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The flipside of fun in West Hollywood

West Hollywood’s nightlife is legendary, drawing local and international crowds to hotspots ranging from The Abbey to The Roxy, with every conceivable kind of watering hole in-between.

But where there’s revelry, there may be a hangover, too. A recently-released public health report on problems associated with alcoholic beverage outlets in Los Angeles County found that West Hollywood  has the highest concentration of on-premises drinking establishments anywhere in the county. It also ranked near the top in “off-premises” stores selling alcoholic beverages to go.

What’s more, the small, sophisticated city ranks third-worst among the 117 communities surveyed for motor vehicle crashes and 13^th worst for violent crime. Its alcohol-related death rate also was deemed a serious enough problem to be ranked “high” among the communities included in the report.

“West Hollywood is, for better or worse, the adult playground of Southern California,” said Mayor John Duran. “It is primarily an adult community,” drawing residents and visitors alike because of its many dining, drinking and entertainment options. “It’s why we all choose to live here.”  But, he noted, “there is a tradeoff.”

The popularity of the city’s restaurants, bars and hotels gives West Hollywood the budget to fund important services—even in tough economic times. “Without all that nightlife activity, we wouldn’t have a surplus,” Duran said.

The report, issued by the Los Angeles County Department of Public Health, seeks to draw connections between the density of liquor establishments and an array of problems ranging from car crashes and hospital admissions to neighborhood disturbances and assaults.

Nowhere are the issues and dilemmas more striking than in West Hollywood.

“While we are home to the Sunset Strip’s nightclubs, we are also a Mecca for recovery,” Daphne Dennis, the city’s social services manager, said in an email describing the city’s support for 12-step recovery efforts.  Overall, she said, West Hollywood commits “substantial resources” to two strategies recommended in the report—access to mental health and substance abuse services and educational services.  Other recommendations— on limiting advertising and on training for alcoholic beverage-selling staffs—are expected to be discussed by the city’s Human Services Commission in May.

The report used 2007 population estimates and information from the state’s Department of Alcoholic Beverage Control to determine the density of liquor outlets in individual communities. Then it analyzed law enforcement and health data to try to measure the impact of such establishments in each part of the county.

It found an average of 16 alcohol outlets per 10,000 people countywide. In West Hollywood, the concentration was far greater—47.3 on-premises outlets per 10,000 residents.

Still, the per-capita measurements of alcohol-related problems may not tell the whole story when it comes to West Hollywood—a 1.9 square mile city with 34,399 residents which has a much larger footprint after dark.

“Our city swells to over 100,000 on the weekend. Even on a weeknight, our population probably doubles,” said Lt. David Smith, of the Los Angeles County Sheriff’s Department’s West Hollywood station.

He said the department responds to the influx by taking a pro-active approach to all kinds of alcohol-related issues, including DUI enforcement.

Every holiday season, deputies and city staffers hand out cocktail napkins bearing an anti-drunk driving message to bars and nightclubs. And for the past several years, a wrecked car has been displayed prominently at the corner of Santa Monica and San Vicente boulevards from early December through New Year’s—a reminder of the consequences of having one for the road.

 “We take drunk driving seriously,” Smith said, “and efforts are underway to counteract it.”

At Barney’s Beanery, a West Hollywood institution that’s celebrating its 90^th anniversary Saturday, regional manager AJ Sacher said it makes good business sense to keep its clientele from drinking and driving.

“We call cabs all the time for our customers,” Sacher said. Barney’s, like other drinking establishments, also offers free non-alcoholic beverages for designated drivers and lets people who’ve overindulged leave their car valet-parked all night, without charge. “We want them to come back.”

Sacher said West Hollywood businesses tend to “operate in an extremely responsible manner” toward the drinking public—“It’s our livelihood.”

And he said he thinks the public as a whole has gotten savvier about drinking and driving in recent years.

“The vast majority of people who go out to restaurants in Los Angeles County every night are very responsible with their alcoholic beverage consumption, get home safely and don’t cause any problems.”

