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6/30/2022402
  
Approved6/27/2022 12:53 PMNo presence informationi:0#.f|uclachissqlmembershipprovider|venetia6/30/2022 12:18 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesVenetia Laivenetialai@ucla.edu310-794-6963Tiffany Lopestlopes@ucla.edu310-794-093010921682YY
PublicationCalifornia Native Hawaiian and Pacific Islander Adult Health Behaviors and Attitudes on Tobacco ; California LGBTQ+ Adult Population Health Behaviors and Attitudes on Tobacco2311; 2298
Two groups that have high rates of smoking and vaping — the Native Hawaiian and Pacific Islander community and the LGBTQ community — have specific hurdles that prevent them from quitting: the cost of cessation therapies and a lack of culturally specific care, according to a pair of reports from the UCLA Center for Health Policy Research.

“Examining the smoking behaviors of specific communities is essential to understanding their unique needs,” said Sean Tan, a senior public administration analyst at the center and lead author of both reports. “We found that many NHPI and LGBTQ smokers who want to quit and have tried to do so lack the means and culturally competent care to quit for good.”  

The reports, based on follow-up surveys conducted by the Center’s California Health Interview Survey in 2019–20, touch on each group’s tobacco, vaping and marijuana use, as well as their exposure to secondhand smoke, attitudes toward smoke-free policies and cessation attempts. Data in the NHPI report looked at differences by ethnic subgroup, gender, age, education and region, while the LGBTQ data looked at differences by sexual and gender minority status, race and ethnicity, age, and education.

NHPI smokers: A large proportion of adults use tobacco

Among the Native Hawaiian and Pacific Islander adults surveyed, 64.3% said they currently used tobacco products of any kind, ranging from cigarettes to hookahs to nicotine pouches to betel nut with tobacco. Other findings from the report:
  • ​83.4% of NHPI smokers have tried quitting in their lifetime.
  • Among NHPI smokers, 52.3% said they would be more comfortable using cessation counseling offered by a health group that serves the NHPI community than with an organization that serves the general population.
  • 92.6% of NHPI adults who have less than a high school diploma are current smokers; among these smokers, 56.4% delayed or could not get nicotine replacement therapy or prescription cessation medicine because of the cost.
Tan noted that the NHPI report is based on the California Native Hawaiian and Pacific Island Tobacco Survey, which used nonprobability recruitment methods, and the data is not entirely representative of all NHPIs in California.

LGBTQ smokers: Marijuana use is higher than use of tobacco

Among LGBTQ adults, 34% currently use marijuana, while 19.5% currently use tobacco products of any kind. Other findings from the report:
  • ​​9.8% of LGBTQ adults currently vape, a figure 3.5 times as high as the 2.8% of all California adults who do so.
  • 80.1% of LGBTQ smokers attempted to quit smoking at least once.
  • 17.2% said they delayed or did not get nicotine replacement therapy due to the cost.
  • 10.5% LGBTQ smokers said they delayed or did not seek cessation programs because of perceived unfair treatment due to their sexual orientation or gender identity.

“Policies and cessation strategies must be tailored to fit the population,” Tan said. “A one-size-fits-all framework doesn’t work.”

The findings of both reports also show similarities between the NHPI and LGBTQ communities on a broad range of other smoking-related issues.

High rates of exposure to secondhand smoke and vapor
  • Overall, 67% of NHPI adults in California reported being exposed to secondhand tobacco smoke or vapor at home. Exposure at work was slightly lower, though still high. In Los Angeles, for instance, 73% of NHPI respondents reported exposure at home and 50.9% at work; figures for the Bay Area were similar, with 68.9% reporting at-home exposure and 56.9% reporting workplace exposure. LGBTQ adults saw a comparable trend, but with lower rates: 47.8% were exposed at home, compared with 19.4% at work
Support for smoke- and vape-fee policies 
  • Both NHPI adults (83.2%) and LGBTQ adults (65%) were supportive of smoke- and vape-free policies for housing. However, just 32.4% of LGBTQ respondents felt that public LGBTQ events should be smoke- and vape-free; 46.9% of them said that public events should be free of marijuana smoke.
Banning tobacco sales in the future 
  • A hypothetical policy proposal to ban the sale of tobacco products to anyone born after 2025 was supported by 76% of NHPI adults and 60.8% of LGBTQ adults.
Targeted by tobacco industry advertising 
  • ​When asked if they felt that the tobacco industry was specifically targeting their community in its advertising, 66.4% of NHPI adults said yes, as did 73.4% of LGBTQ adults.
“Historically, public health data for the NHPI and LGBTQ communities have been sparse, and research — on their tobacco use and otherwise — lacking,” Tan said. “Besides the need for more robust NHPI and LGBTQ survey data, our findings show a need to allocate resources towards population-specific cessation programs and for state and local agencies to work with LGBTQ and NHPI communities to adopt tobacco control policies and programs.”

Researchers can complete an application to download the Public Use Files (PUFs) for these studies at no additional cost.​

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.
6/30/2022404
  
Approved6/30/2022 9:59 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopes6/30/2022 3:24 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
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Winning projects provide mental health crises de-escalation and maternal mental health support
After 10 weeks of working with mentors and community partners to turn their health equity ideas into full project proposals, two UCLA students were named the winners of the Health Equity Challenge, a competition presented by the UCLA Center for Health Policy Research and The MolinaCares Accord.

 

Angelica Johnsen and Alma Lopez were selected as the grand prize winners of the inaugural challenge, and their community partners, the Charles R. Drew University of Medicine and Science and SHIELDS for Families, will receive $50,000 each to fund and implement their proposals, which both tackle critical mental health inequities.  

 

“Health equity should never be an afterthought. It is the bedrock of public health. It is both a core value and a responsibility. And it starts right here in local communities,” said Kathryn Kietzman, director of the Health Equity Program at the UCLA Center for Health Policy Research. 

