What we found:
There are many high-performing counties in California that have high levels of disparity on this issue area, such as San Francisco County. However, there are some counties, including Orange County and San Diego, that are higher-performing with relatively-lower health disparities, which may partially reflect the number of undocumented residents who are not counted in official data. It’s concerning that many populous counties in Southern California, like Los Angeles, Riverside, and San Bernardino, have average levels of disparity, but very low levels of performance. Some of these trends may be related to uninsured rates among those in these immigrant-populated Southern California counties. Even after the implementation of the Affordable Care Act, many immigrants — both those with and without documentation — face challenges obtaining insurance and health care.
Why this issue matters for racial equity?
A majority of uninsured Californians are people of color, who are denied access to basic health care services due to affordability, employment and/or citizenship status. This results in racial and ethnic disparities in health outcomes, such as higher rates of adverse birth outcomes and chronic diseases.
Policy levers:
Current work to build on the successes of health care reform by expanding coverage to all county residents can help address gaps in coverage. But coverage is not enough: even many counties with lower uninsured rates have high levels of race-based disparity in some key indicators, like low birthweight and preventable hospitalization, meaning a comprehensive approach to health access is required. Current campaigns include health care coverage for all Californians at the national and statewide levels, as well as County efforts to increase funding to provide uninsured residents with health care services through medical safety net programs.
Read our Health Care Access Report:
Health Care Access: Securing the Counties’ Health Care Safety Net for All Residents