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Research Finds Black Californians Prioritize Health, While System Fails to Prioritize Black Californians

The data that was collected showed that 90% of Black Californians say that they have health insurance coverage, and 92% of respondents said that they have seen a doctor or healthcare provider in the last year. Most people reported putting “a great deal” or “quite a bit” of effort into getting screenings and preventative care, tracking health indicators like blood pressure and cholesterol, and working to maintain a healthy weight. Four out of five reported focusing “a great deal” or “quite a bit” on mental health.

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More than 80% of the survey respondents said that they are very satisfied or somewhat satisfied with their main source of healthcare. Satisfaction rates were inversely related to age.
More than 80% of the survey respondents said that they are very satisfied or somewhat satisfied with their main source of healthcare. Satisfaction rates were inversely related to age.

Maxim Elramsisy | California Black Media

The California Health Care Foundation (CHCF) has released a study that found Black Californians are highly engaged with their health care, are active in advocating for their health and have strong and clear opinions about how the healthcare system can be improved.

“I think it’s surprising because of the pervasive myths about noncompliance among black patients,” said Shakari Byerly, managing partner of EVITARUS, a Los Angeles based Black-owned public opinion research firm who designed, conducted and analyzed the research. “The fact is that our traditional foods may not be as healthy. While that may have some degree of anecdotal resonance, what we’re seeing broadly is that people are working very hard.”

The study was staged in three different phases intended to get varying levels of insight from different cohorts of Black Californians.

Phase one consisted of hourlong interviews with 100 individuals to understand their views on health, perceptions of discrimination, and their vision for an ideal healthcare system.

In Phase Two, the researchers conducted 18 segmented focus groups to explore structural issues in the healthcare system.

In Phase Three, 3,325 Black Californians were surveyed to determine how well the findings in phases one and two captured and represented the views of the general population of Black Californians.

The data that was collected showed that 90% of Black Californians say that they have health insurance coverage, and 92% of respondents said that they have seen a doctor or healthcare provider in the last year. Most people reported putting “a great deal” or “quite a bit” of effort into getting screenings and preventative care, tracking health indicators like blood pressure and cholesterol, and working to maintain a healthy weight. Four out of five reported focusing “a great deal” or “quite a bit” on mental health.

One in three Black Californians and nearly half (47%) of Black women say they experienced inadequate treatment for pain by their health care provider. “We’ve heard story after story of Black women in particular, talking about not being believed, having their pain and agony inadequately treated,” Byerly said.

Nearly one in three Black Californians was found to be treated unfairly by a healthcare provider because of their race or ethnicity, and more than one in four Black Californians avoid care due to concerns that they will be treated unfairly or with disrespect. Unfair experiences are most common among Black Californians with mental health conditions, disabilities, identifying as LGBTQIA+, and women.

The study found that Black Californians have clear opinions on how to improve the health care system. Strong majorities (75%<) expressed that it is extremely important or very important to increase Black representation among health care leadership and in the healthcare workforce. The majority in each age group said that it was at least somewhat important to have a Black or African American Doctor. According to data released by the American Medical Association, 10% of medical school matriculants in 2021 self-identified as Black, or a combination of Black and Asian, Hispanic, or White.

“There needs to be additional support. Financial support. Upfront financial support, for those who want to be doctors. In nursing there’s also a need for financial support, but there’s also not a standard for advising people about the most efficient, most successful pathways to nursing careers … that’s a problem that can be corrected,” CHCF senior program officer Katherine Haynes told California Black Media. “There is another issue and this has to do with the environment in which physicians and nurses practice … Just as patients experience racism, providers experience racism, and they experience it from their peers, from their supervisors, from patients … building practices of reporting those instances of racist treatment need to be made more robust so that a system is created in which providers of color can do their best work for patients. That means having zero tolerance for racist behavior in our healthcare institution.”

The survey indicated that Black Californians believe that there should be an expansion of community-based education to teach about how to access health care options and an increase of Black community health care advocates. They believe that there should be accountability for providing equitable care using financial and accreditation incentives, and through additional training to providers.

More than 80% of the survey respondents said that they are very satisfied or somewhat satisfied with their main source of healthcare. Satisfaction rates were inversely related to age.

“When you look at elders 65 and older, and really 75+, they are the sickest, yet, they appeared most satisfied with their care … that satisfaction is in contrast to younger people who tend to go to urgent care or emergency rooms for care” said Haynes. “I suspect … that it comes from familiarity, having relationships and knowing how to use the system.”

The CHCF study showed that Black Californians go to great lengths to prioritize their health, but the health care system fails to prioritize them.

Haynes recommended one solution. “You can report it to your health plan. You can return it to the state licensing board. You can contact the Department of Managed Health Care, which oversees health plans and to the Office of the Patient Advocate. Those are your rights,” said Haynes. “I will tell you that if you file a grievance versus a complaint, it poses legal liability and so those things that rise to that, or look like they might rise to that, are much more likely to get a response from a health care system.”