 

Lopez’s proposal will fund a pilot for SHIELDS for Families to evaluate English and Spanish online peer support groups as an intervention for mothers of color with perinatal depression in South LA. 


Johnsen’s proposal will help Charles R. Drew University develop a mental health de-escalation toolkit for medical providers, including students at the university, so that the next generation of health professionals will have the training needed to stabilize patients experiencing a mental health crisis.

“Community safety is a topic rife with political dialogue, yet the question itself is simple: Can we say we love our patients if we are trained, simply, to invoke the threat of violence when they are in crisis? Our health care culture relies heavily on such security measures that have historically harmed patients, especially those in mental health crises,” Johnsen says. “However, I dream for better. I envision a future in which I can tell my patients that they will be safe in my care, knowing definitively that it will be true.”


Step Up, Stand Down: A Mental Health De-Escalation Toolkit for Medical Providers

Despite increasing awareness of mental illness more broadly, mental health crises continue to be stigmatized even in the clinic/hospital setting — occasionally with lethal consequences for patients. Training on crisis de-escalation in the clinic is not addressed throughout the entirety of medical training, leaving medical providers to learn techniques in an on-the-job manner, says Johnsen, a rising fourth-year medical student in the Charles R. Drew/UCLA Medical Education Program.

 

“There are no protocols about stabilizing patients in crisis in the clinic that refocus the opportunity towards health care workers, rather than security presence. Yet, health care professionals are in a unique position to use their therapeutic alliance to heal patients even in these high-acuity situations,” she says. “By implementing both in-person and online educational modules on medical provider de-escalation at the Charles R. Drew University of Medicine and Science, I aim to educate future and current health professionals to de-escalate patients in crisis with empathy and dignity in mind to keep patients safe.”


The outcome of this project, Johnsen says, is that every student who graduates from the Charles R. Drew University School of Nursing, School of Pharmacy, School of Physician Associate Studies and School of Medicine will graduate with basic competency in medical provider de-escalation for patients experiencing mental health crises without resorting to correctional measures. These providers, many of whom go on to serve South Los Angeles, will be prepared to actively manage patients who are in a state of crisis while protecting patient dignity and the sanctity of the patient-provider relationship.

Implementing Peer Support Groups to Reduce Perinatal Depression Symptoms Among South Los Angeles Mothers of Color

 

Maternal mental health conditions, such as perinatal depression during or after pregnancy are common, with up to 1 in 5 mothers being impacted. Among Black mothers, the rate of perinatal depression nearly doubles; and while perinatal depression is treatable, fewer than 15% of diagnosed mothers receive treatment, according to data from 2020 Mom, a national maternal mental health organization.

 

Lopez, a dual degree Doctor of Medicine and Master of Public Policy student at the David Geffen School of Medicine at UCLA and the UCLA Luskin School of Public Affairs and an aspiring OBGYNis committed to addressing disparities in maternal morbidity and mortality, including maternal mental health conditions which disproportionately affect systemically marginalized groups. 

 

Her proposal will bring mothers of color with perinatal depression together for online peer support, which her community partner, SHIELDS for Families, says is a need, given long waitlists for maternal mental health care referrals, especially for Spanish-speaking mothers. 

 

The pilot, Lopez says, will “increase knowledge of maternal mental health conditions among mothers of color, decrease stigma around perinatal depression, reduce perinatal depression symptoms and improve mother-infant bonding among participating mothers and their infants. If successful, this could serve as a model for group interventions to address maternal mental health conditions in other urban communities of color.”

 

Lopez and Johnsen are two of ten finalists in the Health Equity Challenge, supported by The MolinaCares Accord, a Molina Healthcare initiative, which funds meaningful, measurable, innovative programs and solutions that improve health, life, and living where it matters most: in our local communities. 

 

“MolinaCares congratulates the winners and is thrilled to partner with UCLA in selecting this talented set of future health care leaders as they design innovations to reduce health disparities in communities throughout Los Angeles,” said Carolyn Ingram, executive director of The Molina Healthcare Charitable Foundation. 

 

The remaining eight finalists and their projects:

 

Sonya Brooks
“We Are Our Mother’s Gardens: The Impact of Agricultural Sciences on the Mental Health and Well-Being of Inner-City Black Girls” aims to create and curate avenues for access to healthy foods, provide spaces for apprentice-type agricultural practices that curb food insecurities and minimize health disparities, and increase Black girls’ knowledge of food, foodways and food preparation in their schools, homes, and communities.

 

Lei Chen
“The ‘Practice-Research Consensus’ Program to Improve Older Immigrants’ Access to Health and Social Services in the Greater Los Angeles Area” aims to increase the number of older immigrants using social benefits, improve their understanding of these benefit programs, educate Mexican American Opportunity Foundation (MAOF) staff and promotoras about finding and applying research findings and data for their daily work, and improve the services the organization provides for older immigrants.

 

Annalea Forrest
An integrative health platform that aims to decrease health inequities and increase the accessibility, availability and affordability of psychotherapeutic services, trauma informed exercise and nutritional counseling in Los Angeles. The platform connects BIPOC and low-income community members to preventive and integrative care via telehealth, at-home services or on-site with community partners.

 

James Hunh

“Community Open Space: An Intergenerational LGBTQ+ Vietnamese American Community Building Project” is a program to support LGBTQ+ and Vietnamese immigrants and refugees and their loved ones in Orange County by improving their mental health and social well-being through a social support space that encourages communication among different generations to build advocacy, leadership and civic engagement skills.

 

Gwendolyn Lee
“The Whole-Person Obesity and Weight Management (WOW) Program: Nutritional Health and Security, Physical Activity, and Behavioral Health” will create a replicable, sustainable model for a culturally responsive, holistic obesity and weight management program for underserved populations who face significant psychosocial and institutional barriers to health care.

