At the California Health Care Foundation, we know that health care is a basic human necessity. All Californians should have the opportunity to achieve their fullest potential for health. This includes not only access to health care, but also other social factors like housing, food, and jobs that contribute to a person’s well-being.
Why This Work Matters
One in three Californians lives in or near poverty. Because Californians with low incomes face the biggest health burden and the greatest barriers to care, our priority is to make sure this group has access to high-quality care.
Income, however, is not the only factor that limits access to health care in California. Too many Californians face structural barriers to care based on the color of their skin, their ethnic background, or the language they speak. Like the nation as a whole, California has long maintained policies, practices, and norms that give preferential treatment at the expense of Black, Latino/x, Asian, Pacific Islander, and Indigenous people. Health care is just one of many systems — including housing, education, and employment — that perpetuate this structural racism and engender stark inequities in care and outcomes.
As the most culturally diverse state in the country, California can’t succeed without removing these barriers. We all have a stake in eliminating racism from California’s health care system. For these reasons, health equity is the primary lens through which we focus our work at CHCF.
Our Vision for Health Equity
A just and equitable health care system is one that is designed to redress, and not perpetuate, the inequities that too many of our fellow Californians face.
We envision a health care system where . . .
- All Californians get the care they need, when they need it
- Care is responsive, comprehensive, and coordinated
- The health care team represents the diversity of California and is trained and supported in delivering culturally and linguistically appropriate care
Examples of Our Health Equity Work
CHCF works on many different fronts to make California’s health care system more just. Much of our work focuses on documenting inequities in the health care system, holding system leaders accountable, and transforming care and the health workforce to uphold the dignity that each Californian deserves.
Here are some recent examples:
- Advancing Black birth equity. The California Dignity in Pregnancy and Childbirth Act (SB 464) requires hospitals to train their maternity care staff about implicit bias. CHCF partnered with a team at Diversity Science to develop a free e-learning course to assist hospitals in meeting the stipulations of SB 464.
- Listening to Black Californians. CHCF commissioned a three-phase study to understand Black Californians’ experiences of racism and the powerful influence it yields over their health care and outcomes. In Phase I of the study, 100 Black Californians were interviewed about their views on health, their experiences with racism and health care, and their perspectives on quality health care.
- Eliminating barriers to coverage. Ensuring that all Californians, including undocumented immigrants, have access to health insurance coverage and that all Californians eligible for Medi-Cal coverage are enrolled.
- Improving quality and ensuring equity in Medi-Cal. CHCF is paying close attention to efforts to align financial incentives to improve quality in Medi-Cal managed care and to integrate behavioral and physical health care delivery. See our commentary, analysis, and resources on CalAIM (California Advancing and Innovating Medi-Cal), a multiyear process led by the California Department of Health Care Services.
- Building a community-based health workforce. Fully integrating community health workers and promotores into Medi-Cal to bridge cultural and linguistic divides in health care.
- Cultivating entrepreneurs of color. We believe that technology solutions should be developed by people in the communities they serve because they have a better understanding of the challenges in their communities. The CHCF Innovation Fund is committed to cultivating innovative solutions and to promoting equity through investments in companies that reflect the population served by Medi-Cal.
- Promoting equitable COVID-19 vaccine outreach. A lack of tailored, accessible information about the COVID-19 vaccines has been a major barrier to Black and Latino/Latinx communities getting vaccinated. CHCF supported KFF to develop and promote The Conversation / La Conversación, a public information campaign to provide Black and Latino/x communities with credible information about the COVID-19 vaccines from Black and Latinx health care workers. The campaign includes videos in English and Spanish answering FAQs about vaccine safety and pregnancy and fertility.