understanding community health?
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A county is the primary political subdivision of states. It involves relative stable geography,
and proffers good national scope geographic granularity. Thus, it is important to use to
understand community health because it allows for granular tabulation and analysis of data
related to accessing, integrating, and analyzing county-specific demographic-economic
patterns and trends. Though Census tracts were first made to be relatively homogeneous with
respect to population characteristics, economic status, and living conditions, they (post
demographic shifts) have become non-homogenous. They do closely approximate
neighborhoods/neighborhood parts for many areas. Even so, census data poses a challenge to
use because boundaries for many census tracts, the most widely used and important "small
area geography," changed between Census 2000 and Census 2010. This makes it hard to
contrast demographics for these sub-county building blocks between 2000 and 2010.
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Identifying and examining the nature of demographic change for some of the hottest areas of
change can be challenging and elusive, so to understand community health, we can use both
spatial measures.Using your CHNA report for your assigned zip code, answer the following:
3. What are the racial and demographic percentages in your zip code? How do these
compare to the county, California and the US as a whole? Use the table below or make
your own with at least 5 major demographic groups.
% Native
% Some
American
Area % White % Black % Asian Other
/ Alaska
Race
Native
Zip Code 32.61 28.77 26.98 1.3 3.64
County 43.86 11.34 28.19 0.63 8.76
California 61.26 5.85 13.85 0.74 13.28
US 73.35 12.63 5.22 0.82 4.75

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4. (a) What percent of the Latino and/or Asian population in your zip code is categorized as
‘Limited English Proficiency?’

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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018
Due 6 March 2018, 9:30am
Attached to bcourses

4. 21.57 percent of the Latino and 54.47% of the Asian population in my zip code is
categorized as ‘Limited English Proficiency.’
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(b)How might linguistic isolation influence community health?
People who are not able to speak English well may have trouble talking to the people
who provide social services and medical care. As a result, they might not get the health
care and information they need, and this affects community health because the issue is
accessing services that are available to fluent English speakers. The language barrier
keeps such households from receiving transportation, medical, and social services, as
well as limit employment and schooling opportunities. Additionally, in cases of national
or local emergencies, these households might not receive critical notifications.
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5. (a) What is the percent of Children Eligible for Free/Reduced Price Lunch in your zip
code?
(b) How does your zip code’s % compare to the County?
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5. 68 percent of Children Eligible for Free/Reduced Price Lunch in my zip code, compared
to 44.26% in the rest of the county.
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6. (a) What percent of the Children in your zip code are below 200% of the poverty level?
(b) what does 200% below the poverty level mean and how might this economic status
influence health? Please offer a succinct definition:
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6. (a) 63.14 percent of the Children in my zip code are below 200% of the poverty level
(b) 200% below the poverty level means that according to The United States Department
of Health and Human Services which establishes the federal poverty level, people who
earn at or below 200% of this level (i.e. a 1 person household earns $23,540, 2 people
earn 31,860, and so on). Thus 200% of that level means program eligibilities is available
to those with a gross monthly income .02x that figure. This economic status influences
health because this range might not otherwise have access to certain services or basic
necessities due to cost, i.e. housing, sustenance, transportation, and health insurance. “It
is expensive to be poor,” as Barbara Ehrenreich says.
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7. (a) What is the percentage of substandard housing in your zip code compared to the
county, California and the US as a whole?

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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018
Due 6 March 2018, 9:30am
Attached to bcourses