You can read the whole report here.

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Oakland Post: Week of February 5 – 11, 2025

The printed Weekly Edition of the Oakland Post: Week of February 5 – 11, 2025

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OP-ED: Like Physicians, U.S. Health Institutions Must ‘First, Do No Harm’

Coupled with their lack of government and healthcare-related experience, we are concerned these nominees will significantly undermine public health, increase the number of uninsured people, worsen health outcomes, and exacerbate health disparities. Physicians observe Hippocrates’ maxim to “First Do No Harm,”, and we urge Trump administration officials to do the same. It is critical that the leadership of HHS and its agencies make decisions based on facts, evidence, and science. Misinformation and disinformation must not guide policymaking decisions and undermine evidence-based public health strategies. Spreading these falsehoods also erodes trust in our public institutions.

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Albert L. Brooks MD. Courtesy photo.
Albert L. Brooks MD. Courtesy photo.

By Albert L. Brooks MD
Special to The Post

Presidential administrations significantly impact the health and wellbeing of our patients and communities.

Through the Department of Health and Human Services (HHS) and the agencies within it, such as the Centers for Medicare & Medicaid Services and the National Institutes of Health, this new administration will decide how financial resources are allocated, dictate the focus of federal research, and determine how our public health care insurance systems are managed, including the Affordable Care Act (ACA), the Children’s Health Insurance Program, the Vaccines for Children program, Medicare, and Medicaid.

The decisions made over the next four years will impact all Americans but will be felt more acutely by those most underserved and vulnerable.

As physicians, we are greatly concerned by the nominations announced by President Trump to critical healthcare related positions. Many of their previous statements and positions are rooted in misinformation.

Coupled with their lack of government and healthcare-related experience, we are concerned these nominees will significantly undermine public health, increase the number of uninsured people, worsen health outcomes, and exacerbate health disparities. Physicians observe Hippocrates’ maxim to “First Do No Harm,”, and we urge Trump administration officials to do the same.

It is critical that the leadership of HHS and its agencies make decisions based on facts, evidence, and science. Misinformation and disinformation must not guide policymaking decisions and undermine evidence-based public health strategies. Spreading these falsehoods also erodes trust in our public institutions.

Vaccines, in particular, have been a target of disinformation by some HHS nominees. In fact, research continues to confirm that vaccines are safe and effective. Vaccines go through multiple rounds of clinical trials prior to being approved by the Food and Drug Administration (FDA) for administration to the public.

Vaccines protect against life-threateningdiseasessuch as measles, polio, tetanus, and meningococcal disease and, when used effectively, have beenshowntoeliminateorsubstantiallyreducediseaseprevalenceand/orseverity.

Because of vaccine mis- and disinformation, there has been a resurgence in vaccine-preventable diseases such as measles and whooping cough, endangering those who are too young or unable to be vaccinated.

Several nominees have spread disinformation alleging that fluoride in public drinking water is harmful. In fact, fluoride in drinking water at the recommended level of 0.7 parts per million, like we have in our EBMUD water, is safe and keeps teeth strong. Because of public health interventions dating back to the 1960s that have resulted in 72.3% of the U.S. population now having access to fluoridated water, there has been a reduction in cavities by about 25% in both children and adults.

We also encourage the next administration to invest in our public health infrastructure. The COVID-19 pandemic highlighted the critical role of public health agencies in preventing and responding to health crises in our communities.

Health departments at the state and local levels rely on federal funding support and technical assistance to develop public health response plans, implement public health strategies, and work with on the ground organizations to serve hard to reach communities. Public health agencies are critical for protecting everyone in our communities, regardless of income-level, insurance status, or housing status.

Health officials should also work to protect the significant improvements in insurance coverage that have occurred since the passage of theACAin 2010.According to HHS, the numberofuninsuredAmericansfellfrom48millionin2010to25.6millionin2023.

California has led the way by investing in Medi-Cal and expanding eligibility for enrollment. In fact, it reached its lowest uninsured rate ever in 2022 at 6.2%. Voters affirmed this commitment to expanding and protecting access to care in November by passing Proposition 35, which significantly expanded funding for California’s Medi-Cal program. The administration should advance policies that strengthen the ACA, Medicaid, and Medicare and improve access to affordable health care.

Regardless of the president in power, physicians will always put the best interests of our patients and communities at the forefront. We will continue to be a resource to our patients, providing evidence-based and scientifically proven information and striving to better their lives and our community’s health. We urge the new Trump administration to do the same.

Albert L. Brooks MD is the immediate past president of the Alameda-Contra Costa Medical Association, which represents 6,000 East Bay physicians.

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Oakland Post: Week of January 29 – February 4, 2025

The printed Weekly Edition of the Oakland Post: Week of January 29 – February 4, 2025

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