HEALTH PROFILE OF THE EAST BLUFF NEIGHBORHOOD Peoria City, IL
Health Profile of the East Bluff Neighborhood
September 2016
Instructor: Mary Edwards, Associate Professor, Department of Urban and Regional Planning (DURP) Research Assistants: Rachael Wilson and Emily Weimer Students: Allie Goldstein, Cristen Hardin, Natalie Hoke, Taryn Harm, Nathan Lipson, Anna Ma, Oksana Polhuy, Jeremy Shackett, Jaylan Williams and Michael Zearing. DURP students and faculty would like to thank Kathie Brown with University of Illinois Extension, the Peoria Innovation Team, local government staff and officials, local non-profit agencies and the residents of the East Bluff neighborhood for your support and ideas and your generous time and energy. A special thanks to University of Illinois Extension and University of Illinois Office of the Provost for providing the funding to support this important initiative.
TABLE OF CONTENTS Executive Summary
1
Demographic and Socioeconomic Factors
3
Built Environment Factors
9
Housing Profile
12
Social Capital
15
Food Environment
19
Crime Profile
22
Health Factors and Outcomes
23
References
27
Executive Summary This report discusses factors that influence health and health outcomes in the East Bluff neighborhood of Peoria, Illinois. Factors that can influence health include socioeconomic status, the quality of the built environment, access to transportation, housing quality, social capital, and the prevalence of crime. Health outcomes include data pertaining to resident health such as levels of obesity and diabetes. The East Bluff neighborhood is bordered by Glen Oak Avenue and McClure Avenue to the south and north, and by Prospect Road and Knoxville Avenue to the east and west. Data to represent this area comes from census tracts 16 and 25 and zip code 61603, all of which encompass the East Bluff neighborhood.
Section one presents demographic and socioeconomic data as components of social determinants of health. This section compares data from census tracts 16 and 25 with the city of Peoria and the state of Illinois. The East Bluff is found to have a higher likelihood of negative health outcomes due to demographic and socioeconomic factors.
Section two focuses on factors of the built environment that can influence health, such as traffic levels and access to green space. High walkability and access to public transportation in the neighborhood create an environment conducive to physical activity. However, lack of access to outdoor spaces within walking distance and lack of bicycle infrastructure limits physical activity. In addition, high concentration of busy roads in the neighborhood leads to higher local concentration of air pollution and increases the likelihood of traffic accidents. Section three compares housing conditions in the 1
Executive Summary
Health Profile of the East Bluff Neighborhood
East Bluff neighborhood to the city of Peoria and the Peoria Metropolitan Statistical Area (MSA). The neighborhood is found to have higher cost burden and lower house value compared to the other geographies. This section also discusses the Community Core Initiative to revitalize housing stock and create pride in the neighborhood.
Section four presents a list of organizations and programs that can help to build social capital in the neighborhood, including the East Bluff Community Center and the East Bluff Neighborhood Housing Services. Section five profiles the food environment of the East Bluff, and highlights the locations of places to obtain healthy and unhealthy food/substances in the neighborhood. A grocery store with healthy and nutritious options is located in the neighborhood, but this section also shows easy accessibility to unhealthy food found in convenience stores. This section also analyzes access to grocery stores by public transit.
Section six highlights crime data in the neighborhood. Increase in property and in some violent crimes can lead to direct damage of human health. Crime cal also deter people from walking and bicycling in the area due to perception of the neighborhood as unsafe. Lastly, section seven presents information about health outcomes in Peoria County, the city of Peoria and the East Bluff zip code (60613.) The data shows that East Bluff residents have high accessibility to doctors and health institutions. However, disparities in health outcomes such as STDs and obesity along racial and geographic lines are still prevalent in East Bluff.
2
Demographic and Socioeconomic Factors to healthcare, healthy activities, and nutritious food, and those with more money often have more access to better healthcare, nutritious food, fitness opportunities, and other health resources. (CDC, 2016) This analysis examines relevant data collected at the census tract, city, and state level to understand how the East Bluff neighborhood compares to the city of Peoria and the state of Illinois in social determinants of health. Census tracts 16 and 25 encompass the East Bluff neighborhood, and are used as the geography to discuss social determinants of health in the East Bluff. All data comes from the U.S. Census Bureau.
Social Determinants of Health According to the World Health Organization (WHO), the social determinants of health are “the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries� (World Health Organization, 2016). Furthermore, Healthy People 2020, an initiative of the office of Disease Prevention and Health Promotion, identifies economic stability (poverty and employment) and education (high school graduation and enrollment in higher education) as key areas of social determinants of health. (Healthy People, 2016)
Demographic Profile In comparison to the city of Peoria and the state of Illinois, the East Bluff has a higher share of children and young people and less people of ages 45 and older (Figure 1). The share of females is higher in all geographies, but the share of females in the East Bluff is 3-4% higher than in the city and state (Figure 2).
This section examines socioeconomic data from the East Bluff neighborhood that can determine health outcomes including employment, poverty, education, race and gender. Because wealth distribution can have a tremendous effect on health outcomes, it is vital to examine this data. People with lower income tend to have less access
The shares of white and black residents differs greatly between the East Bluff, the city and the state. The East Bluff has almost equal shares
Figure 1. Age distribution in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
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Demographic and Socioeconomic Factors
Health Profile of the East Bluff Neighborhood
Figure 2. Gender in East Bluff, Peoria City and Illinois, 2014
Figure 4. Education attainment in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
of white and black residents with a 4% higher share of the black residents. The share of black residents in the East Bluff if 20% higher than in Peoria City and 32% higher than in Illinois. The share of all other races is similar among the three Figure 3. Race in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
Bluff is two times lower than in Illinois and one and 1/2 times lower than in Peoria City (Figure 6). The majority of cumulative household incomes in the East Bluff are below $100,000, while in Peoria City and Illinois the majority of households earn below $150,000 (Figure 5).
Data source: U.S. Census Bureau, 2014
geographies(Figure 3).
Figure 5. Cummulative household income in East Bluff, Peoria City and Illinois, 2014
Socioeconomic Profile Educational Attainment East Bluff lags behind the city and state in higher education attainment. 52 % of the East Bluff residents as opposed to 38-39% of Peoria and Illinois residents achieved a high school education or less (Figure 4). A significantly higher share of Peoria City (33%) and Illinois residents (32%) obtained a bachelors degree or higher than East Bluff (11%).
