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California, home to the nation’s most culturally diverse population and the fifth-largest black population of any state, has a great opportunity to be a leader in health equity. But, time and time again, research shows that racism and structural barriers in the health care system prevent Black Californians from getting the health care they actively seek.
To identify solutions to address persistent health inequities, CHCF engaged EVITARUS, a black-owned polling firm in Los Angeles, to conduct an in-depth study listening to Black Californians about their experiences with racism and health care.
This survey debunks the narrative that blacks don’t care about their health, when in fact they do on purpose.
– Connie Stewart Listening to black Californians Advisory Board Member, Executive Director of Initiatives, Cal Poly Humboldt
Key Findings: The Experience of Black Californians
Listening to black Californians It is one of the largest studies of the health care experience of black Californians. It represents in-depth interviews with 100 black Californians and 18 focus groups, as well as a statewide survey of 3,325 adult black Californians. Key findings include:
Monitoring quality care
Black Californians are very intentional about pursuing physical and mental health. Most black Californians report focusing on their mental health (79%). receiving appropriate screening or preventive care (77%); and monitoring health indicators such as blood pressure and cholesterol (71%).
Most black Californians have an insured, regular provider, and have had at least one visit with a health care provider in the past year. Nine in ten black Californians (90%) say they currently have health insurance coverage, and 83% say they have access to a regular provider. More than 9 in 10 black Californians (92%) saw a doctor or health care provider in the past year.
Health care system failures
“I feel like black voices don’t sound as loud. They are not taken seriously. . . . I didn’t feel it, and it ended up being a very serious and life-threatening problem. . . . I said [my doctor] I was out of breath, and he said to me: ‘You are out of shape. . . . You just need to lose weight and exercise more.’ I ended up being so anemic that I had to have two blood transfusions.”
– Black woman, focus group participant, private insurance – city
Nearly one in three black Californians have been treated unfairly by a health care provider because of their race or ethnicity. This experience is especially true for black Californians (47%) with mental health problems. For those who identify as LGBTQIA+, which includes lesbian, gay, bisexual, transgender, queer or questioning, intersex, gay, and other (43%); for the disabled (40%); and for women (40%). Overall, higher proportions of black Californians (38%) and black women (47%) say there has been a time when a health care provider did not adequately treat their illness.
More than one in four black Californians avoid care due to fears of being treated unfairly or disrespectfully. Black Californians who are LGBTQIA+ (41%) and enrolled in Medi-Cal (35%) report missing out on care.
Many black Californians take steps to reduce potential negative experiences in preparation for a health care visit. Two-thirds (66%) of black Californians report researching a health condition or concern before meeting with a health care provider, and more than one-third (35%) say they prepare their speech and/or behavior to make the provider feel that way. Ease
What should be done
Black Californians agree on the importance of strengthening the patient-provider relationship. Almost all black Californians consider it very important or very important to have a provider who listens (98%), takes the time to answer questions (97%), and discusses specific health goals (93%).
Black Californians have clear opinions on how to make the health care system work better for them. More than three in four respondents say increasing black representation among health care leaders and providers, expanding community education and advocacy and training providers, and holding the health care system accountable are extremely important or very important. 7 in 10 black Californians think developing comprehensive approaches to health care is extremely important or very important.
“I think it’s about getting more black people represented in the health care professions and in those positions of power and making the change that we need. . . It allows our voices to be heard and our concerns addressed in the health care system.
– Black man, focus group participant, Central Valley stakeholders
The different voices of the participants speak loudly Listening to black Californians. Black Californians tell us that if we are willing to listen, build trust and partner with them, and hold the health care system accountable for equitable care, it is within our power to reverse the harmful effects of racism and discrimination on their health.
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