Black Californians want better health care.  Here's how we can make it happen - California Health Report

Black Californians want better health care. Here’s how we can make it happen – California Health Report

Black Californians have one of the lowest life expectancies in California and face disproportionately higher death rates from COVID-19. This despite the fact that the vast majority of this population have some form of insurance coverage And constantly prove a Strong interest in taking care of their health. This discrepancy begs the question: What is wrong with health care for black Californians?

Recently, California Healthcare Foundation He conducted 100 in-depth interviews With black Californians to discover the challenges they face while navigating the health care system. The responses highlighted several key issues including lack of respect for providers, discrimination based on type of insurance coverage and missed diagnoses due to providers being ignored.

Anecdotes from the report serve as poignant examples of how discrimination and bias within the health care system can negatively impact health. One Bay Area resident said he preferred black doctors because he felt those providers would be more willing to listen to him. Other respondents lamented the shortage of black mental health professionals and said that it hampered their ability to find therapists they could connect with. Some said they just wanted to find a competent and compassionate provider, regardless of race.

Black Californians already face structural barriers to maintaining good health due to a legacy of racism, including disproportionately high poverty rates and a lack of access to healthy food and green spaces.

Importantly, the report also highlighted positive outcomes including high levels of health insurance coverage among respondents, high interest in maintaining health and interest in building relationships with service providers.

Another challenge Shaw faced was finding a service provider that you were comfortable with. During our conversation, I’ve constantly noticed how she’s struggling to find a black female doctor to replace her recently retired former provider. Shaw had positive experiences with this doctor and felt accepted and heard as a black woman.

Shaw’s experience highlights a larger problem in the California health care system, which is the shortage of black caregivers to meet the needs of black patients. Research shows that patients who receive care from caregivers who share a common ethnic identity tend to have it Better communication and increased quality of care. This shortage of providers along with limited accountability for health systems that fail to adequately meet the needs of black patients are structural factors that can have severe consequences for black patients. They go beyond the problem of bias or racism among individual service providers.

Katherine Haynes, chief program officer at California Health Care, told me when referring to the focus on individual provider bias and discrimination in the health care system.

Haynes said California is working to address this. She noted the efforts of Covered California and the California Department of Health Care Services to hold health plans accountable if they fail to take action to address unfair health outcomes among their patients. To achieve this, state health regulators will need more information about how black patients receive care. Health care providers can collect this information by routinely asking patients to comment on the care they receive and efforts to improve their experiences, Haynes said.

The means to collect this information already exist. The statewide Office of Health Care Access and Information, a division tasked with strengthening California’s workforce and expanding access to quality health care, collects key data on race and ethnicity as well as information focused on health care quality and patient access.

A combination of current state laws and regulations require the department to collect aggregate information about the quality of care for black patients. That includes Assembly Bill 1204, which was signed into law last year, and which requires the state to develop and administer a health equity reporting program, with annual stock data from California hospitals. I encourage policy makers and regulators to closely monitor the data to identify frequent inequalities for black patients and to take measures to address any significant gaps.

Working on data and implementing solutions will be key to progress.

Ultimately, the goal is to collect the data needed to show how well the plans are performing when it comes to meeting the needs of their black patients. Besides collecting data and developing performance measures, I support efforts to strengthen California’s health workforce pipeline to ensure that black patients never have to struggle to find providers who look like them.

Over the course of my conversations, 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. The California health care system needs to answer this call.

Denzel Tong wrote a column in the California Health Report on the intersection of racial justice, public policy, and health equality. A native of Oakland, he works in public health and holds a master’s degree from the Goldman School of Public Policy at UC Berkeley.


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