Black Californians are pursuing good health and health care and want the health system to do its part – that is what the California Health Care Foundation (CHCF)’s recently completed study that listened to Black Californians’ experiences with racism and health care discovered. The resulting report, Listening to Black Californians: How the Health Care System Undermines Their Pursuit of Good Health, details recommendations on what decisionmakers within the health care system can do to hold it accountable for equitable care.

The Listening to Black Californians study included a survey of 3,325 Black Californian adults, in-depth interviews with 100 Black Californians, and 18 statewide focus groups – it is one of the largest studies focused on the health care experiences of Black Californians to date. Conducted by Black-owned public opinion research firm EVITARUS, the study’s goal was to identify solutions for the persistent health inequities Black Californians experience.

Key findings include:

• Nearly one in three Black Californians has been treated unfairly by a health care provider because of their race or ethnicity.
• Black Californians are highly intentional in their pursuit of physical and mental health: most Black Californians report putting a great deal or quite a bit of effort into getting appropriate screenings or preventive care (77%) and focusing on their mental health (79%).
• Two-thirds (66%) of Black Californians report researching a health condition or concern before meeting with a health care provider, and over one-third (35%) say they have tailored their speech and/or behavior to make a provider feel at ease.
• Black Californians who identify as women, LGBTQIA+, or who have a physical disability or mental illness are more likely to report experiencing racism and inadequate pain treatment.

“What we found in this study is of no surprise to any Black person who has navigated our health care system,” said Katherine Haynes, senior program officer for CHCF’s People-Centered Care team. “The study demonstrates exactly how much Black Californians are doing in pursuit of good health and the clear vision they have for addressing racism in health care and health systems. However, we need those who hold power within these systems to be partners in this vision.”

Participants in the study made clear recommendations for how to improve health care for Black Californians and address discrimination, including increasing Black representation in health care, expanding education on navigating the system, establishing accountability for equitable care, and developing more holistic approaches to health care.

The common thread throughout the report is that the solutions presented are Black- and community-led, but require buy-in, partnership, and action from the decisionmakers inside and outside of the health care system who can address the root causes.

“Helping patients navigate the health care system is a short-term solution,” explained Venise C. Curry, MD, consultant and western director for the Medical Consortium on Climate and Health’s Climate Health and Equity Fellowship. “You can’t just have people advocating for themselves at an individual level, we need a better care system, and for that there has to be accountability. We need to address the root cause to improve quality care.”

While the average Californians lives to be 81, the average Black Californian only lives to age 75. Black Californians have health insurance, get preventive screenings, prepare for visits to the doctor, and monitor their physical health, but the report concludes this is not enough—the health care system must meet Black Californians halfway. Health systems, medical training programs, and policymakers are encouraged to read the full CHCF report and learn more about how they can help be a catalyst for change at chcf.org/LBCA.

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About the California Health Care Foundation