Key Takeaways from the 2023 California Health Interview Survey
The California Health Interview Survey (CHIS) has long served as a vital resource for understanding the health landscape of California. In its latest iteration, the survey has expanded to include over 50 new questions covering a range of pressing issues, including gambling, housing discrimination, adolescents’ sexual orientation, and unintended pregnancy. This comprehensive data collection aims to inform advocacy and policy decisions that can improve health outcomes for Californians.
Housing Discrimination: A Disparity in Experiences
One of the most alarming findings from the 2023 CHIS is the prevalence of housing discrimination among different racial and ethnic groups. The survey revealed that nearly 10% of Black or African American adults reported experiencing housing discrimination in the last two years, a stark contrast to just 2.3% of white adults. The data also indicated that 7.6% of multiracial adults, 6.9% of Latinx adults, and 2.5% of Asian adults faced similar discrimination.
Furthermore, the survey highlighted that individuals who speak languages other than English at home reported experiencing housing discrimination at nearly double the rate of English-only speakers (6% versus 3.5%). Economic factors also played a significant role, with those earning less than 200% of the federal poverty level experiencing discrimination at more than twice the rate of their higher-income counterparts (8% versus 3.1%).
Mental Health Trends: A Complex Landscape
While the overall rates of serious psychological distress among adults in California appear to be returning to pre-pandemic levels, this trend is not uniform across all racial and ethnic groups. For instance, Asian adults reported a rate of serious psychological distress that remains above pre-pandemic levels, while Black or African American adults also showed concerning rates of severe social impairment due to emotional issues.
The survey found that adults with unstable housing were more than twice as likely to report serious psychological distress compared to those with stable housing (30% versus 13.1%). Additionally, a significant portion of adults—30.6%—who did not receive the emotional help they needed cited difficulties in securing appointments as a barrier.
Gambling: A Growing Concern
The 2023 CHIS also introduced questions about gambling, revealing that about 25% of California adults engaged in gambling in the past year. Alarmingly, 6.7% of these individuals reported symptoms of problem gambling, which can lead to detrimental effects on finances, relationships, and mental health. This data underscores the need for targeted interventions to address the potential health risks associated with gambling.
Health Insurance Coverage: Progress and Gaps
The survey highlighted a notable increase in health insurance coverage among noncitizen adults, with 51.8% now covered by Medi-Cal, up from 41.1% the previous year. This increase follows California’s expansion of Medi-Cal to provide full benefits to qualifying adults aged 50 and older, regardless of immigration status. However, disparities remain, particularly among those facing economic hardships.
Police Stops: A Racial Disparity
Another concerning trend revealed by the CHIS is the increase in police stops among Black or African American adults. While the overall rate of police stops decreased from 20% in 2022 to 16.8% in 2023, the rate for Black or African American adults rose from 26.7% to 30.2%. This data highlights the ongoing inequities in law enforcement practices and their impact on different communities.
Engagement in Civic Life: The Impact of Basic Needs
The survey also examined the relationship between basic needs and civic engagement. It found that adults with stable housing were significantly more likely to engage in national, state, and local elections compared to those without stable housing (65.7% versus 48.8%). Similarly, individuals earning more than 200% of the federal poverty level were more engaged in elections than those earning less (71.8% versus 47.1%). This suggests that addressing fundamental issues like housing and income could enhance civic participation.
Adolescents’ Sexual Orientation and Gender Identity
In a significant addition for 2023, the CHIS included questions about adolescents’ sexual orientation and gender identity. Among adolescents aged 12-17, 13.3% identified as gay, lesbian, bisexual, pansexual, or used another term, compared to 9.3% of adults. Alarmingly, 67.8% of gay or lesbian adolescents reported experiencing serious psychological distress in the past year, highlighting the mental health challenges faced by LGBTQ+ youth.
Unintended Pregnancy: Economic Disparities
The survey also shed light on unintended pregnancies among sexually active women aged 18-44, with 4.4% reporting such experiences in the past year. Women earning less than 200% of the federal poverty level were more than twice as likely to report unintended pregnancies compared to their higher-earning counterparts (7.5% versus 3%).
Food Insecurity and Medical Debt: Widening Inequities
The CHIS data revealed alarming trends in food insecurity and medical debt. Nearly half (44.5%) of California adults earning less than 200% of the federal poverty level reported being unable to afford enough food, a figure that has steadily increased since 2020. Additionally, over half of adults who struggled to pay medical bills reported incurring credit card debt to cover these expenses, with this percentage rising from 45.2% in 2020 to 56.3% in 2023.
A Call to Action
The findings from the 2023 California Health Interview Survey underscore the importance of disaggregating data by race, ethnicity, and socioeconomic status to expose inequities in health and access to care. As Ninez Ponce, principal investigator of CHIS, emphasized, the data serves as a critical resource for policymakers, researchers, and community advocates to identify unmet needs and develop evidence-based solutions to address the challenges facing California’s diverse population.
By making this data publicly available, the UCLA Center for Health Policy Research aims to empower stakeholders to create informed policies that can lead to meaningful change in the lives of Californians.