Listening to Californians with Low Incomes
Between 2019 and 2021, CHCF funded a major research project to better understand the health care experiences, needs, and values of Californians with low incomes, including understanding changes during the COVID-19 pandemic. Learn what we learned by listening to Californians with low incomes.
Since 2014, Latinx people have constituted the largest ethnic group in the nation’s largest state. They now represent 39% of the California population, and in recent years Latinx residents have made significant advances in economic well-being as measured by such metrics as reduced poverty rates and growth in business ownership. The number of Latinx people elected to school boards, local offices, and the state legislature also has increased significantly.
Despite this impressive social and economic progress, Latinx residents have lagged other Californians in achieving important goals like home ownership and income growth. We can now add to that list the disproportionate harm visited on that community by the COVID-19 pandemic. While the pandemic has upended the lives, finances, and health of millions of Californians from all backgrounds, it has hit Latinx people the hardest. State data show that 55% of COVID-19 cases and 46% of deaths have occurred in the Latinx community — far in excess of its share of the state population.
COVID-19’s impact on Latinx Californians came into sharper focus last summer, when CHCF teamed up with NORC at the University of Chicago, a national research organization, to conduct a statewide survey. The researchers interviewed 2,249 California residents age 18 to 64 who had received health care since March 2019. The survey panel included an oversampling of residents with low incomes. The researchers asked respondents about their health care concerns, experiences, and access to care before and during the COVID-19 pandemic. Interviewees also answered questions about their experiences with racial discrimination and the impact of the pandemic on employment and insurance coverage.
Essential at a Dangerous Time
The COVID-19 pandemic has focused attention on essential workers who have continued to work, mostly outside the home, in critical industries such as health care, agriculture, and retail food. These workers have faced increased risk of exposure to the virus, as their work brings them into regular contact with many other people.
In California, 47% of Latinx survey respondents reported that they worked in a job that was considered essential during the pandemic. Estephany G., 27, of San Francisco, a single mom to a nine-year-old, is one of these essential workers. At the beginning of the pandemic, Estephany lost two jobs — as a teacher’s aide and an event planner. She and her son, who has asthma, live with her parents, who lost their jobs too.
For months, they relied on social service organizations that provided resources like food. Recently, Estephany found employment behind a deli counter in San Francisco. That is good news financially, but it means she is now an essential worker with unavoidable exposure to customers who might spread the virus.
As a single mother, Estephany knows she must do everything in her power to stay healthy and provide for her son. Estephany has already survived a COVID-19 infection, during which she was able to isolate in a hotel room for two weeks to protect her loved ones. The last thing Estephany wants to do now is to bring the virus into her home, so she does everything she can think of to avoid infecting her family. When she comes home from work, she goes directly into the shower to clean up before saying hello to anyone. She is scared, but she has few options.
COVID-Related Stresses Pile Up
Estephany is one of the 94% of Latinx survey respondents who reported experiencing at least one stress related to COVID-19. In the NORC survey, 56% of California Latinx respondents were worried about the health or well-being of a loved one, and 41% reported being stressed about their children being out of school or being unable to obtain childcare.
Christina Gutierrez, 42, of Modesto, is concerned about her 16-year-old daughter, who takes high school classes online.
“She is not handling it well,” said Gutierrez. “She does not socialize with friends. She is not doing the things that a regular 16-year-old should be doing. She is home all of the time, and it is getting hard for her.”
Despite having a supportive husband and a helpful rent reduction during the pandemic, plenty of other things are causing her family stress, including uncertainty about their jobs and unemployment benefits.
Because of the pandemic, Latinx families have lost substantial amounts of income because jobs have vanished. The families of Gutierrez and Estephany G. both experienced layoffs or reduced hours. According to the CHCF survey, 52% of Latinx respondents reported a change in their income due to the pandemic — a greater share than experienced by Asian (42%), White (39%), or Black (28%) respondents. Among Latinx respondents with a change in income, 51% reported a decrease in income or hours worked, 16% were laid off, and 11% were furloughed.
Ten months into the pandemic, Gutierrez hasn’t been able to find a new source of income.
“Finding a job is the number one concern right now,” said Gutierrez. “If I don’t, I won’t be able to provide for my family, and this worries me so much.”
Gutierrez says it’s her responsibility to stand strong for her family. She remains hopeful that the pandemic situation eventually will be remembered as a nightmare that her family survived.
Like Gutierrez, most Latinx survey respondents are dealing with several compounding stresses, which are taking a toll on their mental health.
COVID-19 and Mental Health
Nowadays, Estephany says she often feels blue. She is not alone. Since the start of the pandemic, 32% of Latinx survey respondents reported that their mental health got “worse” or “a lot worse.”
Nearly two-thirds of Latinx respondents (63%) who wanted to see a health care provider since the start of the pandemic desired care for a mental health problem such as stress, depression, and emotional problems. Estephany is among them, but she hasn’t been able to find a regular therapist to help her with stress, depression, and other emotional challenges. “It is always harder to find a long-term health professional through Medi-Cal,” she said.
Despite all the hardship she has suffered during the pandemic, she considers herself one of the lucky ones, because her family has survived the pandemic without losing anyone.
“We just hope that this pandemic is gone soon,” Estephany said.
Authors & Contributors
Agustín Durán
Agustín Durán is a metro editor of La Opinion newspaper and previously was a metro editor for Hoy Los Angeles. He has worked as a journalist since 1996 in multiple media outlets, including Univision and weekly newspapers in Los Angeles. He received his master’s degree in mass communication from Cal State University, Northridge.
