Why This Work Matters
According to the 2020 California Health Insurance Survey, 64% of Black Californians have private health insurance and 24% are enrolled in Medi-Cal. Most of CHCF’s work is focused on improving care for Medi-Cal enrollees, but Black Californians face disparities in care and outcomes regardless of the type of health insurance they have.
Generalized approaches to improve health care will neither be robust nor swift enough to control and eliminate disparities, which is why CHCF is investing to end Black health inequities across public and private systems.
CHCF is committed to listening to and centering the voices of Black Californians in this work. We are partnering with Black-led organizations to understand the health care experiences of Black Californians; build data transparency and accountability around equitable care; promote the participation, advancement, and retention of Black people in the health care workforce; and improve birth equity in California’s health care system.
A summary of CHCF’s portfolio of projects to improve health care systems for Black Californians can be found below.
Understanding the Health Care Experiences of Black Californians
- EVITARUS, a Black-owned public opinion research and public policy consulting firm in Los Angeles, conducted qualitative and quantitative research among a diverse sample of Black Californians to understand their experiences of racism and its impact on their health care. This project identified policy actions and practice changes at the clinical, administrative, and training levels that policymakers and health system leaders can take to eliminate the impact of racism on Black Californians’ experiences in health care and to improve their health outcomes. A Black Health Equity Advisory Group composed of academics, policymakers, providers, and community advocates guided our development of this work. Read the final report. (October 2022)
- The Conversation / La Conversación, is a public information campaign to provide Black and Latinx communities with credible information about the COVID-19 vaccines. Co-created by KFF and Rhea Boyd, MD, MPH, and supported by a range of partners, the initial video featured Bay Area comedian W. Kamau Bell in an open, honest conversation with Black health care workers. As vaccine availability and guidance has evolved, subsequent videos have featured Latinx health care workers answering common questions in English and Spanish, pediatricians providing information about the vaccine for children, and maternity care workers providing information about the vaccine and pregnancy. (Ongoing)
Building Transparency and Accountability
- The National Committee for Quality Assurance (NCQA) is developing racial equity quality measures that state Medicaid programs (and potentially other purchasers) can integrate into accountability programs. Measurement can help illuminate how well health systems are serving Medicaid enrollees by race, provide data transparency, and ultimately help drive improvement. The first report in this project describes the current state of use and application of health quality measures among state Medicaid programs. NCQA also developed a health equity measurement framework that state Medicaid programs can use to measure accountability in health plan managed care contracting. (In process)
Cultivating a Diverse Health Workforce
- Thalamus, a cloud-based Software-as-a-Service company and creator of the premier platform for hospital residency application and interview management, is conducting research to measure growth and attrition at key stages of the transition from undergraduate medical education to residency training for newly minted physicians in California. The CHCF-funded analysis will focus on Black and Latino/x physicians with an eye toward increasing recruitment and retention of physicians who are underrepresented in medicine in California. Additionally, based on its observations of inequities in residency matching, Thalamus has established a 501(c)(3) organization to award scholarships to cover the costs of competing for residency placement. CHCF is proud to support that effort as well. (In process)
- The RAND Corporation conducted research to examine whether the race, ethnicity, or gender of health care team members influences the likelihood of reporting patient safety events, particularly when the events involve patients of color. This study helps provider organizations, health plans, regulators, and purchasers understand the role of racism in patient safety, including provider role and system characteristics, better positioning them to intervene. (August 2022)
- The Urban Institute conducted a comprehensive review of historical and current programs designed to encourage people of color, especially Black people, to enter the health professions, persist in professional training, and remain and advance in the health professions. This research built on the work of the California Future Health Workforce Commission and recommends investments that could advance patient-provider race concordance in California. Watch a recording of Urban Institute’s webinar summarizing the findings of the research. The Urban Institute team included Kimá Joy Taylor, MD; LesLeigh D. Ford, PhD; Eva H. Allen, MPP; and Faith Mitchell, PhD. (June 2022)
- CHCF contributed to a scholarship and debt relief fund at the Charles R. Drew University of Medicine and Science, a Historically Black Graduate Institution in South Central Los Angeles that is designated as a minority-serving institution by the US Office for Civil Rights. The scholarships will be based on documented need and continued good academic performance and will help ease the impact of financial burden on medical students of color. (David Carlisle, MD, PhD, president and CEO of Charles R. Drew University, serves on the CHCF board of directors. He was not involved in CHCF’s decision to fund the scholarships.) (2021)
For more information, please contact Katherine Haynes.