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Cam Shaw, a resident of Contra Costa County, is one example of a black Californian who feels that our health care system is in trouble.
In July, Shaw, whose name has been changed to protect her medical privacy, tried to make an emergency appointment for pain in her leg. The pain increased in two days. On the third day, she called her doctor’s office at 6 a.m., hoping to get a same-day appointment. She didn’t hear anything until 4pm, by which time she was in so much pain she couldn’t walk.
Shaw was forced to make an expensive trip to the emergency room but never received a diagnosis. Instead, she was sent home with medication and a bandage to contact her primary care provider in 5 to 7 days if she was still in pain. Shaw received no further follow-up or information about her leg injury from the hospital or her provider. Eventually, Shaw’s leg healed on its own, but even though she had health insurance coverage, she felt no one cared to help her.
Black Californians face one of the lowest life expectancies in California and a disproportionately high death rate from Covid-19. This is despite the fact that most of these inhabitants have some form. Insurance coverage And permanently a Great desire to take care of their health. This contradiction begs the question: What is wrong with health care for black Californians?
Recently, the California Health Care Foundation Conducted 100 in-depth interviews Explore the health care system with Black Californians to find out what issues they face. Responses highlighted several key issues, including disrespect from providers, discrimination based on type of insurance coverage, and missed diagnoses due to neglect by providers.
The report’s findings serve as stark examples of how bias and bias in the health care system can negatively impact health. One Bay Area resident said he prefers black doctors because he feels those providers are more likely to listen to him. Other respondents said they were overwhelmed by the shortage of black mental health professionals and were prevented from finding therapists they could contact. Some said they wanted to find a competent and compassionate provider regardless of race.
Black Californians face structural barriers to health because of the legacy of racism, including disproportionately high levels of poverty and lack of access to healthy food and green space.
Importantly, the report also highlighted positive findings among respondents, including high health insurance coverage, a strong desire to maintain health, and a desire to connect with providers.
Another challenge Shaw faced was finding a supplier she felt comfortable with. During our conversation, she continually noted how she had struggled to find a black female physician to replace her previous provider, who had recently retired. Shaw had a positive experience with this physician and felt accepted and heard as a black woman.
Shaw’s experience highlights a larger issue in California’s health care system, the lack of black providers to meet the needs of black patients. The study found that patients who received care from providers with a shared racial identity tended to be infected. Better communication and increased quality of care. Limited accountability of health systems that fail to adequately meet the needs of black patients are structural factors that cause this provider shortage to have major consequences for black patients. They have gone beyond the problem of discrimination or racism between individual providers.
“We’re spinning our wheels … trying to get people to recognize their own implicit biases and think about what helps them without changing the system around them,” Kathryn Haynes, senior program officer at the California Health Care Foundation, told me when I mentioned the focus. On individual provider bias and bias in the health care system.
California is working to address this problem, Hein said. She pointed to efforts by Covered California and the California Department of Health Care Services to hold health plans accountable if they don’t act to address inequitable health outcomes among their patients. To accomplish this, state health regulators need more information about how black patients are receiving care. Health care providers can routinely collect this information to provide feedback on the care they provide to patients and efforts to improve their experience, Haynes said.
Methods for collecting this information already exist. Charged with strengthening California’s workforce and expanding access to quality health care, the statewide Office of Health Care Access and Information collects key racial and ethnic data, as well as data focused on health care quality and patient access.
A combination of state laws and existing regulations require the department to collect comprehensive data on the quality of care for black patients. This includes Assembly Bill 1204, signed into law last year, which requires the state to develop and administer a health equity reporting program, along with annual equity data from California hospitals. I encourage policymakers and regulators to closely monitor the data to identify recurring inequities for black patients and take steps to address any major gaps.
Acting on the data and implementing solutions will be key to growth.
Ultimately, the goal is to gather the necessary data to demonstrate how well plans are doing in addressing the needs of their black patients. Beyond data collection and developing performance metrics, I support efforts. Strengthening California’s health workforce pipeline To ensure that one day black patients don’t have to struggle to find providers who look like them.
Over the course of my discussions, one thing became clear: Black Californians like Shaw want to build lasting, positive relationships with their health care providers. They want more respect and partnership. California’s health care system needs to answer the call.
Denzel tongue a Column A report on racial justice, public policy, and health equity for California health. The Oakland native works in public health and earned a master’s degree from UC Berkeley’s Goldman School of Public Policy.
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