Income
Median cumulative household income in the East
Data source: U.S. Census Bureau, 2014
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Demographic and Socioeconomic Factors
Health Profile of the East Bluff Neighborhood
Figure 6. Median household income in East Bluff, Peoria City and Illinois, 2014
Figure 8. Unemployment rates in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
Data source: U.S. Census Bureau, 2014
difference. Other industries employ similar shares differing by 0-4%.
Employment The top five industries that employ the largest share of people are the same across all geographies. The industry mix of the East Bluff is close to Peoria City’s mix, but differs from Illinois. Almost half of the East Bluff residents are employed by the educational and health services and arts, entertainment, recreations, accommodation and food services, while the same industries in Peoria City and Illinois employ 40% and 31% of its residents respectively (Figure 7). This is a major
There is a difference not only in the industry mix, but also in the share of employed residents. Unemployment in the East Bluff is 8 % higher than unemployment in Peoria City and Illinois (Figure 8).
Poverty Almost a third of the East Bluff residents live below the poverty line. Poverty is 7% and 15%
Figure 7. Industry mix in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
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Demographic and Socioeconomic Factors
Health Profile of the East Bluff Neighborhood
higher in the East Bluff than in Peoria City and Illinois, respectively (Figure 9). Looking at poverty in connection to other socio-economic and demographic factors can explain it better.
Figure 10. Share of residents within the age group living below the poverty line in East Bluff, Peoria City and Illinois, 2014
More than a third of the East Bluff children (37%) live below the poverty line, which is 5% and 17% higher than children in Peoria City and Illinois Figure 9. Share of residents living below the poverty line in East Bluff, Peoria City and Illinois, 2014 Data source: U.S. Census Bureau, 2014
lower than in the city or state.
When it comes to poverty and race, there is a variety of differences amongst the three geographies. The share of white residents living below the poverty line in the East Bluff is two times as high as city and state. Similarly, the share of residents that identify with two or more races in the East Bluff and live below the poverty line is twice higher than in the state and 7% higher than in the city (Figure 11). The share of black residents in poverty is almost the same in the East Bluff as in the state, and is lower by 8% as compated the th city. The share of Asian residents is almost the same in all geographies. The East Bluff does not have American Indian and Hawaiian residents.
Data source: U.S. Census Bureau, 2014
(Figure 10). The share of residents 18-64 years old from the East Bluff who live below the poverty line is also much higher than in the city or state. The share of older residents (65 years and over) living below the poverty line in the East Bluff is
Figure 11. Share of residents of a specific race living below the poverty line in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
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Demographic and Socioeconomic Factors
Health Profile of the East Bluff Neighborhood
Figure 12. Share of residents with a certain education level living below the poverty line in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
The share of Hispanic residents living below the poverty line is almost the same in the East Bluff and state, and it is lower in the East Bluff than in the city.
Figure 13. Share of families within a family type living below the poverty line in East Bluff, Peoria City and Illinois, 2014
There is a strong correlation between educational level and poverty. In all geographies, the lower the education attainment level, the higher the share of the residents living in poverty(Figure 12.) For example, the share of people who obtained a bachelors degree or higher living in poverty ranges from 4% in Peoria City to 6% in the East Bluff. This share grows to 25-43% for people with less than a high school education. The share of residents living below the poverty line is higher in the East Bluff than in other geographies for all education attainment levels except for the less than high school of Peoria City.
Data source: U.S. Census Bureau, 2014
greatly influence poverty status. A much smaller share of peope who work full-time live below poverty line (3-5%) than do people who do not work at all (23-35%). The share of the East Buff residents living below the poverty line is higher for all work experience situations (Figure 14).
Poverty levels also vary depending on family type. For all family types, a higher share of the East Bluff families live below the poverty line than in the city or state (Figure 13). The share of married couples in poverty is slightly higher in the East Bluff, but it is similar among the East Bluff and Illinois families with a female household, no husband present.
The share of employed people living below the poverty line is lower than unemployed people for all geographies (Figure 15). However, a much higher share of employed people in the East Bluff
Work experience and employment situation
7
Demographic and Socioeconomic Factors
Health Profile of the East Bluff Neighborhood
males. The share of unemployed people(altogether and by gender) from the East Bluff is lower than in the city, but higher than in the state.
Figure 14. Share of residents within the work experience group living below the poverty line in East Bluff, Peoria City and Illinois, 2014
Food Stamps For all household types, more East Bluff residents receive food stamps (Figure 16). However, the state has the highest percentage of households with one or more people 60 years or older using food stamps.
Conclusion Overall, the East Bluff neighborhood has many Data source: U.S. Census Bureau, 2014
Figure 16. Share of households receiving food stamps (SNAP) in East Bluff, Peoria City and Illinois, 2014
residents live below the poverty line than in the city or state. Also, the share of employed females living below the poverty line is higher than that of Figure 15. Share of employed and unemployed residents by gender living below the poverty line in East Bluff, Peoria City and Illinois, 2014
Data source: U.S. Census Bureau, 2014
social determinants that may lead to poor health as compared to the city of Peoria and the state of Illinois. The residents of tracts 16 ans 25 are generally more likely to have a lower level of education, to be living in poverty, to be working while in poverty or to be unemployed. These factors can contribute to poor health, because people living in poverty are less able to afford necessities such as healthcare and nutritious foods for themselves. Furthermore, the stress of living in poverty negatively impacts mental health (Dannenberg et al. 2011).
Data source: U.S. Census Bureau, 2014
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Built Environment Factors Elements of the built environment can have a significant impact on health. Some factors, such as low density of a neighborhood, no places to go, bad conditions of sidewalks and high traffic can prevent people from walking and thus, lead them to be less physically active. Conversely. factors including mixed-use development, good street connectivity, good sidewalk conditions and presence of traffic-calming features have shown to increase walking (Dannenberg et al, 2011). Several studies have shown that the presence of sidewalks and low traffic volumes correlated with higher numbers of children walking or bicycling to school (Franzini, 2009).
