California has made great strides in improving our health care system, and now more than 91 percent of our residents have health insurance.
However, coverage does not guarantee health and significant racial inequities persist. For example, in California, Latinos and African Americans have twice the prevalence of type-2 diabetes and are twice as likely to die from the disease. The prevalence of asthma among American Indians and Alaska Natives is three times greater than the state average and African Americans are four times more likely to be hospitalized or visit the emergency room for asthma related reasons. Approximately one in 10 American Indians and Alaskan Natives, African Americans and Latinos experienced serious psychological distress in the past year.
Now is the time for California to finish the job of improving our health care system by embracing health equity and ensuring communities have the opportunity to be healthy.
The California Pan-Ethnic Health Network (CPEHN) is pursuing a 2019 health equity agenda focused on closing the coverage gap, improving health outcomes and preventing the burden of chronic disease.
Close the Coverage Gap
California’s adult undocumented immigrants remain locked out of health coverage and have limited options for accessing care. It is critical that California expand Medi-Cal for all, regardless of immigration status.
However, coverage alone is not enough. In addition, complex eligibility and enrollment processes, as well as a fractured delivery system, make it necessary to provide consumers with assistance to enroll in and navigate health coverage. Over 500,000 Californians are eligible for Medi-Cal but not enrolled. And immigrant communities are un-enrolling from coverage due to fear over immigration enforcement. We need to fund community-based health navigators and enrollers, and our $30 million budget request would support these activities for the next two years.
Improve Health Outcomes
California has made great strides in providing health care coverage, particularly for communities of color. However, communities of color continue to experience vast disparities in health outcomes, particularly for asthma, diabetes and maternal health.
Disparities in access to care and outcomes are particularly stark for mental health care. Consumers must navigate a complex delivery system that is often not responsive to cultural and linguistic needs.
Three bills in the legislature are aimed at fixing this. Assembly bill 512, introduced by Assembly Member Phil Ting, will improve the cultural and linguistic competency of county mental health services. Assembly bills 537 and 929, from Assembly Members Joaquin Arambula and Luz Rivas, respectively, will require Medi-Cal and Covered California to hold health plans accountable for reducing disparities in health care outcomes.
Prevent the Burden of Chronic Disease
Proven prevention strategies, such as a team-based approach to care that elevates the role of community health workers who are fluent in the languages and cultural practices of the patients they serve, should be embraced and funded. Senate bill 207, introduced by State Senator Melissa Hurtado, will allow community health workers to provide asthma education and prevention services through home visitation, and allow low-income consumers to have minor asthma remediation services, such as carpet cleaning, provided through this program.
The vision we have for California may seem radical—but it is reasonable. It is possible. It is what our communities deserve. And we must work together to make it a reality.
Kiran Savage-Sangwan is the deputy director for The California Pan-Ethnic Health Network (CPEHN), a statewide multicultural health advocacy organization.