. "4 How Have California Communities in Transition Framed Health Disparities for Action?." Demographic Changes, a View from California: Implications for Framing Health Disparities: Workshop Summary. Washington, DC: The National Academies Press, 2010.
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Demographic Changes, A View from California: Implications for Framing Health Disparities - Workshop Summary
of the Ravenswood Family Health Center, a federally funded community health center.
History of East Palo Alto
East Palo Alto is a city of 2.5 square miles and was incorporated 25 years ago. It sits physically between the 101 freeway and the southwest end of the San Francisco Bay. East Palo Alto is in San Mateo County, which is also home to several of the wealthiest communities in the United States (Atherton, Palo Alto, Menlo Park).
Historically, East Palo Alto began as an unincorporated agricultural area of nurseries, orchards, and family farms. Even today, although the nurseries have disappeared and there are few family farms left, sidewalks remain unpaved. Buada described the houses with picket fences and flower gardens in East Palo Alto as being “reminiscent of a sleepy Central Valley town.”
The majority of the residents in East Palo Alto (80 percent of the population) were African American families up until the 1980s. These families were driven out of the nearby predominately Caucasian areas by de facto segregation and redlining. These protective ordinances (as described earlier by Mindy Fullilove) prohibited the sale of homes to nonwhites until 1947, thereby pushing these families into cities that ring the margin of the San Francisco Bay, adjacent to heavily polluted industrial areas. Other examples of these Bay Area cities (besides East Palo Alto) are Marin City, Vallejo, and Hunter’s Point.
In the 1980s, an influx of Latino and Polynesian immigrants seeking low-income housing moved into East Palo Alto. Today, more than 56 percent of the population is Latino, 7 percent is Pacific Islander (primarily Tongans, with some Fijians and Samoans), and only 22 percent of the population is African American.
However, in contrast to East Palo Alto’s wealthier neighbors in the county, most residents live in poverty or do not earn a living wage. In San Mateo County, a “living wage” is calculated to be 400 percent of the poverty level; this is due to the high cost of housing in the county. In East Palo Alto, 77 percent of school-age children qualify for free or reduced-cost lunches. The unemployment rate is nearly 10 percent, whereas the average for the county is 4 percent. In the patient population served by the Ravenswood Family Health Center, 63 percent are uninsured and one-third prefer to communicate in a language other than English.
Other challenges that East Palo Alto residents face include drug and alcohol addiction and the associated violence, involvement with the criminal justice system, and destabilized families. The community has no major supermarkets. The prevalence of diabetes and the rate of mortality from