riders in the city. Use of public transportation can benefit health because it facilitates exercise (walking to the bus stops). Walking can be safe and healthy if sidewalks are present and in a good condition. Also, walking is safer when pedestrians are protected from traffic and criminal activity. (Robert Wood Johnson Foundation, 2012) Peoria is served by the CityLink bus service that serves the “Greater Peoria Mass Transit District.” Three bus lines intersect with East Bluff: #4 Knoxville, #12 Heights and #14 Wisconsin. All of these routes connect to downtown Peoria. Of the stops along all three of these routes, only one has a covered bus shelter (#14 Wisconsin at Wisconsin Ave & Arcadia Ave). According to CityLink’s GIS maps, signage for bus stops is consistent with stops; however, the quality, content and condition of these signs is unknown. (Greater Peoria Mass Transit District, 2016)
This section analyzes the following elements of the built environment in the East Bluff that can influence resident health:
• Transportation use (use of cars, transit, etc.) • Transportation infrastructure (road and sidewalks condition) • Traffic (volumes, safety) • Land use (access to parks)
Transportation Infrastructure Sidewalk infrastructure in the East Bluff neighborhood is considerably better than that in surrounding neighborhoods of Peoria. A study by the City of Peoria, which catalogued and rated sidewalks around the city based on their conditions and compliance with ADA accessibility, found that more than half of sidewalks in East Bluff rank at or below 30% on a scale of 0-100%, with 0% being a perfect sidewalk. Walkscore.org is a website that measures the walkability of a given location. The walking distance to various amenities is taken into account to produce a final score for walkability. According to Walkscore.org, the zip code 61603 has a Walkscore of 56 out of 100, and is the second most walkable zip code in Peoria; Peoria as a whole has a Walkscore of 37. (Walkscore, 2016)
Transportation Use Vehicles ownership and use can indicate levels of physical activity within a certain area. According to the ACS data in 2014, about 41% of East Bluff residents (in census tracts 16 and 25) do not own a vehicle or own only one, which is 5% higher than in the city of Peoria (U.S. Census Bureau, ACS, 2014). A higher share of Peoria city residents own two or more vehicles than in the East Bluff. About 74% of residents from the East Bluff drive to work alone in comparison to 81% in Peoria in 2014 (U.S. Census Bureau, ACS, 2014). On average, 6% of East Bluff residents use public transportation, which is twice as high as the share of transit
The street connectivity index in the East Bluff 9
Built Environment Factors
Health Profile of the East Bluff Neighborhood
is 1.58, which is above the required 1.4 for the walkable community, meaning that it is a walkable neighborhood.
Figure 18. Extent of air pollution and affected people living by the busy roads in East Bluff, IL
Traffic According to collision data collected during 20102013, there were about 17 accidents involving a vehicle hitting a pedestrian during the period from 2010-2013. Most of those accidents happened at the intersections of the roads with the medium and high traffic volumes(Figure 17). The higher the traffic volume, the more car accidents happen on those roads. (Peoria County Accident Data Center, 2014)
Heavy traffic contributes to higher levels of air pollution, which affects health. Studies have shown that daily traffic of 10,000 VMT or more can create enough air pollution to affect people’s health who walk or live near the roads with this traffic volume (Boehmer, 2013). Three roads in Figure 17. Classification of roads in East Bluff, Illinois based on their traffic volume
the East Bluff had daily traffic volume of 10,000 VMT or more in the past ten years: highway I-74, N Knoxville Ave., and N Prospect Ave. The air pollution from these roads dissipates after about 300 meters; many studies have proved that people who are living at least 150 meters away have been negatively affected by the air pollution caused by traffic (Boehmer, 2013). About 17% of parcels in East Bluff lie within a 150-meter distance and about 40% of parcels lie within a 300 meter distance from the roads with high traffic (Figure 18).
Park Access According to the Peoria Park District, the study area does not contain any parks operated/ maintained by the city. (Peoria Park District, 2016) However, the Glen Oak Park is nearby (Figure 19). Within the East Bluff neighborhood, there are some other potential areas for outdoor recreation including the play area and green space adjacent
Traffic data source: Illinois Department of Transportation
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Built Environment Factors
Health Profile of the East Bluff Neighborhood
access to parks in the walking distance, lack of bicycling infrastructure to get to places outside of the neighborhood, and high traffic can prevent residents from being physically active.
Figure 19. Accessibility to local parks in East Bluff, IL
to Glen Oak Leaning Center as well as a number of “pocket parks� and community garden spaces which dot the area. A 2015 Peoria Journal Star article refers to one of these pocket parks located at 500 E Illinois Avenue; the park is owned and maintained by the East Bluff United Neighborhood Association and is facing safety concerns due to the structural integrity of a pavilion on the grounds of the park (Luciano, 2015). Though pocket parks may be easy to construct, Mike Freeburg of the Peoria Park District states that construction costs and maintenance, like mowing, can significantly outweigh the benefits of pocket parks. Additionally, pocket parks are difficult for the city and/or the Park District to approve. Challenges like these can discourage cities from investing in pocket parks.
Conclusion Several built environment factors such as high walkability, street connectivity, access to public transportation and a higher use of public transportation create an environment conducive to high healthy physical activity in the East Bluff. However, these factors can improve health only if people use the built environment. Low 11
Housing Profile Home Ownership and Occupancy
Figure 22. Vacancy rates in East Bluff, Peoria City, and Peoria MSA, 2014
The East Bluff is characterized by a unique historic housing stock. Many of its buildings are aging, and the share of renter-occupied units has increased since 2000 (Figure 20). Figure 20. Change in house ownership in East Bluff, IL
Data source: U.S. Census Bureau, 2014
Home Value
Data source: U.S. Census Bureau, 2014
A majority of the homes in the East Bluff are valued under $100,000. This is lower compared to home values in the city of Peoria and the Peoria MSA, where most residents own homes that are valued at $50,000 to $300,000 (Figure 23).
The East Bluff neighborhood is currently comprised of 59% renter-occupied units. This percentage is higher than the city of Peoria and the Metropolitan Statistical Area (MSA), which are comprised of 44% and 29% renters, respectively (Figure 21). In addition, the percentage of vacant housing units in the East Bluff is 19%, which is two times larger than that of the city and the MSA (Figure 22). There is also a higher percentage of vacant lots in the East Bluff as compared to the city.
