At the California Health Care Foundation (CHCF), 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 they have 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 factors like the color of their skin, their ethnic background, where they live, or the language they speak. Like the nation as a whole, California has long maintained policies, practices, and norms that are biased against people of color. 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, respectful, comprehensive, and coordinated
- The health care team represents the diversity of California and is trained and supported to deliver culturally and linguistically appropriate care without bias
Our Strategy for Advancing Health Equity
CHCF works on many different fronts to make California’s health care system more just. Specifically, there are five ways we are working to drive change across California’s health care system.
- Using data to monitor both inequity and improvement
- Driving improvement through state policy
- Dismantling racism in the health care delivery system
- Ensuring that the health workforce reflects California’s diversity
- Investing in community leaders and organizations
To support the strategies above, CHCF has specific initiatives to improve health equity among Black and Latino/x Californians.
Some examples of our work:
1. Using data to monitor both inequity and improvement
- Listening to Black Californians. CHCF commissioned a major study on Black Californians’ experiences of racism and health care.
- Measuring Equity. CHCF has partnered with the National Committee for Quality Assurance to develop a standard framework for health equity measurement for state Medicaid agencies to use.
2. Driving improvement through state policy
- Removing Coverage Barriers. CHCF has supported research, advocacy, and outreach efforts aimed at removing all remaining barriers to Medi-Cal based on immigration status.
- Medi-Cal Procurement. CHCF supported research and advocacy to strengthen procurement of Medi-Cal managed care, with a goal of improving quality of care and eliminating inequities by race and ethnicity.
3. Dismantling racism in the health care delivery system
- Implicit-Bias Training. CHCF helped develop an evidence-based online course to teach maternity care providers to identify and address bias. The training includes identifying unconscious biases and misinformation, power dynamics, impact of historical oppression of minority communities, and local perspectives on provider–community relations.
- Anti-Racism Tools. Through the California Improvement Network, CHCF is helping health care delivery organizations understand anti-racism as a legitimate health intervention, develop communication tools for confronting racism denial, and use tools to combat racism.
4. Ensuring that the health workforce reflects California’s diversity
- Community-Based Workforce. CHCF has been developing tools and providing technical assistance to integrate community health workers and promotores in the delivery and coordination of care in Medi-Cal.
- Pipeline Programs. CHCF has also partnered with other health funders to support the California Medicine Scholars Program, which taps into the diversity of the California Community Colleges to support and increase the numbers of underrepresented minority physicians.
5. Investing in community leaders and organizations
- Entrepreneurs of Color. The CHCF Innovation Fund has provided investment dollars and technical assistance to bring more health tech entrepreneurs with valuable lived-experience into the Medi-Cal space.
- Community Resilience. CHCF has been providing support to statewide and regional organizations — like the Latino Community Foundation and Black Equity Collective — for community resilience, disaster preparedness, and disaster recovery. The emphasis of this initiative is building under-resourced communities’ ability to respond to and recover from emergencies by providing support before a disaster occurs.