Monday, May 7, 2007

Weekly Calendar


Latino Urban Forum

Meetings, activities and events that promote our mission as of

May 7, 2007

1. Homelessness: What Planners Can Do

2. Bike to Work Week

3. Sustainable Transportation Forum

4. LANI's Fifth Annual Community Forum

5. LA River Clean Up

6. LA River Bike Ride

7. LA Times Article on Diabetes

The Built Environment and Health Conference Comments!

The Built Environment and Health conference was a great success, in bringing together urban planners and health officials for a long overdue reunion. The urban planning profession is an outgrowth of the 19th century city reform movement to solve the urban ills experienced by the phenomenal growth of cities like New York , London and Paris . The creation of sanitation systems, zoning and Central Park as part of the early parks movement were considered health remedies for urban inhabitants. Somewhere along the line planning and health parted ways.

Today our urban form and health problems are much more expensive, complicated and critical to solve than they were in the 19th century. We are faced with the obesity epidemic, failing health system and global warming partly due to bad urban form. Unlike the urban ills of the 19th century which were solved by building infrastructure and creating zoning codes, today's problem focus on changing people behavior patterns. Planners and doctors must realign themselves in order to build sustainable cities and address our health problems.

Most urban planners love cities and do not need to be convinced that our zoning has to change in order to build density, good public transit, mixed use, and walkable communities. However it's the LA residents that need the smart growth convincing. These smug privileged single-family homeowners maintain a 1960's vision of LA consisting of single story structures, plenty of free parking and non congested freeways. These people live in R-1 neighborhoods (R-1) and believe this is the bible for all city zoning. They want little to change in their neighborhoods or city and want to maintain three undeliverable things: single story structures, plenty of free parking and reduced auto traffic.

These residents, which attend the community meetings, believe that every community plan and new development must solve these problems. They are a vocal minority, who believe that density, public open space, and transit – things public health and planner's want - are neighborhood liabilities rather than assets. We build rail projects and residents what more parking and wider streets. Residents want affordable housing but not density. Sadly this vocal minority has political power and ear of the politicians who need votes and not healthy communities.

As planners we are seen as incompetent by the R-1 brigade because we can't reduce density or traffic. Our well-intentioned plans and development proposals become comprised to accommodate for parking and road widening. Than, from the politician's point of view, planners are not satisfying their constituents and they simply over ridden our recommendations to become R-1 heroes.

Fortunately there is a new generation of Angelinos; namely immigrants and young people who realize they will never afford a single-family home. They see global warming, density and public transit as a fact of life in 21st century LA. However this group has no political juice.

Urban planners and health officials most work together to solve the urban crises that is creating heath and environmental problems. However given the current planning process and political landscape it will be difficult to make progressive changes in the built environment. And convincing our family and friends to change their behavior patterns and tell them that their 5,000 square foot house or hillside house is excessive, or that driving your child to school is not good for the health of your child and environment.

Like European royalty before them, the R-1 brigade will share the same fate of obsolesce from external forces such has the energy, environment and social changes. The price of gas, health insurance, harm to the environment will lead to lifestyle and political changes.

Change is enviable so how as we as urban planners and health workers create a smooth transition to build healthy communities?

Planners need the power of the white coat to change the behavior patterns of people. What if the health profession set street standards based on noise, pollution and overall safety concerns as well as land use policies?? What if we had a massive marketing campaign that promoted active living? What if we taxed junk food? As planners if we tell people take a hike we lose our jobs. If a doctor tells people take a hike they just might listen.

James Rojas

Visit www.latinourbanforu m.org or Myspace.com/ LatinoUrbanForum

http://latinourbanf orum.blogspot. com/

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Tuesday, May 8, 2007 from 11:30 to 12:30 p.m

Homelessness: What Planners Can Do. Dr. Wolch will speak on this issue.

Location: City Hall

200 North Spring Street

City Hall Planning Dept. Training Room

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May 14-18, 2007

Bike to Work Week!

Thursday, May 17, 2007, local cyclists will converge on Hollywood and Western in a demonstration of cycling solidarity and at 9 am they will ride down to City Hall.

The Hollywood and Western Pit Stop is hosted by illuminateLA and will offer refreshments, swag and encouragement to cyclists from 7 am to 10 am.

