Residential Care in Los Angeles: evaluating the spatial distribution of facilities and neighbourhood access to care among older adults

ABSTRACT

Residential care has increased in number of facilities and has grown in density in urban areas, yet it is disproportionately dispersed in cities and only beginning to meet the current long-term care need of older adults as an alternative to institutional and in-home care. California State Department of Social Services residential care facility data were linked with Los Angeles County census tract data to examine the spatial distribution of facilities through hot spot analysis of clusters of small and large facilities and zero-inflated negative binomial regression of census tract facility counts on older age and race groups, older disabled adults, and older adults in poverty in the area. The results show clusters of large facilities west of downtown Los Angeles and clusters of small facilities in the northern suburbs of the city in the San Fernando Valley. Increases in pre- and early-retired adults and older Hispanics in census tracts are associated with the greatest decreases in facility tract capacity in the area, whereas increases in the oldest old and older disabled adults are associated with the greatest increases. Understanding spatial disparities in residential care can help local agencies and developers plan and partner in more intentional and equitable development of facilities. The greatest opportunity for such development may lie in institutional tools for eldercare facility development such as the eldercare facility ordinance of Los Angeles and development of board and care facilities in residential zones of Los Angeles and other cities.     

Bedded Sediment Conditions and Macroinvertebrate Responses in New Mexico Streams: A First Step in Establishing Sediment Criteria

Excess fine sediments in streambeds are among the most pervasive causes of degradation in streams of the United States. Simple criteria for acceptable streambed fines are elusive because streambed fines and biotic tolerances vary widely in the absence of human disturbances. In response to the need for sediment benchmarks that are protective of minimum aquatic life uses under the Clean Water Act, we undertook a case study using surveys of sediment, physical habitat, and macroinvertebrates from New Mexico streams. Our approach uses weight of evidence to develop suggested benchmarks for protective levels of surficial bedded sediments <0.06 mm (silt and finer) and <2.0 mm (sand and finer). We grouped streams into three ecoregions that were expected to produce similar naturally occurring streambed textures and patterns of response to human disturbances. Within ecoregions, we employed stressor response models to estimate fine sediment percentages and bed stability that are tolerated by resident macroinvertebrates. We then compared individual stream sediment data with distributions among least‐disturbed reference sites to determine deviation from natural conditions, accounting for natural variability across ecoregion, gradient, and drainage area. This approach for developing benchmark values could be applied more widely to provide a solid basis for developing bedded sediment criteria and other protective management strategies in other regions.