 

Michelle K. Nakphong

A community-level patient education approach to educate immigrant women about their rights to high-quality care and empower them in their own care, and a health care systems audit and feedback approach aimed at designing a quality improvement program within the health care system.

 

Bianca Salvetti
“MyTruMe: Gender Affirming Treatment Interactive Website” is an interactive, web-based decision aid on gender-affirming treatment, with balanced information on treatment benefits, risks, resources and potential long-term effects, to improve knowledge and decisional conflict among transgender and gender-diverse youth and their caregivers.

 

Skye Shodahl
“A culturally-centered prenatal breastfeeding toolkit developed by and for Native Hawaiians and Pacific Islanders in the San Francisco Bay Area using the Ecological Validity Model” to advance breast/chestfeeding equity in Asian American, Native Hawaiian and Pacific Islander (AANHPI) pregnant and lactating parents — an overlooked and understudied population.

 

 

For more information about all the Health Equity Challenge finalists, visit healthequitychallenge.com/finalists.

 

 

---

 

About the UCLA Center for Health Policy Research

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

About The MolinaCares Accord

Established by Molina Healthcare, Inc., The MolinaCares Accord oversees a community investment platform created to improve the health and well-being of disadvantaged populations by funding meaningful, measurable, and innovative programs and solutions that improve health, life, and living in local communities.

About Molina Healthcare of California

Molina Healthcare of California has been providing government-funded care for over 40 years. The Company serves members through Medi-Cal, Medicare, Medicare-Medicaid (Duals) and Covered California (Marketplace). Molina’s service areas include Sacramento, Los Angeles, San Bernardino, Riverside, San Diego, Orange County, and Imperial counties. Through its locally operated health plans, Molina Healthcare, Inc., a FORTUNE 500 company, served approximately 4.8 million members as of September 30, 2021. For more information about Molina Healthcare of California, visit MolinaHealthcare.com. ​​

6/29/2022403
  
Approved6/28/2022 8:52 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopes6/29/2022 10:16 AMNo presence informationi:0#.f|uclachissqlmembershipprovider|venetiaTiffany Lopes; Venetia Laitlopes@ucla.edu; venetialai@ucla.edu310-794-0930; 310-794-6963Venetia Lai; Tiffany Lopesvenetialai@ucla.edu; tlopes@ucla.edu310-794-6963; 310-794-09301682; 10921092; 1682Y; YY; Y
Publication
More than half who aren’t vaccinated are still worried about side effects, report finds
Despite the U.S. Food and Drug Administration's full approval of the COVID-19 vaccine, 58.8% of Californians who are not fully vaccinated are still worried about its side effects, according to a new UCLA survey.

The finding is among the results of the 2022 California Health Interview Survey Preliminary COVID-19 Estimates Dashboard, published today by the UCLA Center for Health Policy Research. 

The survey also found that of Californians who are either unvaccinated or partially vaccinated, 41.0% haven't gotten the vaccine because they believe it was developed too quickly and 30.0% said that they believe the vaccine is unnecessary. 

And of Californians who were not fully vaccinated or had received the vaccine but would not get boosted, 56.1%, said they believe the booster is unnecessary.

The dashboard, which uses data collected from 3,752 households in February and March, includes new insights about Californians’ experiences with long-lasting COVID-19 symptoms, as well as respondents’ reasons for not receiving the vaccine or booster shots, and where they obtained their news about COVID-19. The survey also delved into the personal and financial effects of the pandemic, and whether and how Californians adhered to recommended risk reduction behaviors, such as wearing masks and following guidelines on social gatherings.

“Since the start of the COVID-19 pandemic, the California Health Interview Survey has released survey data early to help show the impact of COVID-19 on Californians,” said Todd Hughes, the survey director. “As mandates, guidelines and concerns have changed over the past two years, we have added new questions to CHIS to provide policymakers, community organizations, advocates and other stakeholders with data they can act on. 

“The dashboard gives us a chance to compare behaviors over time, and to take a look at who is affected by the pandemic, and how, as we venture into its third year.”

Among adults who had tested positive for COVID-19, or who thought they had contracted the disease, 30.9% said they had experienced symptoms for two months or longer, often called long COVID. Of those who have asthma, diabetes or high blood pressure, 38.8% experienced long-lasting symptoms, while 26.4% of people who do not have such conditions had long COVID. The researchers also found that long COVID was more common among lower-income adults. 

The survey suggests that Californians’ sources of news and information about COVID-19 plays a role in whether they decide to follow government officials’ advice about getting booster shots and following safety guidelines. Only 12.1% of California adults turned to government agencies for their COVID-19 information. The most common resources were television (cited by 32.9% of respondents) and social media (19.0%). 

The percentage of unvaccinated adults who said social media was their main source of information was 30.8%, while just 17.9% of fully vaccinated adults said social media was their top source. 

Other highlights:
  • Financial consequences. 16.5% of adults reported a reduction in their work hours or income, 11.9% experienced financial difficulties with basic necessities — including paying bills, tuition and groceries — and 11.2% had lost their jobs due to layoffs, business closures or changes in the market.
  • Racial and ethnic bias. 9.8% of Asian adults reported having been treated unfairly during the pandemic because of their race or ethnicity, compared to 3.0% of all respondents.
  • Mask use. 44.3% of adults with bachelor’s degrees and 48.5% of those with graduate degrees said they always wear a mask when leaving home, compared with 78.7% of adults who have less than a high school education. Mask use also varied by region: 61.6% of Los Angeles County residents said they always wear a face covering, while just 36.5% of adults in the Northern/Sierra region said they do.
  • Large gatherings. 9.4% of adults said they had participated in indoor gatherings with more than 1,000 attendees or outdoor events with more than 10,000 attendees within the past 30 days.
Hughes said he was surprised that the proportion of adults who said they always wear a mask when they leave home is still above 50% statewide, although the figure dropped to 53.5% in the current survey from 58.2% in August 2021.

