Speaking Up: Findings from 2019 Focus Groups and Interviews with Californians with Low Incomes

Jen Joynt, Independent Health Care Consultant
Rebecca Catterson, NORC
Lucy Bailey, NORC


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.

In 2019 CHCF commissioned NORC at the University of Chicago to embark on an extensive research project to better understand the health care needs, wants, and values of California adults (18–64) with low incomes. In April and May of 2019 NORC began by holding multiple focus groups and in-depth interviews with Californians with low incomes who represented various racial/ethnic and language groups as well as regions. All participants were screened for having at least one health care encounter in the previous six months.

Four major themes emerged. They are listed below along with common needs voiced by participants.

  • Inadequate Access to Care
    • Don’t make it so hard to make an appointment.
    • Don’t make me wait so long to see a specialist.
    • Don’t make me wait for substance use treatment.
    • Give me access to providers like me.
    • Make it easier to access care.
    • Make it easier to access care with technology.
    • Don’t make me wait.
  • Unsatisfactory Patient-Provider Relationships
    • Spend more time with me.
    • Focus less on money and more on me.
    • Treat me well, regardless of my insurance coverage.
    • Treat me like a person.
  • Desire for Better Care
    • Make sure my care is coordinated.
    • Help me prevent illness and stay healthy.
    • Provide clean, private, nice care settings.
  • Medication Needs Not Adequately Met
    • Don’t just give me a pill.
    • Give me pain medication when I need it.
    • Make it easier to get my medications.
    • Help me afford my medications.


The findings, illustrated with direct quotes from participants, are available in PDF and PowerPoint formats under Document Downloads.

These findings informed the development of a major statewide survey of Californians with low incomes, which was later adjusted to capture experiences during the COVID-19 pandemic. The final findings from that survey were released in spring 2021.

About the Authors

This report was written by Jen Joynt, independent health care consultant. The focus groups and interviews were conducted and analyzed by Rebecca Catterson, MPH, senior research director at NORC, and Lucy Rabinowitz, MPH, principal research analyst at NORC. NORC at the University of Chicago is an objective nonpartisan research institution that delivers reliable data and rigorous analysis to guide critical programmatic, business, and policy decisions. For more information, visit www.norc.org.