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California’s Rural North covers more ground than most people realize, and it receives far less attention than it deserves. Although the region spans nearly one-quarter of California — about 39,000 square miles — it is routinely left out of the health care conversations that shape state policy.
Yet by almost every measure — cost, access, outcomes — the region’s 1.1 million residents face some of the steepest challenges in California. The California Health Care Foundation’s 2026 statewide survey finds that 69% of residents in the region’s 18 counties say their health care expenses are growing faster than their income, the highest regional percentage in the state. More than 70% say they have skipped doctor visits because of cost. More than half carry medical debt. And in Shasta County, the all-cause death rate is nearly 60% higher than the statewide average.
The region’s infrastructure is under intense pressure, as our recent market report on Shasta and Lassen counties shows. Workforce shortages in the region are among the most severe in the state, with just two-thirds as many physicians per 100,000 people as the state overall. Three in 5 residents rely on Medi-Cal and/or Medicare, making the area especially vulnerable to recent federal funding cuts.
Looking for Solutions
Policy tools that could make a real difference here are available. Following through with the California Office of Health Care Affordability’s mandate to limit unsustainable spending growth would address the Rural North’s outsized premium burden. With more than half of the region’s residents burdened by medical debt, expanding relief programs represents a meaningful and immediate solution.
We should also be looking to the region itself for solutions. The people closest to these challenges in the Rural North — local providers, health center leaders, hospital administrators, and community advocates — have insights that should inform what statewide leaders are thinking and doing.
That’s why we are coming to Redding later this month. We’ll be sharing findings from our recent report on the situation in Shasta and Lassen counties and, just as importantly, listening. Local health care leaders will bring real-world context to the data and discuss how these trends shape care on the ground. Foundation leadership will be present for an open dialogue about the future of health care in the region.
The people who understand these communities best should help shape what comes next. If you’re a health care leader in the region, we hope you’ll join us.
Join regional health care leaders and connect with CHCF leadership at an in-person meeting in Redding on April 2. Register now!