Some of the dashboard findings are highlighted in an infographic.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health​. For more information, visit healthpolicy.ucla.edu.​
​​
6/23/2022401
  
Approved6/22/2022 5:35 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes6/23/2022 4:10 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
PublicationThe Health, Mental Health, and Social Service Needs of Asian Americans and Pacific Islanders in California2312
Data from the California Health Interview Survey and the American Community Survey highlight diversity and needs of California’s fastest growing population groups
5/5/2022397
  
Approved5/2/2022 2:59 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes5/9/2022 8:08 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
PublicationThe California Malpractice Cap on Noneconomic Losses: Unintended Consequences and Arguments for Reform2285
UCLA-led study finds cap imposed in 1975 may be costing the state Medi-Cal program $245 million a year
A new analysis from UCLA suggests the state’s cap on noneconomic losses in malpractice cases has fallen far behind present-day values, and may even be associated with an increase in malpractice cases over the past five decades.

“The lack of adjustment to reflect inflation or the growth of household incomes is inequitable, because it lowers the real value of the reward — which in current dollars, could be as much as $1.5 million — six times the 1975 value,” said Jack Needleman, PhD, FAAN, the UCLA Fielding School of Public Health’s Fred W. and Pamela K. Wasserman professor and chair of the Department of Health Policy and Management. “The second issue is that the cap, by lowering the risk of suit for malpractice, has also weakened the deterrent effect of risk of being sued on a physician’s efforts to avoid malpractice.”

The policy paper — “The California Malpractice Cap on Noneconomic Losses: Unintended Consequences and Arguments for Reform” — was published today by the UCLA Center for Health Policy Research, where Needleman serves as a faculty associate.

An estimated 250,000 people die annually in United States hospitals due to medical error, and many millions more are harmed. Needleman’s work suggests the cap is actually associated with a significant increase in reported malpractice cases in California.

“The best available research suggests imposing caps is associated with a 16% increase in adverse events,” Needleman said. “Given this, it is likely that the repeal of a cap on noneconomic damages would increase attention to patient safety and lead to reduction of adverse patient events. These changes would be associated with cost savings to payers and patients, and reduced economic and noneconomic damages that improve the life and health of patients.”

Needleman reviewed spending by the state Medi-Cal program associated with a narrow range of potential malpractice cases from “never events,” serious incidents defined by the state as wholly preventable or avoidable. "Never events" include objects left in patients after surgery, mismatched blood transfusions, or hospital-acquired pressure ulcers. In 2018, over a quarter of a million Medi-Cal patients experienced one of these “never events” and the state spent approximately $1.5 billion on these cases.

Many of these costs could be avoided if California’s malpractice cap was lifted or substantially raised. A 16% reduction in adverse events could mean savings to the state as much as $245 million annually, Needleman said. 

The cap was adopted by California at a time of perceived crisis, when state legislators and others believed rising malpractice premiums and risk of lawsuit would encourage physicians to retire from practicing medicine and would raise overall medical costs through defensive medicine. No provision was made for indexing the cap level for inflation or growth in household income.

Between November 1975 and November 2021, the Consumer Price Index (CPI) increased by a factor of 5.03, according to the 
U.S. Bureau of Labor Statistics. If the cap had been adjusted based on CPI to maintain its purchasing power, its current value would be $1.257 million.

Given the cap addresses noneconomic losses, perhaps a better measure of the value of the cap would be the ratio of the cap to household income. In 1975, the cap of $250,000 was 19.5 times the median California household income of $12,778. If the cap had been adjusted to maintain the ratio of value to household income, its current value would be $1.5 million.

“That is six times the difference,” Needleman said. “In effect, someone who suffered in a malpractice case in the 1970s received much, much more in compensation, in a relative sense, than someone suffering the same injury today.”

The key argument for a cap on malpractice awards is that the caps lower malpractice risk and premiums. The lower premiums and lower risk reduce practice costs, reduce the incentive for defensive medicine such as unneeded diagnostic testing — which increases overall health care costs — and reduce the incentive for physicians to leave practice.

“Imposing a cap on awards also reduces the incentive to avoid malpractice,” Needleman said. “If the incentive to reduce malpractice is weakened, and malpractice rates increase, this raises the potential costs to patients and insurers, as well as increasing potential noneconomic losses for patients.”

Assessing the magnitude and impact of the loss of deterrence associated with a cap or other tort reforms is challenging. Malpractice, while economically and personally significant to the families experiencing it, is rare, and records in the United States are often limited by states.

However, Needleman said the most detailed research suggests state adoption of caps on noneconomic damages in medical malpractice lawsuits is associated with higher rates of preventable adverse patient safety events in hospitals, estimated as a 16% increase in these adverse events. 

“The economic and noneconomic losses for patients and their families from malpractice can be significant,” Needleman said. “Beyond these, there are substantial costs to the state in Medi-Cal and medical payment for state and local government employees that would be reduced by raising or eliminating the cap on noneconomic losses in malpractice.”

Methods: The inflationary element of this analysis is based on federal and state records, including from the California Legislative Analyst's Office, the United States Bureau of Labor Statistics, and the United States Census Bureau. The estimated costs and savings elements are derived from study of some 40 datasets, going back to 1991, and from across the United States, with statistical analysis to determine the potential benefits in California.

Funding: There was no external funding for this study.

Data availability statement: The data presented in this policy paper are available from the state of California Medi-Cal program.

Citation: Needleman J. 2022. The California Malpractice Cap on Noneconomic Losses: Unintended Consequences and Arguments for Reform. Los Angeles, CA: UCLA Center for Health Policy Research.