Figure 23. Cummulative value of owner-occupied houses in East Bluff, Peoria City, and Peoria MSA, 2014
Figure 21. Proportion of house ownership and renting in East Bluff, Peoria City, and Peoria MSA, 2014
Data source: U.S. Census Bureau, 2014
Housing Units in Structure The East Bluff neighborhood has more structures with multiple housing units compared to the city
Data source: U.S. Census Bureau, 2014
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Housing Profile
Health Profile of the East Bluff Neighborhood
Figure 24. Structure of housing units in East Bluff, Peoria City, and Peoria MSA, 2014
Figure 25. Share of cost burdened and severely cost burdened households in East Bluff, Peoria City, and Peoria MSA, 2014
Data source: U.S. Census Bureau, 2014
more as severely cost burdened (HUD, 2016). Cost burden affects health because it leaves less money for residents to spend on health care and healthy foods. Mental stress associated with cost burden also negatively affects health (Dannenberg et al, 2011). Figure 25 shows that 47% of the East Bluff and Peoria City renters are either cost burdened or severely cost burdened. Cost burden is slightly less at 41% in the MSA.
Lead Paint Hazard Peoria is ranked third for Illinois’ top ten rates of lead poisoning in homes. In 1978, lead paint regulations were passed. The median year structures were built in the East Bluff neighborhood is 1939, or 23-25 years older than in Peoria City and MSA, which indicates more risk for lead paint in the East Bluff homes (Figure 26). The Lead Hazard Control Program has created programs to address this issue by using various techniques to remove lead paint in houses that were built before 1978. Some techniques include replacing wood windows, enclosing with new drywall or using primer paint, replacing door stops, door slabs, and sealing floors (Peoria County Government, 2016).
Data source: U.S. Census Bureau, 2014
and the MSA; approximately 13% of housing structures in the East Bluff have two seperate units. while the city and the MSA have 4% and 3% of housing structures with two units, respectively (Figure 24). Approximately the same amount of residents live in mobile homes in the East Bluff and the MSA.
Housing Cost Burden
Figure 26. Median year structure built in East Bluff, Peoria City, and Peoria MSA, 2014
The Department of Housing and Urban Development defines households that spend 30% or more of their income towards housing costs as cost burdened, and households that spend 50% or 13
Housing Profile
Health Profile of the East Bluff Neighborhood
Community Core Initiative The Community Core initiative revitalizes housing stock in the neighborhood using a three million dollars from the Attorney General (AG) grant. This initiative is a partnership between the East Bluff Neighborhood Housing Services (EBNHS) and Greater Peoria Local Initiatives Support Corporation (LISC) Projects include increasing curb appeal with new paint, front porch improvements, lighting, door and window replacements, and lock replacement. These improvements are implemented with sweat equity from residents and volunteers. The Community Core initiative also aims to transform vacant land into community gardens and pocket parks. One community garden has already been established right outside the East Bluff Neighborhood Housing Services. The community core has also facilitated relationship building within the neighborhood, new neighborhood associations have been formed. (EBNHS, 2016) Additionally, the EBNHS manages sixteen affordable, ADA accessible units. This project is called Access Peoria. Funding comes from the AG grant and from the Williams Act, which was enacted to provide accessible housing for disabled people living in nursing homes.
Conclusion Older housing stock of the East Bluff neighborhood may have higher levels of lead that can cause health problems for its residents. Furthermore, the East Bluff has lower home values, more renters, and higher cost burden than the city or the MSA, all of which relate to the higher poverty levels in the neighborhood.
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HealthCapital Social Factors and Outcomes Social capital is a fundamental component in community development. It is the networks, interactions, and resources that can be accessed by individuals and groups to inspire trust, connections, and reciprocity among citizens. Building social capital within East Bluff can motivate all residents to take pride in their community. The social fabric of the East Bluff Neighborhood is sustained by the active work of neighborhood associations and non-profits, such as the East Bluff Community Center. These organizations are supported by long-time residents who are invested in restoring neighborhood pride and dedicated to developing an actively engaged community of choice. The challenge in East Bluff is sustaining social capital by bridging the gap between both long-time residents and newer, less invested residents to a point where the community can begin to change the perceived and actual quality of life in the community. The following list highlights groups and programs that can help facilitate the building of social capital; Figures 1 and 2 show the locations of these resources.
Pride in Peoria Litter Campaign | Neighborhood Dumpster Cleanup Pride in Peoria Litter campaign happens every year and lasts from April till November (Pride in Peoria, 2016). Campaigners: • Collaborate with Peoria Disposal Co. for dispensing trash and landscape dumpsters to local Neighborhood Associations • Loan litter grabbers, safety vest, trash bags and buckets • Loan Pride Pals mascots for cleanup events
East Bluff Neighborhood Associations
East Bluff has committed neighborhood watch groups. There are also several neighborhood associations listed below with contact information. (EBNHS, 2016) • • • • • •
East Bluff Programs and Services List
East Bluff Serenity: 309.685.1768 East Bluff United: 309.645.8841 Community: 922.8888 Glen Oak Flanagan: 309.673.1552 Wisconsin East: 865.384.6132 Glen Oak Park: 309.685.1424
Ride with a Cop Residents can schedule a ride-along with a patrol officer during a day shift to learn what happens on average workday as a police officer.
National Night Out (NNO) Against Crime NNO takes place on the 1st Tuesday in August. It is an annual community-building campaign that promotes police-community partnerships and neighborhood camaraderie to make neighborhoods safer, better places to live (City of Peoria, 2015). This program encourages neighbors to build social relationships and become more familiar with their surroundings in a community-wide effort to prevent crime and create safer communities. (National Night out, 2015) 15
Social Capital
Health Profile of the East Bluff Neighborhood Figure 27. Places that can contribute to the growth of social capital in the East Bluff neighborhood
16
Social Capital
Health Profile of the East Bluff Neighborhood
the economic health and value of the East Bluff neighborhood. (EBHNS, 2016)
Citizen Police Academy Citizen Police Academy lasts from June to July every year. It educates residents about the workings of the police department and introduces officers to residents who would like to gain a better understanding of the Department’s procedures and policies. (City of Peoria, 2015)
Services Include: • • • • •
Help for homeowners Home weatherization Emergency housing rehab Lead hazard removal Health and safety loans (Assists homeowners, in need of financial help, in bringing their properties up to adequate health code and safety.) • East Village Growth Cell (Active planning initiative focused on the East Village Growth Cell.) • Neighborhood associations • Community Core Initiative (Utilizes grant funding to spur investment and improvement to the physical environment of homes in East Bluff including: locks, lights, lawn care, landscaping, and vacant properties.)