There will also be entertainment and Hollywood Pro Bike Shop will be offering bicycle tune-ups, all of which will serve to prep the crowd for a ride downtown to "Bang the Drum" at City Hall. Bike to Work Day is intended to encourage the cycling community to keep on riding, to educate motorists about cyclists rights to the road and to urge our leaders to support the cycling community with appropriate enforcement. Call Stephen at 323.962.6540 or email him

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Wednesday, May 16, 2007 @ Noon to 1:00 p.m.

Sustainable Transportation Forum: Tim Lindholm to speak on green transportation buildings.


Location: Metro Head Quarters

Board Overflow Room on the 3rd floor.
(Cafeteria is located across the hall)

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Thursday, May 17, 2007 From 8:00 am to 2:30 pm

LANI's Fifth Annual Community Forum

Workshop topics include: Accounting for Nonprofits, Billboards, Farmer's Markets

Business Development, Community Murals, Disaster Preparedness at a Neighborhood Level Transportation Linkages Water Quality and Your Community

Register at www.lani.org or by calling (213) 627-1822 x20. The event is free and includes parking.

Location

USC Davidson Conference Center

3415 S. Figueroa Street

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Wednesday May 23, 2007 from noon - 1 pm

Cork Meeting: Tom Banner from Cork USA will review the production and use of one of the world's great sustainable materials, cork. Cork is a sustainably grown and harvested product and has found myriad uses in building construction today. Tom will review the process from harvest to installation, and will describe the many products that have been developed from cork and their sustainable characteristics.

Location: Brown Bag lunch
LACCD Board Room
770 Wilshire Blvd , at Flower
Please use public transit, DASH, Red Line, METRO all nearby.

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18th Annual Great Los Angeles River CleanUp, La Gran Limpieza,

Takes Place on FOUR Days
This year over 4,000 volunteers are expected to participate in the largest urban river cleanup in the country -- FoLAR's La Gran Limpieza, the Great Los Angeles River CleanUp. For the first time the CleanUp will take place on four different days:

Friday, April 27
River School Day & Press Conference
Over 800 students are expected
Sunday, April 29
Big Sunday CleanUp at Taylor Yard
Saturday, May 5, CleanUp in
Atwater Village Hosted by PAVA
Saturday, May 12 CleanUp at 13 sites throughout the region:

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Saturday, June 16, 2007 9:00 am to 1:00 pm.

Keep LA Beautiful and help clean the surrounding area around Fuller Lofts on Gloves, tools and lunch will be provided. Grab your old jeans, t-shirts & sneakers and give the neighborhood a makeover.

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Saturday June 10, 2007

LA River Bike Ride

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Saturday, June 23, 2007 from 10 am - 3 pm

STRATEGIC PLANNING WITH RON MILAM

At L.A. Eco-Village, 117 Bimini Pl , LA 90004

What's your community's mission? What's your vision? Values? What will you do to make your vision reality? Knowing the answers to these questions plays a key role in your nonprofit group's success, whether it be a shared house, cohousing group, ecovillage, or other type of co-op living or working situation.

Topics covered in this workshop include:

Welcome & Introductions, Expectations, Preparing to Plan, Decision making options, Vision, Mission , Activities and Values, SWOT Analysis, Identifying and Prioritizing Strategic Issues Defining Strategic Goals and Objectives & Establishing a Monitoring Schedule Plan Presentation Summary & Evaluations

Fee: $75 (sliding scale available)

Pre-registration required: 213/738-1254 or crsp@igc.org

Note: Bring a brown bag lunch or enjoy lunch on your own at a local inexpensive restaurant

READ MORE AT http://laecovillage .org/strategicpl anningmilam. html

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ART

May 18th - June 23rd, 2007

Reception: Friday May 18th 2007 7-10pm

LA Botanical ; A project by Joyce Campbell

LA Botanical is an ongoing project, massive and perhaps unachievable in its full potential scope, to document each plant that grows in Los Angeles for which there is a documented use - be it food, medicine, weapon, abortive, analgesic, fuel, stimulant, building material, deadly toxin or mind altering entheogen. The plants are documented as wet-plate Ambrotypes, an anachronistic photographic form ubiquitous the 1850's-1890s, the period during in which Los Angeles grew from a dusty town of 1400 inhabitants to a major metropolitan center.