Contact:

Brad Smith

bssmith@support.ucla.edu

(424) 832-6408​  ​
5/5/2022400
  
Approved5/4/2022 5:44 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes5/5/2022 1:03 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
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Finalists will develop proposals to address a health equity issue in California and two organizations will be awarded $50,000

The UCLA Center for Health Policy Research (CHPR) and MolinaCares today named the 10 finalists in the inaugural Health Equity Challenge, a competition that provides UCLA graduate students the opportunity to respond to a health equity issue in California. The 10 finalists will turn their ideas into full proposals that a community-based organization can implement, and two community organizations will be awarded up to $50,000 each in funding to implement the project.

 

Selected projects include direct interventions and program development, and range from an app on gender-affirming treatment for transgender and gender diverse youth, to a de-escalation toolkit for medical providers working with patients who are experiencing a mental health crisis, to an intervention aimed at improving the quality of maternal care for immigrant women.

 

“We asked UCLA graduate students for ideas to improve health equity in California and they really delivered,” said Kathryn Kietzman, PhD, project lead and director of the UCLA CHPR Health Equity Program. “There were so many impressive submissions showing true innovation, passion, and leadership. These proposals all have the potential to have a tangible impact on communities who face significant inequities: LGBTQ+ people, Native Hawaiians and Pacific Islanders, immigrants, older adults, Black girls, and many more.”

 

“As an aspiring OBGYN, I am interested in addressing disparities in maternal morbidity and mortality, including maternal mental health conditions which disproportionately affect systemically marginalized groups,” said Alma Lopez, a Health Equity Challenge finalist and MD and Master of Public Policy dual degree student at the David Geffen School of Medicine at UCLA and UCLA Luskin School of Public Affairs. “I hope that through the Health Equity Challenge, we can help address maternal mental health inequities among Los Angeles communities of color and low socioeconomic status, and bridge access gaps to compassionate quality care.”

 

Each student finalist will be awarded $2,500 and paired with a mentor to develop a full project proposal over the next 10 weeks and identify a community partner to partner with. At the end of the project, an independent review committee will review the final proposals: two winners will be announced and their selected community organizations will receive up to $50,000 each to implement the proposal. The two winning students will receive an additional $2,500 and to continue to document the impact of the project’s implementation.

 

The 10 finalists are:

 

Sonya Brooks

PhD in Urban Schooling, UCLA Graduate School of Education

Project: Create convivial spaces for Black girls and their mothers/caregivers to cook and share intergenerational narratives, navigating through spaces of healing, health, and advocating for their unmet needs.

Mentor: Dr. Keith C. Norris, MD, PhD, Professor of Medicine, David Geffen School of Medicine at UCLA

 

Lei Chen

PhD in Social Welfare, UCLA Luskin School of Public Affairs

Project: Develop a “Research-Practice Consensus” program to connect researchers and community organizations working with older immigrant adults to bridge the gap in health care and social services and build trust and solidarity with each other.

Mentor: Dr. Keith C. Norris, MD, PhD, Professor of Medicine, David Geffen School of Medicine at UCLA

 

Annalea Forrest

Master of Social Welfare and Master of Public Health, UCLA Luskin School of Public Affairs and UCLA Fielding School of Public Health

Project: Develop an integrative health platform to increase the accessibility, availability, and affordability of psychotherapeutic services, trauma informed exercise, and nutritional counseling for BIPOC and low-income communities in Los Angeles.

Mentor: Dr. Rashmi Mullur, MD, Endocrinologist, UCLA Health

 

James Huỳnh

PhD in Community Health Sciences, UCLA Fielding School of Public Health

Project: Develop an Intergenerational LGBTQ+ Community Space to bridge the social gap between different generations of Vietnamese, Latinx, and Black immigrants, refugees, and their children.

Mentor: Ilan H. Meyer, PhD, Distinguished Senior Scholar for Public Policy, Williams Institute, UCLA School of Law

 

Angelica Johnsen

Doctor of Medicine, Charles R. Drew/UCLA Medical Education Program

Project: Develop a de-escalation toolkit for medical providers working with patients who are experiencing a mental health crisis, providing guidance on de-escalating high-acuity mental health crises and stabilizing patients who are in distress, without correctional measures, such as incarceration, chemical, or physical restraints.

Mentor: Dr. O. Kenrik Duru, MD, Professor of Medicine, David Geffen School of Medicine at UCLA

 

Gwendolyn Lee

Doctor of Medicine, David Geffen School of Medicine at UCLA

Project: Create an obesity and weight management program for adults who obtain health care at Los Angeles County safety net hospitals.

Mentor: Dr. Michael Garcia, MD, Assistant Professor of Medicine, David Geffen School of Medicine at UCLA

 

Alma Lopez

MD and Master of Public Policy dual degree, David Geffen School of Medicine at UCLA and UCLA Luskin School of Public Affairs

Project: Work with community clinics to address gaps and disparities in maternal mental health, including developing a series of workshops for pregnant and recently pregnant women for education on peripartum mental health and recognition of symptoms.

Mentor: Dr. Michael Ong, MD PhD, Professor in Residence of Medicine and Health Policy and Management, David Geffen School of Medicine at UCLA and UCLA Fielding School of Public Health

 

Michelle Kao Nakphong

PhD in Community Health Sciences, UCLA Fielding School of Public Health

Project: Develop a community-level patient education approach to educate immigrant women about their rights to high-quality care and empower them in their own care, and a health care systems audit and feedback approach aimed at designing a quality improvement program within the health care system.

Mentor: Dr. Candace Gragnani, MD, Associate Physician Diplomate, David Geffen School of Medicine at UCLA

 

Bianca Salvetti

Doctor of Nursing Practice student, UCLA School of Nursing

Project: Implement an educational app with information on gender-affirming treatment — benefits, risks, resources, and potential long-term effects — to improve knowledge and decisional conflict amongst transgender and gender diverse youth and their caregivers.