7. 48.03% is the percentage of substandard housing in my zip code compared to the county,
which is 41.82%, California which is 45.58% and the US as a whole, which is 33.75%.
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(b) How might substandard housing act as a determinant of health?
Housing is a determinant of health because poor housing conditions are linked to a wide
range of infectious diseases, chronic diseases, injuries, childhood development, and nutrition
issues, and mental health. For example, lead poisoning can lead to neurological damage
among community members; contaminated water pipes can result in whole groups of people
becoming poisoned, and substandard housing conditions including poor ventilation, pest
infestation, and water leaks are directly associated with the development of respiratory
illnesses such as asthma.
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8. (a) What percent of the population in your zip code uses public transportation to commute
to work?
8. 38.61 percent of the population in my zip code uses public transportation to commute to
work.
(b) is access to public transportation beneficial or detrimental to community health?
Please briefly explain:
Access to public transportation is beneficial to community health because there are
people who would not otherwise have access to crucial essential services such as health
care, health services, or grocery stores. People without cars or those who are afflicted
with illnesses that keep them from driving. Without public transport, low-income
neighborhoods would be affected because of the lack of transportation infrastructure that
prevents them from traveling to tend to their needs.
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9. (a) How many Primary Care Physicians (PCPs) per 100,000 people are there in your zip
code, and how does this compare to the rate in California and the US?
9. There are 120.2 Primary Care Physicians (PCPs) per 100,000 people in my zip code, and
this compare to the rate in California which is 120.24 and the US, which is 87.8.
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(b) does the # of PCPs in your zip code help explain the average life expectancy? Why or
why not?
It is likely that the generally higher life expectancy of my zip code (low to mid 70s) can
be due to the high number of PCPs, because it is a few years more than the national
average, which has far fewer PCPs per 100,000 people. Studies have shown the ratio of
primary care physicians per 10,000 people inversely correlates with overall mortality

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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018
Due 6 March 2018, 9:30am
Attached to bcourses

rate, possibly because PCPs are front-line health care workers who know where the flaws
and inefficiencies are, so it’s important to interface with them early on to prevent issues
from materializing in the future.
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10. (a) What percent of the population is walking or biking to work in your zip code,
compared to the County, California and the US?
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10. 18.96 percent of the population is walking or biking to work in my zip code, compared to
the County’s 5.69%, California’s 3.8% and the US’ 3.37%.
(b)how might walking and biking to work be a health promoting activity?
Walking and biking to work is a health promoting activity because it entails exercise,
which prevents and keeps people at lower risk of developing certain diseases that
accompany a sedentary lifestyle, including cardiovascular diseases and strokes, or obesity
and diabetes, all of which are correlated. Additionally, it is a green thing to do, as it
reduces carbon dioxide and NOx emissions, thus keeping the air cleaner and less
polluted, and decreasing collective/community risk of respiratory illnesses such as
asthma or COPD.
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NOTE: You must create a map as defined in your Zip Code instructions before completing
the questions below. Please refer to the HW#3 instructions for creating the map using
communitycommons.org.
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PART 2
11. Describe the specific area and point data sets you used to create your map. For example,
if you used “Adult poor physical health” as your area data, what does this mean and how
was it measured? Similarly, if your point data were “SNAP Retailers,” define what this
means. What is/are the sources of the data and how were they collected? Be sure the
description is easy for a non-public health person to understand.
(a) Area data used, Name: Asthma prevalence among adults ages 18+ by Tract
Meaning: This shows the measurement of all individuals affected by the disease at a
particular time, the disease being asthma, in the particular area of downtown oakland
94612.
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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018
Due 6 March 2018, 9:30am
Attached to bcourses

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Source and collection method: This was collected via area study, so health data and
records from census information records.
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(b) Point data used. Name: Assisted housing units, all by tract, HUD 2016.
Meaning: This is the number of assisted housing units in my zip code, in which people
live, subsidizedly due to inability to afford housing.
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Source and collection method: External surveyor who goes about understanding the
property lines and drawing out the housing units on a mao.
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12. Now, interpret your map. What do you think it is showing? Please briefly describe the
‘story’ that your map might reveals about community health in this place? Do your data
help reveal any correlations between a particular ‘exposure’ and health outcomes? What
additional information might you want to help make sense of your map? Please briefly
explain in 1 paragraph.
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PH150E/CP117AC: Community Health - - HW Assignment #3 Spring 2018
Due 6 March 2018, 9:30am
Attached to bcourses

I think that it’s showing a certain relationship between the housing units and their immense
density and the prevalence of asthma in my zipcode, which is almost pervasively above 12%.
This relationship may exist because of the fact that substandard housing is pervasive here, and
that leads to poor respiratory conditions for communities - i.e. poor ventilation means increased
risk of asthma, and COPD. The data does reveal this particular relationship, elucidating an
otherwise concerning health coutcome. I would want more information on the relationship,
specifically the housing that is substandard and more respiratory illnesses, not simply asthma.

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