Programs include:
• Crime view Mapping & Emergency Communications Center Tour • Traffic Division Patrol • Identifying and Avoiding Scammers • Resident Officers Bus Tour • Don’t Shoot Initiative and K9 Units • Women in Policing • Neighborhood Nuisance Abatement Program
City/County Leadership Academy This program provides education about the local government through meetings with staff and tours of city and County departments. (City of Peoria, 2016) Educational sessions, taught by elected/ appointed officials, include: • • • • • • • • • • •
East Bluff News The East Bluff Community Center distributes this community letter. East Bluff News connects residents with each other and the activities and events happening in their neighborhood. The newsletter also promotes the East Bluff throughout the Greater Peoria area.
County and City overviews Tour of City Hall Health and Welfare Tour of Heddington Oaks Public Safety Fire and Rescue Tour of County Jail Infrastructure Tour of Public Works Coroner Office Tour of Morgue
Peoria Children’s Home Peoria Children’s home provides counseling, education and support services for more than 1,700 children and families each month. (Children’s Home, 2016) Programs include residential care, group homes, foster care, adoption, supervised independent living, private schools, crisis intervention, and homelessness support.
East Bluff Housing Neighborhood Services (EBHNS) EBHNS improves East Bluff by providing support services to the residents through innovative programs to promote safety, security, upkeep, maintenance, rehabilitation, restoration, and revitalization to increase the quality of life and
East Bluff Community Center The community center provides a place where residents can congregate for self and community improvement. Activities include: 17
Social Capital
Health Profile of the East Bluff Neighborhood
• Boys and Girls Club of Greater Peoria: »» Mentoring and social programs »» Youth sports »» Twilight Basketball (Ages 14-18) »» Summer Basketball @YMCA »» Girls Volleyball (Ages 14-18) »» Language Learning and GED Classes • Senior Pride • Take Back Our Neighborhood Rallies • Office for rent to non-profit groups • Event/meeting space for rent to the general public
captial in the East Bluff neighborhood.
Hult Health Center The Hult Health Center is not located in the East Bluff, but it is Peoria’s premier non-profit provider of comprehensive health education and wellness services for people of all ages. Services include: • • • • • • •
Health education programs Youth outreach & education programs Senior programs Mental health programs Cancer programs and services Health fairs Fun and health-oriented community event
University of Illinois Extension University of Illinois Extension develops and implements educational programming aimed at increasing the health of youth and adults in Fulton, Mason, Peoria and Tazewell Counties. Programs include 4-H youth development, healthy food education, and community and economic development. Illinois Extension also collaborates with the Peoria County Health Department. (University of Illinois Extension, 2016)
Conclusion Social Capital is an essential component of community wellbeing. The East Bluff and the city of Peoria have numerous institutions and programs that can potentially facilitate the building of social 18
Section...
Health Profile of the East Bluff Neighborhood
Food Environment Diet-Related Health Issues in Peoria County
Health Impacts of Unhealthy Food Americans are not eating enough healthy and nutritious foods. According to the Community Food Security Assessment Toolkit, 83.9% of adults ate less than five servings of fruits and vegetables per day and 49% of adults eat 0-2 servings of fruits or vegetables per day (Community Food Security Assessment Toolkit, 3). Negative health impacts of an environment without access to healthy food include obesity, diabetes and heart attacks. In the U.S. adult obesity alone currently adds $3.4 billion to annual healthcare costs, including $1 billion to Medicaid and $800 million to Medicare. In 2000, the total cost of obesity in the United States was approximately $117 billion. This included medical bills, wages lost due to illness, disability and premature death (Peoria Community Health Needs Assessment, 2011-206).
From 2004 through 2007, Peoria County had a 40% increase in obesity compared to neighboring Macon County. Furthermore, obesity is correlated with low income in Peoria County. 49% of obese adults in Peoria County earn less than $35,000 annually (Peoria Community Health Indicator Report, 2015). Additionally, according to Peoria Community Health Indicator Report, 4 in 10 non-white adults in Peoria are obese; and 4.5 in 10 deaths in Peoria County were caused by heart disease or cancer. Figures 28 and 29 show that instances of diabetes, high blood pressure, and cholesterol are increasing in Peoria County. Figure 28. Percentage of adults diagnozed with diabetes
Food deserts are areas in which residents do not have access to affordable, fresh, and healthy foods due to a lack of grocery stores within a convenient travelling distance. Food deserts are most often located in low-income areas. In some studies, wealthy areas have been shown to have three times as many supermarkets as poor ones do, and that white neighborhoods contain an average of four times as many supermarkets as predominantly black ones do (Food Empowerment Project, 2014). Fast food restaurants and cheap, processed foods in convenient stores are often the most realistic options for people living in food deserts. These food options are usually more accessible and affordable than healthy food options. Because a Kroger is located in the heart of the neighborhood, the East Bluff is not a food desert. However the location of many corner/convenient stores is problematic and will be discussed in more detail further on in this section of the report.
Figure 29. Change in share of Peoria County adults diagnozed with high blood pressure (BP) and cholesterol, 1997-2013
Source of graphs: Peoria Community Health Indicator Report, 2015
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Food Environment
Health Profile of the East Bluff Neighborhood
This section assesses the food environment in the East Bluff neighborhood. Food retail, access to liquor and tobacco, charitable food and community gardens, and access to food via public transportation will be discussed.
Access to Food Retail Figure 30 shows grocery stores, markets, corner stores and restaurants. The East Bluff has a Kroger grocery store at its heart, which provides fresh and healthy foods. However, there are also many
Figure 30. Location of food retail, tobacco and alcohol outlets, food pantries and community gardens in East Bluff. Accessibility of these outlets by CityLink buses. Routes: #4 (purple, Knoxville), #12 (teal, Heights), and #14 (green, Wisconsin)
20
Food Environment
Health Profile of the East Bluff Neighborhood
convenience stores in the neighborhood, which do not provide nutritious options.
neighborhood and some of the main grocery stores within the community. The green line (Route 14, Wisconsin) provides access to the main grocery store, Kroger, and runs directly through the East Bluff neighborhood. The purple line (Route 4, Knoxville) runs along Knoxville road and intersects two grocery stores. Lastly, the teal line (Route 12, Heights) serves the community, but does not intersect any grocery stores. (Greater Peoria Mass Transit, 2016)
Access to Liquor and Tobacco Equally important as access to healthy food is the ease of access to unhealthy substances, such as alcohol and tobacco. Peoria residents, especially those in the East Bluff neighborhood, have many choices of stores with unhealthy substances. Figure 30 illustrates the abundance of locations one can obtain or be served alcohol within the East Bluff neighborhood. The liquor stores and gas stations represented by a green bottle also provide access to tobacco products.
