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Structural inequities in the health care system make it difficult or impossible for many Black Californians to get compassionate and high-quality health care. To help address these challenges, the California Health Care Foundation launched the Pulse of Change initiative in 2024. Grants were made to eight community-based organizations that understand how they can improve outcomes through deep knowledge of the people they serve.
Three of these grantees share parallel origin stories. Each was started by members of local communities stepping up to meet the needs of their people. Baywell Health, Marin City Health and Wellness Center, and San Ysidro Health are continuing a time-honored tradition of prioritizing people who might otherwise be left behind. All are federally qualified health centers that are leveraging their Pulse of Change funding to tackle persistent challenges to the Black community. Here are profiles of these three organizations and descriptions of their projects:
Responding to Health Care Discrimination
Baywell Health in Oakland is using its grant to provide culturally concordant patient navigation services and social interventions to 100 Black residents with chronic conditions. Baywell’s Pulse of Change project provides home and community visits, clinic appointments, and post-clinic follow-ups to these participants to improve prevention and management of uncontrolled diabetes and high blood pressure, and to increase cancer screening rates and vaccination uptake.
In 1966, four Black mothers created the West Oakland Health Center, now known as Baywell Health. “The goal was to be a community-based operation that functioned in contrast to private and public health facilities,” said Baywell CEO Robert Phillips. “They created West Oakland Health because the community was especially at risk for medical discrimination stemming from such problems as disrespectful or incompetent treatment and unethical experimentation.”
To mitigate the Black community’s mistrust, the center established a care model incorporating community members as part of patient care teams. “It’s an experiment in a different kind of health care culture,” Phillips said. “We demystify medical authority by making lay folks vital to our operation. Experience as expertise is just as important and valid here as medical expertise.”
Baywell’s staff of 200 serves more than 1,000 patients at two Oakland locations. They recognized that culturally concordant navigation provided by people who understand the culture, neighborhood rhythms, and clinical workflows that resonate with Black patients could link home and community touchpoints to evidence-based clinical care and follow-up.
Baywell’s Pulse of Change project enhanced culturally relevant patient navigation and social interventions provided by the health center. They used project funding for cultural concordance training for providers, transportation assistance and other practical supports, an evaluation of health care outcomes, and to underwrite patient surveys and focus groups.
Serving People the System Overlooked
San Ysidro Health, one of the largest health centers in San Diego County, is piloting a program to increase colorectal cancer screenings among Black patients ages 45 to 75. The effort uses a care coordination team to identify screening barriers faced by Black patients, gather input from them on those barriers, and design and test process changes. Patients with a positive screen are quickly linked to a specialist for follow-up care and treatment.
In 1969, there was just one part-time doctor serving the mostly Mexican-American population in San Ysidro, a community in San Diego near the U.S. border with Mexico. A group of seven women got together to find ways to avoid taking their entire families on daylong journeys on multiple buses just to access reliable medical care far from home. Led by Carmen Martinez, El Club de Madres brought to their community quality health care, job opportunities, and inspiration for young people to pursue medical careers.
Faced with language barriers and a system they didn’t fully understand, they enlisted Ruth Covell, MD, of the University of California San Diego School of Medicine and opened San Ysidro Health in a two-bedroom house. With the help of three volunteers, two physicians provided care to a total of 40 patients each of two days a week. “When I look back, I believe what we did was revolutionary,” Covell told an interviewer years ago.
Since then, San Ysidro Health has grown into a regional health system of 50 sites providing care to a highly diverse community. San Ysidro Health delivers medical, dental, and behavioral health services to over 160,000 patients annually. This includes the Care View Health Center, which serves the largest Black population in San Diego County.
Pulse of Change funding enabled Care View to deepen its collaboration with the San Ysidro care quality department to refine measurement efforts; replace manual tracking with electronic health records; create educational social media materials; and improve colorectal cancer screening rates by 25% in one year. According to preliminary data, this work led to the highest level of colorectal cancer screening in Care View history, increasing from 28% in 2024 to 57% in 2025. This was the top performance among the network’s 19 primary care sites.
Culturally Concordant Care for Black Residents
Marin City Health and Wellness Center is piloting a program to improve hypertension control for Black patients through enhanced care and social interventions. The program screens patients for high blood pressure and social needs, provides care management support, and engages patients’ families and friends in lifestyle change activities.
The community of Marin City was developed in 1942 just north of the scenic waterfront city of Sausalito as government housing for shipyard workers. Thousands of these workers were Black Americans fleeing the Jim Crow South. After World War II, the community became Marin County’s largest public housing project. In the 1950s, local residents enjoyed a thriving community featuring Black-owned businesses and public safety. Over time, inequities and segregation in education and housing intensified. By 2019, nearly eight decades after the community became the nation’s first integrated housing project, California issued its first school desegregation order in 50 years to Marin City in the face of deepening inequities.
Marin City remains the only place in Marin County with a double-digit percentage of Black residents.
In 2006, as Black residents continued to navigate disproportionately high levels of chronic conditions and barriers to quality care, doctors and local activists opened Marin City Health and Wellness Center. The goal was to be a hub of health equity and culturally responsive care for Black residents.
The center’s Pulse of Change project focuses on uncontrolled hypertension, a persistent and ongoing health issue that disproportionately affects Black patients. The center recognized that clinical care alone has not closed this gap, and it focused on culturally tailored education, equitable outreach, and incentives that reduce barriers to engagement and care.
Pulse of Change funds allowed the center to strengthen patient trust and improve access by combining free blood pressure screenings and self-monitoring tools for home use with individualized education, nutrition counseling, and social supports.
“The funding allowed us to bring in nutrition‑trained staff who provide culturally relevant, realistic education based on foods and habits that reflect our members’ daily lives,” said Jowan Boykins, the center’s quality improvement coordinator. “It also allowed us to purchase home blood pressure devices so members can manage their hypertension without needing constant clinic visits — a game‑changer for people with mobility challenges or limited access.”
Participants have expressed appreciation for these offerings, which include healthy grocery bags that encourage better eating habits and blood pressure devices that keep them focused on their chronic conditions. The experiences of participants reinforce patient agency and commitment to long-term care, Boykins said.
This is the second of three planned articles reporting on how Pulse of Change grantee organizations are working to help providers deliver culturally responsive health care to Black patients.