The project is an attempt to reconcile Campbell 's own rural background with her life here in Los Angeles , one of the most sprawling and unsustainable metropolises on earth.

LA Botanical operates simultaneously as map, inventory, and survival guide to the city of Los Angeles . It has the potential to reveal who lives here, from where they originate, what they value, how they eat, worship, heal, harm, travel, clothe themselves, seek insight or achieve oblivion. It also serves as a tool or guide - enabling its audience to see Los Angeles , not as a desiccated industrial wasteland into which resources must flow, but as a field of abundant life that might be harvested to satisfy our needs.

Joyce Campbell is an interdisciplinary artist working in photography, sculpture, film and video installation. She is a visiting lecturer at Scripps College and Claremont Graduate University in Claremont , California .

Joyce¹s recent work utilizes anachronistic photographic techniques to examine the collision of natural and cultural systems.

In October of 2006, Joyce traveled to the Ross Sea region of Antarctica for two weeks sponsored by Creative New Zealand and Antarctica New Zealand.

While in Antarctica she shot large format negatives and Daguerreotypes, an archaic and exquisite form of photography that predates Antarctic exploration.

Location: Gallery 727

727 S. Spring Street #12

LA, CA. 90014

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May 19, 2007 from noon to 5:00 pm

Los Angeles Women Remembered and Honored. The Studio for Southern California History will host a Story Symposium for its current exhibit Los Angeles Women: A Record of Experience. This event is intended to be a broader conversation between scholars, experts, students, and the general public regarding the role of women in Southern California history. In honor of Mother's Day (the previous Sunday), those who bring their mom or daughter to the Story Symposium will receive a flower while supplies last. This event is free but reservations are recommended Contact Person: Sharon Sekhon. Telephone Number: 213 – 229 – 8890 Email Address: sharons@socalstudio .org

Location: National Center for the Preservation of Democracy

111 N. Central Avenue

Little Tokyo ..

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Articles:

Diabetics need much more than a shot

Managing the disease requires constant support and substantial investment, but would pay off in the end for thousands of people.

By Susan Brink, Times Staff Writer, May 7, 2007

TWENTY-EIGHT- YEAR-OLD Jack Perkins has lifestyle choices middle-class people take for granted. From his home in Valencia , it's walking distance to both a Whole Foods and a Vons supermarket.

He exercises daily — lifting weights in his condo's workout room or jogging through safe, quiet, meandering streets. "It's almost like it's designed for runners and walkers," he says.

Maria Sahagun's Huntington Park home has bars on the windows and doors, and the 61-year-old doesn't venture far on foot.

Her neighborhood has a hefty supply of mom-and-pop food markets where the variety of chips and sodas vastly exceeds that of fruits and vegetables.

Robberies in her neighborhood are 75% higher than the county average, so she walks on busy Pacific Boulevard only in daylight, and never alone.

Perkins, who has health insurance, and Sahagun, who does not, both have diabetes. He has Type 1, and since childhood his pancreas has not been able to make insulin; she has Type 2, and can no longer make enough insulin nor properly respond to it. For each, the disease means using insulin, medications, diet and exercise to do the work the pancreas cannot do.

Diabetes is afflicting more people, at younger and younger ages, sending doctors, insurers and public health officials into a tizzy as the epidemic threatens to overwhelm the healthcare delivery system. The annual cost of healthcare for an adult with diabetes is more than $13,000, and rates of Type 2 have risen sharply in the wake of the upsurge in obesity in this country.

A bold experiment is unfolding in Los Angeles County that may serve as a lesson for the nation as it battles the epidemic.

Experts know that the cost of care could be much lower if patients could take simple measures to control their disease and avoid complications: nerve damage, amputations, heart disease, blindness, even death. But surveys show that many, even those with adequate health insurance, do not get that care, which is costly and labor intensive, demanding daily attention from patients and timely responsiveness from doctors.

Poverty creates additional obstacles, such as finding fresh vegetables or a safe place to exercise. Study after study shows that low-income people have less access to healthcare and a greater risk of getting sick and dying prematurely.

But in an odd twist to the usual healthcare disparity story, more than 1,000 L.A. residents in low-income areas, most of them uninsured or on MediCal, are getting the gold standard of aggressive diabetes management — better, even, than many with insurance who live in ritzy ZIP codes.

