Research reveals how a year of change affected Californians' health
Although more Californians than ever had health insurance in 2020, disparities in access to health care among the state's racial and ethnic groups was magnified during a year of unprecedented challenges and changes.
Those are among the key findings of the latest California Health Interview Survey, which is conducted by the UCLA Center for Health Policy Research. The survey included responses from 22,661 California households, including 21,949 adults, 1,365 adolescents and 3,548 children.
"This is one of the most important data releases in the survey's 20-year history because it sheds light on how impactful the pandemic was on multi-year trends in California for health-related behaviors and access to health care, as well as unfair treatment due to race or ethnicity," said Todd Hughes, director of the California Health Interview Survey.
According to the survey:
- 21.6% of Californians delayed or forewent medical care in 2020 due to the COVID-19 pandemic; the phenomenon was more pronounced among adults 65 and older, 44.2% of whom said they delayed or forewent care.
- 94.0% of Californians had health insurance in 2020—the highest percentage ever recorded in the survey. The figure was 92.7% in 2019, and 85.4% in 2001, when the survey began.
- 6.4% of Black adults and 4.2% of Asian adults experienced "unfair treatment" based on their race or ethnicity, more than any other racial and ethnic groups.
- 19.3% of adults who had been treated unfairly due to their race or ethnicity had thoughts of suicide, versus 12.1% of all adults who had not experienced unfair treatment due to race.
A policy brief accompanying the full report explores the ways in which the pandemic affected Californians' access to health care and the measures that indicate a continued inequality in access to care among various racial and ethnic groups. The brief reports that although almost 90% of Black respondents had health insurance coverage, about 11.0% said they did not have a usual place to go when they were sick or needed health advice in 2020, up from 8.1% in 2019.
The latest report builds on preliminary estimates published monthly by the Center for Health Policy Research beginning in September 2020. In the full-year survey, researchers learned that 15.1% of essential workers either had COVID-19 or thought they had contracted the disease, compared with 12.1% of all other adults.
Researchers also learned that circumstances around the pandemic had interesting effects on Californians' health and wellness practices. For example, stay-at-home mandates and remote schooling seemed to lead to healthier diets among children—as evidenced by the percentage who ate fruit and vegetables daily—and less binge drinking among adolescents ages 12 to 17.
Conversely, sedentary activities, including using the internet, increased dramatically. The percentage of adolescents who said they were online "almost constantly" was 43.2% in 2020, up from 28.6% the previous year.
"Seeing how COVID-19 affected the physical, mental and emotional health of Californians benefits not only researchers, but also individuals and groups engaged in policy and on-the-ground efforts across the state," said Ninez Ponce, the center's director and principal investigator of the survey. "Because the targeted data can be acted on, it enables those in power to determine which Californians most need help."