Conclusion While the East Bluff is served by a large Kroger, easy access to unhealty foods and substances found in convenience stores have the potential to contribute to ill health in the neighborhood.
Charitable Food and Community Gardens
Throughout the East Bluff neighborhood, there are many individuals, groups, and organizations working to serve their community and its residents. At the East Bluff Community Center (EBCC), residents are offered a free-of-charge space to gather. Additionally, EBCC is home to a food shelter and community garden in which community members can come to obtain produce and other necessary food items. There are other locations throughout the neighborhood similar to EBCC that provide aid for those in need. Figure 30 displays the locations of community gardens and food pantries in or near the East Bluff (Shanker, V. 2013). East Bluff and its surroundings are home to about seven food shelters and two community gardens.
Accessibility by Public Transportation CityLink, Peoria’s public transportation system. provides transit throughout the city and the East Bluff neighborhood. There are three routes that serve the East Bluff neighborhood. Figure 30 displays the bus routes that serve the 21
Section...
Health Profile of the East Bluff Neighborhood
Crime Profile In addition to direct harm that crime can cause individuals, crime can influence health in other ways. Living in a neighborhood with high levels of crime can contribute to mental stress. (Dannenberg et al, 2011) Also, residents may avoid walking, bicycling, and other healthy outdoors activities in the neighborhood if they perceive that the neighborhood is unsafe. Due to this, a crime profile is an important component of this overall health profile.
Violent crimes are crimes in which an individual had acted violently against the victim. These crimes include: murder, sexual assault, robbery, and aggravated assault/battery. There was an overall decrease in violent crimes by 13% from 2013 to 2014 (Table 1). This can be accredited to the significant decrease in murders and aggravated assault/battery charges in the area. However, some specific violent crimes, such as sexual assault increased significantly. East Bluff has experienced the same decrease in drug offenses as it has with violent crimes.
The East Bluff falls into the 10th Police District of Peoria. This section presents analysis of violent, property and drug crimes in the East Bluff neighborhood in the years 2013 and 2014.
While violent crime has decreased, property crime has grown. Property crimes include burglary, theft, motor vehicle theft, and arson. In just a year, East Bluff experienced an 18% increase in property crimes, shifting the neighborhood’s total from 560 to 661 property crimes (Table 1). The neighborhood has seen significant increases in burglary and theft, and decrease only in motor vehicle thefts.
Table 1. Change in number of crimes in East Bluff (10th Police District), 2013-2014 Number of crimes 2013
2014
Change
2
0
-100%
39
3%
Violent Crimes Murder
Sexual Assault Robbery Assault Total
13
38
142
21
110
195
170
188
219
62%
Conclusion
-23% -13%
Crime data shows mixed results for the changes in instances of crime. While violent crime has generally decreased, property crime has increased. This may lead to mixed perceptions of safety in the neighborhood.
Property Crimes Burglary Theft
328
404
Arson
8
9
Motor Vehicle Theft Total
36
16%
23%
29
-19%
560
661
18%
126
110
-13%
13%
Drug Offences Total Drug Offenses
22
Section...
Health Profile of the East Bluff Neighborhood
Health Factors and Outcomes This section presents health factors and outcomes for the East Bluff, the city of Peoria, Peoria County, Illinois, and the U.S. as a whole. Health outcomes are usually diseases, while health factors directly influence people’s health. Health Factors could include availability and accessibility of doctors, limited access to healthy food, and so on. Data for the East Bluff neighborhood is available only for a few diseases. Most health data is available for the city and county level and is presented here as a proxy to understanding health profile of the East Bluff neighborhood.
Peoria City-Level Data Health outcomes for Medicare beneficiaries are shown in Table 2. Data from the City and County of Peoria does not differ for any of the outcomes. Positive attributes for health outcomes in both the city and county as compared to the state and country include a slighlty lower share of people with diabetes, heart diseases and high blood pressure. However, a higher share of residents from Peoria City and County have high cholesterol. The percentage of people with depression is the same in all geographies.
Peoria County Health Factors and Outcomes Table 3 summarizes health factors, outcomes, and access to
healthcare services in Peoria County in comparison to the state of Illinois. The data show that many negative health factors are slightly or much higher in Peoria County than in the state. For example, there is a higher share of adults in Peoria County who smoke, are obese, live with higher food insecurity and have lower access to healthy foods and physical activities than in Illinois. The percent of adults without any regular doctor is significantly less than the national or state average. This is not surprising due to Peoria’s high rate of
Table 2. Comparison of numbers and rates of medicare beneficieries with certian diseases in Peoria City, Peoria County, Illinois, and the United States. Data source: Community Commons, 2015. Peoria City Total medicare beneficieries
Peoria County
Illinois
US
14,865
25,597
2,211
3,808
239,311
5,271,176
Beneficieries with Diabetes
3,667
6,315
441,148
9,224,278
Beneficieries with Heart Diseases
3,443
5,929
470,575
9,744,058
Beneficieries with High Blood Pressure
8,252
14,209
934,967
18,936,118
Beneficieries with High Cholesterol
7,326
12,615
754,150 15,273,052
Beneficieries with Depression % with Depression
% with Diabetes
% with Heart Diseases
% with High Blood Pressure
% with High Cholesterol
23
15%
25%
23%
56%
49%
15%
25%
23%
56%
49%
1,623,784 34,126,305
15%
27%
29%
58%
46%
15%
27%
29%
56%
45%
Health Factors and Outcomes
Health Profile of the East Bluff Neighborhood
Table 3. Comparison of health outcomes, factors and access to clinical care in Peoria County and Illinois. Data sources: County Health Ranking, 2015. Community Commons, 2015.