The care is taking place at clinics in East L.A. and South L.A. , two communities with the highest rates of diabetes in the county, as well as three other outlying clinics. A team of L.A. doctors is participating in the experiment, training nurse practitioners, pharmacists, social workers and community educators to intervene in a way that doctors cannot do.

They're offering frequent patient checkups to monitor the disease, and teaching patients to track blood sugar, get out and take a walk, cut out the doughnuts, all the things they need to do to keep complications at bay.

They are reaching people with uncontrolled disease in some of the county's poorest pockets.

"The county patients [in the program] receive care that is as good, and probably better, as anywhere in the country," says Dr. Mayer B. Davidson, endocrinology professor at Charles Drew Medical Center and UCLA.

Davidson and others hope that if such a program is multiplied across L.A., and if similar programs are adopted across the country, the approach could slash the soaring cost of treating diabetes and save thousands of hearts, eyes, feet and lives — of the insured and comfortably well-off as well as the poor.

There are signs that it's working. Studies so far show that patients in the program have improved blood sugar and have had fewer emergency room visits and hospitalizations.

Local pioneers

The intensive program is a response from local academic and public health experts to the crisis ahead. One of those experts, Dr. Anne Peters, professor at USC's Keck School of Medicine and an endocrinologist who specializes in diabetes, works both sides of the disease's socioeconomic divide.

Peters has a Beverly Hills practice where she sees insured patients, including Perkins, and offers an intensive program not usually available to even those with good health coverage. She has cared for many of her private patients for years. "I know them so well," she says. "It's the old model of having a doctor who takes care of you your whole life."

But she also has a second job: supervising teams of workers on the same intensive model at five clinics including the Edward Roybal Health Center in East L.A., and the Hubert Humphrey Health Center in South L.A.

Sahagun, a patient at Roybal, is part of the experiment.

She has had diabetes since she was in her 20s, and for decades thought of it benignly as a "touch of sugar."

But over the years, she saw her weight go up to 250 pounds, was hospitalized several times, and had to stop driving because of neuropathy, a consequence of the disease that led to pain in her legs and numbness in her feet. "I'm afraid I'll step on the wrong pedal," she says.

Her parents both have diabetes. Her father recently died after a stroke, and her mother has lost a toe to gangrene. Last year, Sahagun was referred to the county program because her disease was uncontrolled. "It took me more than 20 years to take it seriously," she says.

And yet it is very serious. Uncontrolled, it results in a buildup of sugar in the blood and, over time, damage to the eyes, kidneys, nerves and heart. Three in five diabetic patients suffer from at least one significant complication, according to research presented in April.

Those numbers could worsen because diabetes is striking more people at younger ages. Type 2 diabetes used to be unheard of in children. Now, because of the rise in childhood obesity, more than 200,000 children and teens younger than 20 have the disease, according to the Centers for Disease Control and Prevention.

"It's like a tsunami coming," says Dr. Francine R. Kaufman, head of the division of endocrinology and metabolism at Childrens Hospital Los Angeles and professor of pediatrics at USC's Keck School of Medicine.

There are an estimated 20 million diabetics today, 18 million with Type 2, and the Centers for Disease Control and Prevention now projects that 1 in 3 children born in 2000 will develop diabetes in their lifetime. When Type 2 diabetes hits a middle-aged person, the consequences of uncontrolled disease show up 20 to 30 years later as heart attacks, strokes, blindness, kidney failure, amputations and death.

When the disease strikes younger adults and children, it's anybody's dismal guess what will happen. The number of children hospitalized, already suffering from complications from Type 2 diabetes, increased by 200% between 1997 and 2003, according to data presented Saturday at a pediatrics meeting.

"I have colleagues who tell me that they have actually lost patients in their 20s to heart attacks," says Dr. Larry Deeb, pediatric endocrinologist and president of the American Diabetes Assn.

Reducing complications is key to protecting patients and controlling costs. It's not rocket science: lose weight, watch your diet, exercise, monitor blood sugar, blood pressure and cholesterol, take your medications, have regular eye and foot exams.

