Healthcare Disparities in California
What are health disparities?
Healthy People 2020 defines a health disparity as “a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater obstacles to health based on their racial or ethnic group; religion; socioeconomic status; gender; age; mental health; cognitive, sensory, or physical disability; sexual orientation or gender identity; geographic location; or other characteristics historically linked to discrimination or exclusion."
There are millions of families in California that are affected by health disparities. These families face difficulties such as not being able to receive quality care, affordable coverage, and knowledge/access to available resources.
As someone who comes from a lower-middle-class family of immigrants, I've seen how difficult it can be to receive proper healthcare in California. Family members who needed daily insulin, heart medications, and other types of medication therapy, were always in constant stress, worrying if they were able to receive their next needed doses. One month their medications are covered by insurance, and by the next, their copay is within the hundreds of dollars, their insurance monthly rates are up, and they're unable to get in contact with their provided primary care physician. Looking back on this situation, there are many factors that contributed to my family's healthcare difficulties such as, socioeconomic status, lack of access to healthcare resources, and lack of education/direction, which are affecting factors that are still present in today's healthcare system.
People who are affected by health disparities
With the factors that contribute to health disparities in mind (socioeconomics, geographic environment, education, etc.), people of color are affected by healthcare disparities the most. The graph below shows the U.S. uninsured rates for the non-elderly population by race and ethnicity from 2010-2019.
There are longstanding disparities in health care. The Affordable Care Act health coverage
expansions led to large gains in coverage across groups. Despite these gains, however, people of color and low-income individuals remain at increased risk of being uninsured. contributing to greater barriers to accessing health care. Further, starting in 2017, coverage gains stalled and began reversing, reflecting a range of actions by the Trump administration, including decreased funding for outreach and enrollment assistance, approval of state waivers to add new eligibility restrictions for Medicaid coverage, and immigration policy changes that increased fears among immigrant families about participating in Medicaid and CHIP. These coverage losses eroded some of the previous coverage gains under the ACA, particularly among Hispanic people, who already were at increased risk of being uninsured.
expansions led to large gains in coverage across groups. Despite these gains, however, people of color and low-income individuals remain at increased risk of being uninsured. contributing to greater barriers to accessing health care. Further, starting in 2017, coverage gains stalled and began reversing, reflecting a range of actions by the Trump administration, including decreased funding for outreach and enrollment assistance, approval of state waivers to add new eligibility restrictions for Medicaid coverage, and immigration policy changes that increased fears among immigrant families about participating in Medicaid and CHIP. These coverage losses eroded some of the previous coverage gains under the ACA, particularly among Hispanic people, who already were at increased risk of being uninsured.
Improving healthcare disparities in California
There are many aspects of California's healthcare system that need major changes and improvements, such as government/state policies, financial aids, insurance costs, available resources, higher quality healthcare, etc. Changes within the state healthcare programs can take a long time. But improvement can easily start at home with the people. Everyone should be familiar with their healthcare insurance and any existing government-funded programs that can support/guide them in the right direction. The state of California is also responsible for educating and spreading awareness regarding healthcare policies and making sure the people of California understand what's available to them.
The Department of Healthcare Servies (DHCS) is a department within California's health and human services agency that finances and organizes government-funded healthcare programs such as Medi-Cal. Their goal is to provide Californians with access to affordable, integrated, high-quality health care, including medical, dental, mental health, substance use treatment services, and long-term care. The Department's vision is to preserve and improve the overall health and well-being of all Californians. Quality improvement is a key component to achieving this mission and vision.
As a student who's studying to work in healthcare. I believe patient education goes a long way when achieving improved health outcomes. This can apply to health management knowledge, but also healthcare insurance knowledge. If more Californians are familiarized with their available resources in healthcare, the number of people affected by healthcare disparities will decrease, this is a small but necessary step towards healthcare equality. The support of programs and events that advocate and spread awareness of available healthcare resources is a great way to help.
Link to lists of California healthcare resources and support:
https://www.dmhc.ca.gov/healthcareincalifornia/resourcelist.aspx
References
Damico, A., Orgera, K., Hill, L., & Artiga, S. (2021, July 16). Health Coverage by Race and Ethnicity. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/health-coverage-by-race-and-ethnicity/
Gaines, K. (2021, October 23). Health Disparities by Race and Ethnicity. California Health Care Foundation. https://www.chcf.org/publication/2019-edition-health-disparities-by-race/
Healthy People. (n.d.). Disparities. https://www.healthypeople.gov/2020/about/foundation-health-measures/Disparities
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