Health Outcomes Peoria County Premature death (per 100,000 population) Poor or fair health (adults self-reporting)
Poor physical health days (adults self-reporting in the last 30 days) Poor mental health days (adults self-reporting in the last 30 days)
Child mortality (number of deaths among kids 18 or younger per 100,000 population) Infant mortality (per 1000 life births) Diabetes prevelance
6349
3.4
3.4
10% 2.6
73.3
9.4
8%
HIV prevelance (per 100,000 population)
175
Asthma
16.70%
Chlamydia
Illinois
7551
825.3
15%
3.3 55
7.1
9%
300
13%
526.1
Health Factors Peoria County Adult smoking
19%
Adult obesity
28%
Access to exercise opportunities
75%
Physical inactivity (% of adults reporting no physical activity in leasure time) Excesive drinking
Alcohol-impaired driving deaths (% of all driving deaths with alcohol invovled) Sexually transmitted infections (per 100,000 population) Teen births (per 1,000 female population ageds 15-19) Food insecurity (lack access to food) Limited access to healthy foods
23%
18%
27%
23%
89%
21%
20%
824
526
38%
49
37% 35
15%
14%
9
9
7%
Motor vehicle crash deaths (per 100,000 population)
Illinois
4%
Clinical care Peoria County Uninsured
12%
Primary care physicians ratio*
Illinois 15%
“909:1” “1,266:1”
Dentists ratio*
“1,472:1” “1,453:1”
Mental health providers ratio*
“515:1”
*Ratio: population to institution/doctor
24
“604:1”
Health Factors and Outcomes
Health Profile of the East Bluff Neighborhood
primary care physicians. There is also a ratio of mental healthcare providers in the county than in the state, but slightly lower access to dentists.
East Bluff and nearby (Figure 31). The East Bluff neighborhood is just north of state of the art medical complexes OSF St. Francis and Unity Point Health-Methodist. The University of Illinois College of Medicine is just southwest of these complexes. OSF. St. Francis is the fourth largest medical center in Illinois, and employs 850 physicians, 6,500 employees and has 616 patient beds; this facility is also affiliated with the U of I college of medicine. The Heartland Community Health Clinic at the heart of the East Bluff neighborhood on Wisconsin Avenue provides primary health care regardless of ability to pay. It also provides counseling for coverage under the Affordable Care Act.
Compared to Illinois, Peoria County residents experience worse health outcomes such as higher rates of premature deaths, child mortality, asthma, and chlamydia. However, county’s residents have lower rates of HIV and diabetes, and adults selfreport less poor general and mental health.
Health in East Bluff Location of Health Services in the East Bluff Neighborhood There are several healthcare locations in the
Zip Code Level Data for STD and Maternal Health
Figure 31. Location of health services in East Bluff
25
In the 2014 Peoria County Sexually Transmitted Disease report, women, individuals’ ages 1524, African American/ Blacks, and residents of the zip codes 61603 (East Bluff), 61604, and 61605 were identified as the population groups at highest risk for STDs. At the county level, the highest number of Chlamydia cases were reported in the African American population, with 557 cases recorded for women, and 316 cases recorded for men. Furthermore, the most cases occurred in people from the ages of 15-24, with 771 cases recorded for women in this age category and 286 cases
Health Factors and Outcomes
Health Profile of the East Bluff Neighborhood
recorded for men. At the zip code level, East Bluff (61603) is among the top three zip codes with the highest rates of Chlamydia, with the other two being 61604 and 61605. For 15-24 year olds, 286 cases were recorded for residents of the East Bluff; 713 cases were recorded in 61604 and 61605 total, and 487 cases occurred in the rest of the county. This shows that 24% of the total cases were recorded for East Bluff residents.
They are also higher than the percentages of babies born at low birth weight and very low birth weight in Peoria County.
Lastly, women aged 18-19 accounted for about 40% of births in the East Bluff. This is the secondhighest percentage of births for this age group for any zip code in the city.(Peoria County Maternal and Child Health Report, 2014).
Conclusion
The same statistics at the county level apply to Gonorrhea cases. The African American population experienced the highest number of cases, with 175 cases recorded for women and 150 cases recorded for men. Again, most cases occurred within the age range of 15-24, with 195 cases reported for women and 100 reported for men. At the zip code level, East Bluff, 61604 and 61605 had the highest number of Gonorrhea cases. For 15-24 year olds, a total of 106 cases were recorded for residents of the East Bluff. 209 cases were recorded in 61604 and 61605, and 88 cases were recorded in the rest of the county. This shows that 26% of total cases for this age group were recorded for East Bluff residents. (Peoria County Sexually Transmitted Disease Report, 2014).
The data presented in this report show that although there are many physicians and large medical centers in Peoria, racial and geographic disparities in health exist, and STDs and general health issues such as obesity are still prevalent. This presents a challenge as well as an opportunity. The Peoria City/County Health Department recently released the Peoria County Community Health Needs Assessment and Plan that used the Mobilizing for Action through Planning and Partnerships (MAPP) methodology of community inclusion into the health planning process. Representatives from medical, public health, and religious organizations created a vision for Peoria County as a “fully engaged, inclusive community with optimal levels of health and wellness in a safe, just and sustainable environment.” The strategies for improving physical, oral and sexual health laid out in this plan include increasing community partnerships and health education. The proximity of East Bluff to renowned medical facilities could be taken advantage of through an increase in hospital-community partnerships. Perhaps youth employment, health education or community gardening programs could be run out of the hospital to enrich the community. The hospital could also incorporate a community center to integrate with the East Bluff neighborhood.
About 70% of pregnant women in the East Bluff neighborhood (61603) had first trimester prenatal care. This is lower than any other zip code, and is below the 77.9% goal of Healthy People 2020, a national health initiative. Furthermore, the highest percentage of preterm births was reported in the East Bluff neighborhood. Approximately 12.5% of births were preterm, which is also below the 11.4% goal of Healthy People 2020. The percentage of very preterm births in the East Bluff was slightly higher than in Peoria County and slightly higher than the Healthy People 2020 goal of 1.8% at approximately 2%. (Healthy People 2020, 2016) The percentage of babies born at low birth weight and very low birth weight were approximately 11.5% and 3%, respectively. These percentages are significantly higher than the Healthy People 2020 goals of 7.8% and 1.4%. 26
Section...
Health Profile of the East Bluff Neighborhood
References 2015 County Health Rankings. Retrieved from http://www.countyhealthrankings.org/app/ illinois/2015/rankings/peoria/county/outcomes/ overall/snapshot
Island Press. Print.