Mentor: Dr. Erin Baroni, MD, Clinical Instructor of Internal Medicine and Pediatrics, David Geffen School of Medicine at UCLA

 

Skye Shodahl

PhD in Community Health Sciences, UCLA Fielding School of Public Health

Project: Advance breast/chestfeeding equity in Asian American, Native Hawaiian, and Pacific Islander (AANHPI) pregnant and lactating parents, through the development of a culturally tailored and linguistically relevant breast/chestfeeding toolkit for providers to share with share with this overlooked and understudied population.

Mentor: May Wang, DrPh, Professor, UCLA Fielding School of Public Health

 

“Assuring equitable care for diverse populations is a challenge for us all nationally, but even more so in California,” said Carolyn Ingram, executive director of The Molina Healthcare Charitable Foundation. “That’s why I am so thrilled that MolinaCares has been able to partner with UCLA in selecting this set of future health care leaders as they design innovations to reduce disparities in communities across the Los Angeles area.”

 

Read more about the finalists on the Health Equity Challenge website.


 


About the UCLA Center for Health Policy Research

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.


About The MolinaCares Accord

Established by Molina Healthcare, Inc., The MolinaCares Accord oversees a community investment platform created to improve the health and well-being of disadvantaged populations by funding meaningful, measurable, and innovative programs and solutions that improve health, life, and living in local communities.


About Molina Healthcare of California

Molina Healthcare of California has been providing government-funded care for over 40 years. The Company serves members through Medi-Cal, Medicare, Medicare-Medicaid (Duals) and Covered California (Marketplace). Molina’s service areas include Sacramento, Los Angeles, San Bernardino, Riverside, San Diego, Orange County, and Imperial counties. Through its locally operated health plans, Molina Healthcare, Inc., a FORTUNE 500 company, served approximately 4.8 million members as of September 30, 2021. For more information about Molina Healthcare of California, visit MolinaHealthcare.com

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5/4/2022398
  
Approved5/4/2022 2:12 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes5/4/2022 6:13 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesVenetia Laivenetialai@ucla.edu310-794-6963Tiffany Lopestlopes@ucla.edu310-794-093010921682YY
PublicationFinal Summative Evaluation of California’s Public Hospital Redesign and Incentives in Medi-Cal (PRIME) Program2274
Decreased use of emergency department visits and hospitalizations and slower growth in estimated Medi-Cal payments found for patients of public hospitals compared with patients of other hospitals.

Researchers at the UCLA Center for Health Policy Research (CHPR) have released findings from the Final Summative Evaluation of California’s Public Hospital Redesign and Incentives in Medi-Cal (PRIME) Program.

 

The report, led by Nadereh Pourat, PhD, associate center director and director of the Health Economics and Evaluation Research (HEER) Program at UCLA CHPR, provides a final assessment of the five-year program’s impact on health outcomes, utilization of services, and Medi-Cal payments. Prior reports, such as the Interim Evaluation of PRIME report, described detailed information on the program’s implementation and hospital-reported performance metrics.

 

PRIME was implemented by 54 public hospitals in California, including 17 designated public hospitals (DPHs) and 35 district and municipal hospitals (DMPHs), to improve care delivery, cultural competence, patient health outcomes, and to move public hospitals towards value-based care. 

 

The UCLA CHPR research team conducted the PRIME evaluation, along with the California Medicaid Section 1115 Waiver Whole Person Care (WPC) Program and other innovative Medi-Cal programs such as the Health Homes Program (HHP).

 

The report findings show that PRIME hospitals had: 

  • Reduced hospitalizations (2.33 fewer per 1,000 patients per year among DPHs) and emergency department visits (6.32 fewer among DPHs; 15.36 among DMPHs) for PRIME patients compared with patients of other providers.
  • Reduced Medi-Cal payments per person per year ($836 among DMPH; $865 among DPHs). 
  • Used innovative approaches and modifications to implement PRIME projects, mitigating COVID-19 pandemic disruptions. 
  • Improved public hospitals’ ability to participate in managed care value-based payments.  


"The findings of this evaluation highlight the importance of federal funding for initiating and promoting progress in quality improvement projects," Pourat said. "They can be used to inform federal and state Medicaid policies to promote better care, better health, and lower costs."

 

The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is affiliated with the UCLA Fielding School of Public Health​.​

 

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5/4/2022399
  
Approved5/4/2022 5:00 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes5/10/2022 11:45 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
Presenters to share how CHIS is advancing inclusion and equity through data collection, measurement and community
The UCLA Center for Health Policy Research’s California Health Interview Survey (CHIS) will be featured at the 77th Annual American Association for Public Opinion Research (AAPOR) Conference on May 11–13 in Chicago. 

 

The premier forum for the exchange of advances in public opinion and survey research, the AAPOR Conference will bring more than 1,200 experts together to learn about the latest updates and trends in the field and discuss how data collection and measurement can advance inclusion and equity. 

 

For more than 20 years, CHIS has served as a critical source of data on Californians, interviewing more than 20,000 households each year to provide a detailed picture of the health and health care needs of California’s large and diverse population. 

 

From using a population health survey to capture instances and effects of racial discrimination due to COVID-19, to adapting sampling and data collection to better include underrepresented and underserved communities, CHIS staff will present seven sessions during AAPOR:

 

Wednesday, May 11


Using a Combination of Probability and Nonprobability Sampling Strategies for NHPI and LGBTQ Health Studies
12:45–2:15 p.m. Central Time (CT)
Authors: Todd Hughes, Royce Park (presenter), Sean Tan, Ninez A. Ponce, Margie Engle-Bauer (SSRS)

Too Protective to Grant Permission? Understanding Factors Impacting Parental Permission in Surveying Adolescents 
3:45–4:30 p.m. CT
Authors: Jiangzhou Fu (presenter), Todd Hughes, Royce Park, Ninez A. Ponce


Thursday, May 12


How the California Health Interview Survey Adapts Sampling and Data Collection to Better Include Underrepresented and Underserved Populations
8–9:30 a.m. CT
Authors: Royce Park (presenter), Todd Hughes, Jiangzhou Fu, Ninez A. Ponce, Susan Sherr (SSRS)

