Important points
More than 50 questions have been added to the California Health Interview Survey on topics such as gambling, housing discrimination, adolescent sexual orientation, and unwanted pregnancies. Survey data has been used to inform advocacy and policy for more than 20 years. About 10% of Black or African American adults in California report experiencing housing discrimination in the past two years, compared with about 2.3% of white adults. Although the overall proportion of adults reporting severe psychological distress is returning to pre-pandemic levels, this was not consistent across all racial and ethnic groups.
Differences in race and ethnicity, income level, sexual orientation and gender identity will continue to influence a wide range of health-related issues affecting Californians in 2023, according to the latest California Health Interview Survey from the UCLA Center for Health Policy Research. was found to be related to differences in the experience of fairness. , or CHIS.
Housing Discrimination is the nation’s largest state health agency that has collected data since 2001 to help inform budgeting, advocacy, and legislation, and to expose disparities in access to health care and health services. It was one of many topics added to the survey in 2023. Collecting data on topics such as discrimination and housing insecurity improves researchers’ understanding of how people’s daily experiences are associated with health outcomes.
Among adults, 4.6% said they had experienced housing discrimination in the past two years. According to the data, 9.4% of Black or African American adults have experienced housing discrimination, more than four times the rate of white adults (2.3%). CHIS also found that 7.6% of multiracial adults, 6.9% of Latino adults, and 2.5% of Asian adults have experienced housing discrimination.
Adults who speak one or more languages other than English at home said they experienced housing discrimination at nearly twice the rate of adults who only spoke English at home (6% vs. 3.5%). According to CHIS, people with incomes below 200% of the federal poverty level ($60,000 for a family of four in 2023) are more than twice as likely as those earning above (8% vs. 3.1%) to I have experienced housing discrimination.
Other new topics included gambling, unwanted pregnancy, young people’s plans for college, young people’s sexual orientation, and children’s gender identity.
Gambling is associated with risk of poor health and mental health problems
Researchers found that about 25% of California adults reported gambling in the past year, and 6.7% of them reported having symptoms of a gambling problem.
“These new topics will provide policymakers, researchers, journalists, community advocates, and the public with additional, validated information that will help them better understand the challenges facing California’s diverse population. We provide data,” said Nines Ponce, principal investigator at CHIS and director of the UCLA Center for Health Policy Research. , or CHPR. “CHIS data serves as an important resource for understanding which groups’ needs are not being met by current policies and programs.”
CHIS showed that in 2023, 51.8% of noncitizen adults, including those with green cards, were covered by Medi-Cal, up from 41.1% the previous year. In May 2022, the state expanded Medi-Cal, the program that provides health insurance to low-income Californians, to provide full benefits to qualifying adults age 50 and older, regardless of immigration status. .
Police off limits to all but black or African American adults
The CHIS data also showed an alarming pattern in how race and ethnicity correlate with being stopped by police. The number of all California adults stopped by police in the past year decreased from 20% in 2022 to 16.8% in 2023, but the number of Black or African American adults decreased from 26.7% to 30.2%. increased. All other races and ethnicities reported fewer police stops from 2022 to 2023.
“Disaggregating data by race and ethnicity highlights inequities in our systems and people’s experiences,” said Todd Hughes, director of the California Health Interview Survey.
Main findings
The 2023 survey includes responses from 21,671 adults, 968 adolescents, and 3,377 children and includes topics related to and affecting health. Among them are access and use of health care, health insurance, health conditions, mental health, food insecurity, housing, child care, long-term care, discrimination, firearm safety and gun violence, and climate change.
Adult Californians with U.S. citizenship are less likely to participate in national, state, and local elections because they struggle more with basic needs such as housing and income.
65.7% of those with stable housing said they always or often participate in national, state, or local elections, compared with 48.8% of those without stable housing. 71.8% of people with incomes above 200% of the federal poverty level always or often participate in elections, compared to 47.1% of people with incomes below 200% of the federal poverty level. I was doing it.
In a new question added in 2023, CHIS asked youth (12-17 years old), in addition to adults, about their sexual orientation. The survey also included questions about gender identity for children under 12.
Among adolescents, 13.3% said they were gay, lesbian, bisexual, pansexual, or used another term, compared with 9.3% of adults. 67.8% of gay or lesbian youth reported experiencing severe psychological distress in the past year, compared with 23.2% of heterosexual youth. Among children, 99.6% reported being cisgender and 0.4% reported being transgender or gender-expansive.
In 2023, new questions regarding unwanted pregnancies have also been added.
4.4% of sexually active women ages 18 to 44 reported an unintended pregnancy in the past year. Women earning less than 200% of the federal poverty level ($60,000 for a family of four in 2023) were more than twice as likely to have an unplanned pregnancy (7.5 % vs. 3%).
mental health concerns
Although the proportion of adults reporting severe psychological distress is returning to pre-pandemic levels (13% in 2019, peaked at 17% in 2021, and 13.9% in 2023), for some groups Mental health and access to care remain a concern.
For Asian adults, rates of severe psychological distress remain above pre-pandemic levels (9.7% in 2019, peaking at 14.5% in 2021, and 12.8% in 2023). Black or African American adults (9.6% in 2019 vs. 11.6% in 2023) and Asian adults (7.2% in 2019 vs. 2023) are more likely to have had a severe social disorder due to emotion in the past 12 months. 8.9% per year), which remains high. Adults living in unstable housing were more than twice as likely as adults living in stable housing to report experiencing severe psychological distress in the past year (30% vs. 13.1%). %). 30.6% of adult respondents who didn’t get the emotional support they needed said it was because it was difficult to get an appointment. In 2023, 24.7% of adults reported needing help for an emotional/mental health or alcohol or drug problem in the past year. In 2020, it was 20.9%.
Two other categories that showed rising inequality in California were food insecurity and medical debt.
Nearly half (44.5%) of California adults with incomes below 200% of the 2023 federal poverty level reported not being able to afford enough food. This number has increased every year since 2020, when it was 35.8%. More than half of adults who had trouble paying medical bills in the past year reported taking out credit card debt to pay for medical bills. This percentage increased from 45.2% in 2020 to 56.3% in 2023.
“As part of a public university, making our research available to the public is not only the mission of the UCLA Center for Health Policy Research, but also our moral obligation,” Professor Ponce said. “We would like to thank everyone who took part in our research. We sincerely hope that people will use our data to create evidence-based solutions to our serious problems.”
Approximately 6.7% of Californians reported having symptoms of gambling addiction. Gambling addiction is often characterized by an uncontrollable urge to gamble, negative financial consequences, poor relationships, and/or mental health problems.
Read more about the CHIS findings on gambling.