EBNHS. Community Core. 2016. Retrieved from http://www.ebnhs.com/
Department of Housing and Urban Development. Affordable Housing. 2016. Retrieved from http:// portal.hud.gov/hudportal/HUD?src=/program_ offices/comm_planning/affordablehousing/
Accident Data Center. Peoria County, IL. 04 Aug. 2014. <http://accidentdatacenter.com/us/illinois/ peoria-bloomington-il/peoria-county-il>. Boehmer, T. E., 2013, November 22. Residential Proximity to Major Highways — United States, 2010. Retrieved from Centers for Disease Control and Prevention: http://www.cdc.gov/mmwr/ preview/mmwrhtml/su6203a8.htm
East Bluff Neighborhood Housing Services. East Bluff Neighborhood Associations. 2016. Retrieved from http://www.ebnhs.com/neighborhoodassociations.html East Bluff Neighborhood Housing Services. Home. 2016. Retrieved from http://www.ebnhs.com/
Center for Disease Control. Social Determinants of Health, 2016. Retrieved from http://www.cdc. gov/socialdeterminants/
EBNHS. East Bluff News. 2016. Retrieved from http://www.ebnhs.com/east-bluff-news.html
Community Commons. Health Outcomes Data, 2016. Retrieved from h t t p : / / w w w. c o m m u n i t y c o m m o n s . o r g / CommunityCommonsData
Greater Peoria Mass Transit District | CityLink. 2016. Retrieved from <http://www.ridecitylink. org/>.
CityLink, 2016. Schedule and Routes. Retrieved from CityLink: http://www.ridecitylink.org/ridecitylink/schedules-routes
Pride in Peoria. City of Peoria Litter Campaign. 2016. Retrieved from http://www.prideinpeoria. com/!/home
City of Peoria. Neighborhood information page. Retrieved from http://www.peoriagov.org/peoriapolice department/neighborhood-programs/
Food Empowerment Project. Food Deserts. 2014. Retrieved from http://www.foodispower.org/fooddeserts/
City of Peoria. Neighborhood Association President’s directory. Retrieved from http:// www.peoriagov.org/content/uploads/2012/11/ Neighborhood-Association-Presidents-DirectoryJan-12-2016_1452619192_add.pdf
Franzini, E. A., 2009. Influence of Physical and Social Neighborhood Environments on Children’s Physical Activity and Obesity. American Journal of Public Health. Facebook. East Bluff Community Center. Retrieved from https://www.facebook.com/ ebccpeoria/?fref=ts
Children’s Home. 2016. http://www.chail.org/ pages/ Dannenberg, A. L. 2001. Making Healthy Places.
Healthy People 2020. Social Determinants of 27
References
Health Profile of the East Bluff Neighborhood
Health. 2016. Retrieved from https://www. healthypeople.gov/2020/topics-objectives/topic/ social-determinants-of-health
RWJF. Transportation and Health. Oct. 2012. Retrieved from <http://www.rwjf.org/en/library/ research/2012/10/how-does-transportationimpact-health-.html>.
Heartland Clinic. 2016. Retrieved from http:// www.heartlandchc.org/# Hult Center for Healthy Living. Home. 2016. Retrieved from http://www.hulthealthy.org/
Shanker, V. Community gardens taking root in Peoria. Peoria Journal Star. 2013, September 25. Retrieved from http://www.pjstar.com/ article/20130925/NEWS/309259864
Lead Hazard Removal. Peoria County Government. 2016. Retrieved from <http://www.peoriacounty. org/pcchd/lead>
“University of Illinois Extension Serving Fulton, Mason, Peoria and Tazewell Counties.” Our Programs. 2016 <http://web.extension.illinois. edu/fmpt/programs.html>.
Luciano, P., 2015, August 15. Problems Pops up at Peoria Pocket Park Pavilion. Retrieved from http://www.pjstar.com/article/20150815/ NEWS/150819545
U.S. Census Bureau, 2014. ACS 5-year estimates. Prepared by Social Explorer:
National Night Out. Home. Retrieved from https:// natw.org/
• • • •
Peoria Community Health Needs & Assessment Plan, 2011-2016. National Citizen Survey Peoria, 2015.
Tenure Occupancy Status House value for all owner-occupied units Median year structure built
U.S. Census Bureau, 2014. American Community Survey 5-year estimates. Retrieved from http:// factfinder.census.gov:
OSF Healthcare. https://www.osfhealthcare.org/
Peoria Community Health Indicator Report, 2015 Public Health Department. Retrieved from http:// www.peoriacounty.org/
• • • • • • • • • •
Peoria City/County Health Department. Peoria County Sexually Transmitted Disease Report, 2014. Peoria City/County Health Department. Peoria Maternal and Child Health Report. 2014. Peoria County. Peoria County Community Health Needs Assessment and Plan. 2011. Retrieved from http://www.peoriacounty. org/download/?path=%2Fpcchd%2FIPLAN_ MAPP%2FIPLAN_July2011.pdf
Age, gender: S0101 Race: B02001 Educational attainment: S1501 Median household income: DP03 Unemployment: DP03 Income distribution: S1091 Food stamps SNAP: S2201 Industry breakdown: DP03 Poverty: B1701, B17003 Means of transportation to work: S0802
Walk Score. Get Your Walk Score. 2016. Retrieved from <https://www.walkscore.com/>. World Health Organization. Social Determinants of Health. 2016. Retrieved from http://www.who. int/social_determinants/en/
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References
Health Profile of the East Bluff Neighborhood
Sources of images on the cover (from the top left to the bottom right):
• East Bluff Community Center (red brick building), screenshot from Google Maps.
• Blue renovated house. Screenshot from the video on YouTube, “2015 Community Core - Change you can in the East Bluff”, https:// www.youtube.com/watch?v=dGJM-6c4Nys.
• People working on green buildings. Screenshot from the video on YouTube, “2015 Community Core - Change you can in the East Bluff”, https://www.youtube.com/watch?v=dGJM6c4Nys.
• A person walking down a street in the East Bluff. Photo taken by Oksana Polhuy, April 2016. • Two boys and a lady working in the garden. Screenshot from the video on YouTube, “2015 Community Core - Change you can in the East Bluff”, https://www.youtube.com/ watch?v=dGJM-6c4Nys. • A doctor checking a patient. Freestockphotos. • Men improving a house. Screenshot from the video on YouTube, “2015 Community Core - Change you can in the East Bluff”, https:// www.youtube.com/watch?v=dGJM-6c4Nys. • A mural in the East Bluff. Screenshot from the video on YouTube, “2015 Community Core - Change you can in the East Bluff”, https:// www.youtube.com/watch?v=dGJM-6c4Nys. • Fruit and vegetables. Wikipedia. org.
Free
commons,
• Background: Screenshot of the East Bluff neighborhood from Google Earth.
29