Understanding the Impact of Enhanced Weighting Tools on Key Health Survey Indicators in the California Health Interview Survey
8–9:30 a.m. CT
Authors: Jiangzhou Fu (presenter), Todd Hughes, Royce Park, YuChing Yang, Ninez A. Ponce, Arina Goyle (SSRS)

Applying Modern Machine Algorithms in Income Imputation of Survey Data
3:45–5:15 p.m. CT
Authors: Zheyu Jiang (presenter), YuChing Yang, Todd Hughes, Royce Park, Ninez A. Ponce


Friday, May 13


Using Race Data Upcoding to Advance Equity and Data Disaggregation: Reporting Multi-Racial Identities and Increased Granularity of Racial/Ethnic Origins
10:15–11:45 a.m. CT
Authors: Andrew Juhnke, Parneet Ghuman (presenter), Jiyoun Yoo

Discrimination and Disparities in Mental Health Outcomes: Using a Population Health Survey to Capture Instances and Effects of Racial Discrimination
1:15–2:45 p.m. CT
Authors: Todd Hughes, Sean Tan, Ninez A. Ponce, Kathy Langdale (SSRS), Royce Park (presenter)​

View a PDF of all presentations.


The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR is the home of the California Health Interview Survey (CHIS), the nation’s largest state health survey, and is affiliated with the UCLA Fielding School of Public Health​.​

 

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5/2/2022263
  
Approved12/14/2016 12:57 PMi:0#.f|uclachissqlmembershipprovider|celeste6/2/2022 5:44 PMi:0#.f|uclachissqlmembershipprovider|celesteTiffany Lopestlopes@ucla.eduUCLA Center for Health Policy Research310-794-09301682Y
Publication
The Center is pleased to host leading health policy experts at our
monthly seminar series. 

Health Policy Seminar on Wednesday, May 18, 2022 

ExperiencesofExclusion-webinar-may182022-425x239-image.jpg

"Experiences of Exclusion: How Policy Shapes the Lives of Latinx and Asian Immigrants"

Public charge. Discrimination in the workplace. Experiences with law enforcement. 

How are Latinx and Asian immigrants in California faring under state and federal policies?

The RIGHTS (Research on Immigrant Health and State Policy) Study was developed by the UCLA Center for Health Policy Research (CHPR) to understand the experiences of Asian and Latinx immigrants in California as they seek health care, go to work and school, and engage in their communities. Join RIGHTS investigators as they share their findings from four studies on Asian and Latinx immigrants’ experiences with a range of public policies that influence health — from health care to labor protections to immigration enforcement. Presenters will discuss how the intersecting experiences of policies are a critical social determinant of health for Asian and Latinx immigrants.

What: "Experiences of Exclusion: How Policy Shapes the Lives of Latinx and Asian Immigrants"
Date: Wednesday, May 18, 2022
Time: Noon to 1 p.m. PT ​
Watch the webinar:

**As a safety precaution due to the COVID-19 pandemic,
seminars are held exclusively online.** 

Previous seminars

Monday, February 28, 2022: "Gaps in Health Care Access Among LGBT Adults in California"

California is home to more than 2 million lesbian, gay, bisexual, and transgender (LGBT) adults, who experience many of the same challenges and barriers to accessing health care as straight and cisgender adults, including lack of insurance and poverty.

However, research shows that LGBT populations are more likely to be uninsured, to be living in poverty, and to have disabilities that may impact access to health care. Sexual and gender minorities also have unique barriers to health care that include experiences of discrimination, lack of competent providers, and barriers to gender-affirming health care.

 A new study from the UCLA Center for Health Policy Research (CHPR) and Williams Institute is taking a closer look at differences in health insurance coverage and health care access by sexual orientation and gender identity, revealing significant disparities within the LGBT community.

Using data from the California Health Interview Survey (CHIS), authors found that although lesbian, gay, and bisexual adults had similar or better rates of insurance coverage compared to straight women and men, they were more likely to experience barriers in accessing health care, particularly delays in getting needed health care and experiencing unfair treatment when getting medical care. Transgender adults had higher rates of public insurance coverage than cisgender adults but were not more likely to lack health insurance. However, transgender adults were more likely to experience a number of barriers to care, including being less likely to have preventive care visits, being more likely to have difficulty finding primary or specialty care providers, and being more likely to experience delays in getting needed health care.

Join UCLA CHPR Senior Research Scientist and Chronic Disease Program Co-Director Susan H. Babey, PhD, and the Williams Institute's Senior Scholar of Public Policy Jody L. Herman, PhD, and Senior Scholar of Public Policy Bianca D.M. Wilson, PhD, as they share their findings and discuss some of the LGBT community's unique barriers to care, as well as the need to identify health care and structural interventions that will improve access to care for sexual and gender minorities. View recording of the seminar.


Wednesday, December 1, 2021: "Who Is Caring? How Are They Faring? A Look at Family and Friend Caregivers in California"

In 2020, there were an estimated 6.7 million people who were family and friend caregivers in California alone. Nearly 1 in 4 provided 20 or more hours of care to a family member or friend with a serious or chronic illness or disability in a typical week and yet only 1 in 12 reported having been paid for any of these caregiving hours. Statewide population-level data that captures the experience and consequences of caregiving is limited. Using data from the 2020 California Health Interview Survey (CHIS), researchers at the UCLA Center for Health Policy Research (CHPR) shed light on caregivers’ demographic profiles, financial concerns, and physical and mental health issues. 

Led by Kathryn Kietzman, PhD, director of the Health Disparities Program and senior research scientist at UCLA CHPR, and Sean Tan, MPP, senior public administration analyst at UCLA CHPR, the webinar will highlight the role of caregivers as the backbone of the long-term care system. Researchers will walk through findings of their new policy brief, sharing demographic profiles of California caregivers, as well as characteristics of individuals they are providing care to. The presentation will also unveil the hidden costs of caregiving, for instance, the hours associated with caregiving, much of which are not financially compensated for, as well as missed opportunities for educational or career advancement. Researchers will highlight the financial and physical and mental health toll that caregivers experience as well as the disparities that exist across these health factors.