But when there are alcohol-related problems, the public health report found, they tend to happen where liquor-selling facilities are clustered.

And West Hollywood is not alone in feeling the effects.

On the Westside, Culver City, Santa Monica and Malibu also have high numbers of alcoholic beverage establishments per capita and have had their share of related problems, particularly motor vehicle crashes. (Beverly Hills, on the other hand, has one of the county’s highest concentrations of restaurants, bars and stores selling liquor, but has experienced only low levels of the social problems surveyed in the report.)

Elsewhere in the county, Commerce had the county’s highest concentration of stores selling liquor. It also had the worst rate of car crashes, the 2^nd worst rate of alcohol-related deaths, and one of the worst violent crime rates. San Fernando, with a high proportion of liquor stores, had the worst rate of alcohol-related deaths. The correlation between liquor establishments and social problems wasn’t always quite so pronounced, though. For example, Westmont, an unincorporated area close to South Central Los Angeles, had the worst violent crime rate among the communities surveyed—but ranked only “medium” in the number of liquor stores.

“Obviously, there are always going to be exceptions,” said Ben Lee, chief of the research and epidemiology unit that crunched the data for the report. But overall, he said, the report should serve as an eye-opener for people and communities across the county, as well as a tool for policy-makers seeking to combat an array of ills associated with alcohol abuse.

Posted 4/28/11

New health report takes aim at alcohol

A newly released study by Los Angeles County’s Department of Public Health paints a grim picture of the rippling impact of alcohol sales and consumption across the region, disclosing, among other things, that close to 1 in 5 high school students reported at least one episode of binge drinking in the past month.

The report draws a direct correlation between communities with a high number of alcohol outlets and a variety of harms, including violent crime, motor vehicle crashes and alcohol-related deaths. These neighborhoods, mostly in poorer areas of the county, are up to 10 times more likely to have increased rates of violent crime and three times more at risk for alcohol-involved crashes, according to the study, called “Reducing Alcohol-Related Crimes in Los Angeles County.”

“Each year, 2,500 people in the county die from alcohol-related causes, with the loss of approximately 78,000 years of potential life,” Public Health Director Dr. Jonathan E. Fielding said in an introduction to the report. “In addition to the devastating personal and societal effects of alcohol abuse on individuals, families and communities, excessive alcohol consumption costs Los Angeles County an estimated $10.8 billion annually, or roughly $1,000 for every resident.”

Fielding said in an interview that he was particularly troubled by the high rate of binge drinking among younger people.

“They have less experience and don’t understand the limitations of what they can and cannot do,” Fielding said. “We already know they are risk-takers in the way they drive at higher speeds. It’s a very bad combination, one that every family should be concerned about. It’s very disturbing.”

The report, which examines the density of alcohol outlets in 117 communities and cities across the county, calls for a series of measures aimed at reducing alcohol availability and consumption.

Fielding specifically called for an increase in alcohol taxes through legislation or ballot initiatives. “We should be doing everything we can to reduce consumption,” he said. “We need to change the economics.”

California’s last increase in alcohol taxes, he said, occurred in 1991. The study states that only Louisiana, for example, has a lower wine tax than California.

For the complete study, including a community-by-community ranking of alcohol outlet density and related harms, click here.

Posted 4/21/11

New ER offers Rx for better care

For somebody who’s spent more than 20 years on the frontlines of life-and-death medicine, Johnnie Holmes was looking a lot like a kid in a candy store.

Holmes, a supervising charge nurse in the emergency room of Olive View-UCLA Medical Center, was breezing through the halls and treatment rooms of her new workplace this week and searching for adjectives to describe it all.

“Amazing,” “exciting” and “incredible” were all getting a workout.

After working in extremely cramped quarters to care for patients suffering from everything from gunshot wounds to gallstones, Holmes and her crew are about to start nursin’ large.

As in 31,000 square feet large—more than double the size of Olive View’s old emergency room.            `

The new ER, unveiled at a ribbon-cutting ceremony on Monday, will begin serving patients on March 6.