But often, these simple things aren't done. When the federal Agency for Healthcare Research and Quality looked at national rates of recommended diabetes interventions between 2000 and 2002, they found that only about half of patients received the blood glucose test and foot and eye exams called for in treatment guidelines. Only 40% had their blood glucose levels under good control; half had cholesterol levels controlled; and 70% had their blood pressure controlled.

And, of course, Americans prove again and again that it's difficult to eat right, exercise, take medications on schedule and follow doctors' orders.

For diabetics, the consequences are gruesome.

Doctors needed

Even fully insured patients rarely get the hands-on medical attention it takes to properly control diabetes. All but about 5% of diabetics are seen by primary care doctors, who are rushed and have varying degrees of expertise in the disease.

Some insurers, such as Kaiser Permanente, have adopted an intensive team approach to diabetes management, but such programs are uncommon. "It's not happening much in the real world out there," Davidson says.

The reason, he says, is the convoluted bottom line of America 's fragmented health care system, which pays more to amputate a foot than to prevent amputations, or to treat heart attacks than to prevent them.

Peters' practice is an exception. She's a private practice doctor who spends as much time with her patients as they need. Her practice follows a team model, with a staff of nutritionists, educators, nurses and nurse practitioners to advise and prod patients via face-to-face discussions, phone calls and e-mails.

"I personally believe that anyone can take good care of their diabetes, no matter who they are or what their level of education," she says. "But they need a team, or at least a guide."

Perkins of Valencia is one of Peters' insured, Westside patients. He was diagnosed with Type 1 diabetes at the age of 13, and it took time to learn his body's unique reaction to food, exercise and doses of insulin.

As a child, he spent an initial week in the hospital, getting educated on the disease and learning to give himself shots. "I didn't want to be doing all that," he says. But he did, for the most part, except for a couple of rebellious years in college.

Now, as Peters' patient, he gets constant reminders of how he has to live. He has learned to count carbohydrates and anticipate the amount his blood sugar will rise with a meal.

He's learned what working out does to his body (he lifts weights three times a week, runs 10 miles a week, and plays basketball three times a week.) "If I lift weights on a Monday night, it's going to help my blood sugar the whole next day. I'll need less insulin," he says.

He's thinking like a pancreas.

So successful has Peters' method been, that six years ago, she launched a pilot program for the county, supervising a team of professionals trained to educate, monitor and, when necessary, nag. The program took off in four other county centers in 2005.

The treatment team members make phone calls, hold classes, help patients change their diets, prescriptions or medication doses. They will even visit patients' homes to keep treatment on track.

Community members who speak the same language and share the same culture and who have successfully controlled their diabetes are recruited to teach classes and help coordinate care for newcomers to diabetes management. The idea is to allow specialist physicians to become consultants to community-savvy teams who offer up a steady drumbeat of medical attention and lifestyle education.

"It makes more sense to reach out to people where they live 24/7, and not think that a visit every three months to a provider is where all the care happens," says Dr. Jeffrey Guterman, medical director of the L.A. County Department of Health Services.

Before being accepted, patients in the county program sign an agreement that they will keep appointments and follow medical instructions. If they fail to comply, they're out.

Because funding is limited, patients can stay with the program only 6 to 9 months, but the expectation is that they can learn to control their disease in that time, then go back to a primary care physician. Those county doctors are ready, having been trained in how to manage diabetes patients.

"They explain to you a lot of things," Sahagun says. "I've learned to eat more vegetables, chicken, fish. They teach you how to examine your feet, how your eyesight can change."

She's gone to education programs with others with diabetes. "We talk," she says. "Some people talk about how they can't handle it. I say that we have to eat what they tell us to eat. We can't eat all the stuff we're accustomed to. Chips. Sodas.

"I still eat Mexican food, but I don't fry tacos. My mother taught us to use lard when we cook. No more."

Early studies suggest that the program works. A report in the April 2006 American Journal of Managed Care looked at how a key blood sugar test, called A1c, was controlled in 367 patients in the L.A. County program the year before and the year after they entered the program.

The A1c guideline was met by only 28% of participants when they were under traditional medical care. After a year in the program, 60% of patients met the blood sugar level goal.

A second study published in February in the journal Diabetes Care found that diabetic patients in the program reduced their use of emergency rooms by half and cut down on hospitalizations. Total hospital charges dropped that year for the 331 patients studied to $24,630, from $129,176 the year before.