Its 51 treatment areas include two “trauma/procedure rooms” for the sickest patients, seven rooms for cardiac patients and specialized rooms for obstetric-gynecological exams, eye problems and orthopedic needs.

The facility also features a separate isolation ward for patients with tuberculosis and other infectious diseases, as well as, potentially, victims of a bioterror attack.

In the new ER, tests such as CT scans, ultrasounds and basic lab work will all be done onsite, so patients won’t have to be transported across the hospital for such workups.

The ER’s gleaming new equipment includes a device called VeinViewer Vision, which uses light and digital imaging to allow nurses to, in effect, look through a patient’s skin to find a vein to insert an IV or to draw blood.

“This is an amazing machine,” Holmes said as she demonstrated the VeinViewer for visitors.

But it will take more than new technology to confront some of the ER’s biggest challenges. The ER’s patient load has grown by 15% over the past two recession-plagued years, from 40,000 patients to 46,000. That mirrors a trend seen in emergency rooms across the county recently, with high unemployment and people losing their health insurance.

A related issue is that Olive View’s ER, like other emergency rooms, has long waiting times–a problem the hospital has been working to address, with some success, even before the move to the new ER.

In the past 12 months, median wait times in Olive View’s emergency area dropped from just under three hours to just under two hours, despite the increased patient load, thanks to the addition of a physician to perform rapid medical screening exams. The overall length of stay for patients dropped from eight hours to seven. (Similar efforts to make sure the sickest patients are treated first are underway at other county facilities as well.)

In hopes of continued improvement, Olive View officials are planning to add another nurse practitioner and to increase the physician staffing in the ER in the next four months, and have also hired a consultant to look at patient flow and staffing issues in the new space. They expect that greater efficiencies will come from having onsite labs and radiology, as well as a chest pain observation area and more versatile exam rooms and monitoring equipment.

Olive View is only public hospital serving the San Fernando, Santa Clarita and Antelope valleys, and is a key part of the county’s overall emergency services network. The new ER should allow Olive View to serve from 8,000 to 10,000 more emergency patients each year. The $53 million project, which started in 2002, finished nearly $1 million under budget and nine months early.

That’s good news for patients, who in addition to the long waits have gone without privacy and even beds, being treated in chairs or crammed into hallways on gurneys.

“We have the most incredible patients,” Holmes said. The new ER “is going to be less stressful for us and hopefully a lot less stressful for them.”

“You find yourself apologizing all the time,” she said. “All of the nurses go home with bruises on their thighs because they’re always running into gurneys. It will be amazing to have all that space.”

Holmes, 61, who worked for the folk rock duo Seals & Crofts (“Summer Breeze”) before becoming a nurse, now acts as a kind of air traffic controller in the ER, making sure the most urgent cases are seen first. In preparation for the new ER, she staged a scavenger hunt (with See’s truffles as prizes) to help nurses learn their way around the vastly larger space.

“It’s like a dream come true for all of us,” she said, even though she expects some “separation anxiety” among nurses who’ll be shifting from a single nursing station in the old ER to seven in the new space.

She said that–with the notable exception of the waiting times–public hospital emergency rooms provide care that equals or exceeds that offered in many private facilities.

“It always amazes me that people have a tendency to put down public hospitals. I’m here to tell you that, after being in private emergency rooms with my family members…they give the most amazing care here.”

The new emergency room is “first class,” said Supervisor Zev Yaroslavsky, who represented the Board of Supervisors at the inaugural event along with Supervisor Michael D. Antonovich. “The only thing missing right now is patients.”

Before the ribbon was cut, Dr. David Talan, chief of the hospital’s emergency medicine department, gave a shout-out to those patients. “Thank you for your trust. It’s an honor to help you…Above all else, the new Olive View emergency room is for our community and all of the people we are dedicated to serving.”

Talan also saluted his emergency department staff. “They’re here after everyone else goes home,” he said. “They have been doing their best under some very challenging circumstances.”

Posted 2/16/11

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