The program still treats only a fraction of underserved patients with diabetes. It is expected to expand after a recent state grant of $54 million was awarded to the county to treat chronic diseases.

For insured patients, the upfront costs of such care to practitioners are high, and America 's patchwork quilt of payment systems offer few incentives to do diabetes care right.

Peters, for one, does not break even from her intensive approach in private practice: In fact, she says, she loses about $250,000 a year caring for these patients and keeps her private practice going only through donations from grateful, wealthy diabetic patients to a foundation she has started.

The health insurance benefits that her Westside patients have cover visits — generally about every three months. They don't cover extra visits to change medications or search out the reason blood sugar has fallen out of control. They don't cover time spent analyzing complex blood glucose printouts, insulin pump data or teaching patients to adjust insulin and drug doses.

Nor do they cover time for long discussions, phone calls, e-mails or the nutritionist, educators and nurses she employs to advise and prod patients.

Most plans pay physicians a set rate per patient, regardless of how much care they provide. The incentive for doctors has been to treat people quickly.

Patients on track

On a recent afternoon, Perkins is having his quarterly exam with Peters. He's a conscientious patient, has the drill down, and usually only needs to check in every three months or so.

She's looking at his lab results, and smiling. " Normal kidneys, normal everything," she tells him. "I'm thrilled."

Perkins says it has gotten easier to keep his disease well controlled since he switched from shots to an insulin pump, a small device strapped to his leg with a thin, plastic catheter that delivers insulin in a steady, preprogrammed dose.

On the other side of town a few days later, at Roybal Health Center , Peters squats on the floor in front of Sahagun, looking over her most recent lab results. She studies the computer printout, and calculates adjustments, then coaches Sahagun on the meds she must take.

Sahagun leaves the center with prescriptions and instructions.

"You get used to it," she says.

As well as not cooking with lard anymore, she's already eating fewer sweets and trying to walk on her treadmill or in the neighborhood every other day.

It's a start. She'll be back for her next checkup in a month.
susan.brink@ latimes.com

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JOBS

Audubon Summer Day Camp & Internship Opportunities

This summer, the Audubon Center at Debs Park is offering "Audubon Summer Day Camp: An Arroyo Adventure" for kids ages 6-10 and a *paid* summer internship program for local college students. We hope you can help us spread the word about these programs!

In two separate sessions, July 23-27 and August 6-10, a total of 60 summer campers will develop a sense of understanding and appreciation for the natural world. We are conducting a special outreach effort in the communities surrounding Debs Park (90030, 90031, 90032, 90041, 90042, 90065) and offering financial aid to families in need. Our goal is to ensure that to we reach children who might otherwise go without outdoor enrichment activities this summer.

Our *paid* summer interns will work closely with our day camp program. We have space for four interns. Again, we are recruiting from the communities surrounding Debs Park . We are looking for energetic young people who are interested in nature and working with children. Interns will gain a deeper understanding of environmental education principles while working for a leading, national conservation organization.

Please help us with our outreach efforts by disseminating the summer day camp registration forms, in English and Spanish, and the internship announcement to organizations and individuals with constituents who would be interested in these programs.

All of these documents will be posted on our website shortly.

http://www.audubond ebspark.org/

Please contact me Elva Yañez @ 323-221-2255 ext 11

323-397-1554 cell www.audubondebspark .org

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Urban Eats:

Farmer Markets in the Hood!

Tianguis: South Central Farmers Market.

Support Community Sustainable Agriculture (C.S.A.)

Music, high quality produce,

www.southcentralfar mers.com

Date: First Sunday of every month (May 6th)

Time: 10:00 am. to 4:00 p.m.

Location: 41st and Alameda

" East Los Angeles Farmer's Market" every Saturday from 9AM TO 1PM

Features fruits and vegetables grown locally by local farmers. In addition, you'll find one of a kind creations offered by local artisans and meet representatives from local community organizations.

Location: First Street (between Rowan and Ditman).

Homegirl Café!

1818 East First Street

LA, CA. 90014

Mama's Hot Tamale Cafe

7th Street across from Macarthur Park

To post events, activities or meetings that promote planning, cultural or dialogue contact James Rojas at 213 892-0918 or email Latinourbanforum@ yahoo.com Please submit post in word.


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