In addition to outlining the financial, physical, mental, and emotional factors associated with caregiving, researchers will discuss some of California’s policies that support caregivers and propose different policy recommendations or solutions to improve conditions for family caregivers who are providing vital, life-supporting care. These proposed solutions may be used by policymakers, program creators, and other community-support organizations in order to address issues of caregivers across California. View recording of the seminar. 

Wednesday, September 22, 2021: "California Health Interview Survey (CHIS) 2020 Data Release"

The COVID-19 pandemic. Racial injustice and inequality. A national election, a divided nation. 2020 was a year of unprecedented challenges and change, but how big of an impact did it have on the lives and health of Californians? Join the UCLA Center for Health Policy Research (CHPR) on Wednesday, September 22, 2021, as we release comprehensive findings from the 2020 California Health Interview Survey (CHIS).

For the last two decades, UCLA CHPR has produced the CHIS, which collects information from more than 20,000 Californians on a wide range of health topics — from health conditions to health care access, mental health to health status and behaviors, and many more topics across various sociodemographic factors such as race and ethnicity, gender, age, and income — to provide a detailed picture of the health and health care needs of California’s large and diverse population. 

As the pandemic began, CHIS quickly adapted to add a series of COVID-19 questions to better understand how COVID-19 has affected the diverse health care needs of the 39.5 million people who live in California. From COVID-19 as a barrier to care, to the impact of the pandemic on binge-drinking and smoking, to race/ethnicity and mental health distress, plus much more, we will highlight data on a broad range of topics to help policymakers, health departments, community advocates, researchers, and others identify needs in the state and in their communities and improve the health and well-being of adults and youth across California. 

On September 22, 2021, the UCLA CHPR will release comprehensive findings from the 2020 California Health Interview Survey (CHIS). Ninez A. Ponce, PhD, MPP, UCLA CHPR director and CHIS principal investigator, and Todd Hughes, CHIS director, will discuss key data from the 2020 survey. Sean Tan, MPP, senior public administration analyst, will share findings from a policy brief that looks at health care access and the challenges faced by various racial and ethnic groups, older adults, and other at-risk communities.

These comprehensive findings will build on CHIS’ preliminary COVID-19 estimates, which provided early monthly data on COVID-19 treatment and vaccine acceptability, personal and financial impacts of the pandemic, and conflict in the household during stay-at-home orders, easily filtered by numerous demographic and socioeconomic characteristics and health risk factors. For the first time in history, these data were released more than a year in advance of the full CHIS to provide timely data to aid in the state’s response to COVID-19. Data have been featured in various news media, including NBC, CBS, FOX, the Los Angeles Daily News, KCRW, and much more.  

As the largest state health survey in the nation, policymakers, legislators, local health departments, community organizations, researchers, health experts, members of the media, and others depend on CHIS for credible and comprehensive data on the health of Californians. View recording of the seminar. View speakers' slide presentation.

Monday, June 21, 2021: "Disparities in Oral Health and Access of Low-Income Californians"

Oral health plays a vital role in overall health status and has been linked to chronic conditions such as diabetes and heart disease, yet it is often overlooked as a critical health issue. For Californians who have low incomes, access to care is a challenge. Education, where people live, race/ethnicity, age, English language proficiency, immigration status, and other determinants of oral health can play a significant role in oral health status, according to recent studies by the UCLA Center for Health Policy Research (CHPR).

On Monday, June 21, Nadereh Pourat, PhD, UCLA CHPR associate director and director of the Health Economics and Evaluation Research Program, walked through findings from several studies she conducted on factors that contribute to or improve disparities in oral health status and access to dental care.

For example, a third of the 39.5 million people living in California have low incomes, and face continued challenges in accessing oral health care. A high proportion ─ 39% ─ reported having fair or poor oral health status and 41% reported not having visited the dentist in the past year, according to one of the studies that uses 2019 California Health Interview Survey (CHIS) data. A heightened demand for services and a short supply of dentists who see Medi-Cal patients also play a role in why low-income California adults are having difficulties in meeting their dental care needs.

A professor at the UCLA Fielding School of Public Health, Pourat highlighted several policy recommendations on policies that can improve access to dental care and improve oral health outcomes for California’s most disadvantaged communities. These include promoting the availability of affordable dental insurance options, including dental care as an essential health benefit, advancing policies to fund services for Medi-Cal related treatments, expanding on pipeline education programs to attract a workforce to serve in low-income neighborhoods, and more. View recording of the seminar.

April 28, 2021: "Breaking Down Barriers Faced by Metastatic Breast Cancer Patients"

Each year, thousands of patients across the United States are diagnosed with metastatic breast cancer (MBC), or breast cancer that has spread to a different part of the body. In 2019, 30,650 individuals were diagnosed with breast cancer and 4,620 died from the disease in California alone. Metastatic breast cancer is the cause of nearly all these deaths.On Wednesday, April 28, researchers from the UCLA Center for Health Policy Research (CHPR) and UCLA Jonsson Comprehensive Cancer Center (JCCC) shared findings from a study they conducted that looks at barriers to metastatic breast cancer care in California.AJ Scheitler, EdD, director of stakeholder relations at UCLA CHPR, and Beth Glenn, PhD, co-director for community outreach and engagement at UCLA JCCC, presented on three crucial aspects ─ referrals to clinical trials, removing hurdles in health insurance requirements, and access to palliative care ─ and propose possible solutions for system or policy changes that can improve care for metastatic breast cancer patients.The study, which was conducted in early 2020, collected insights from several sources, including patients, caregivers, research, and a social media Twitter chat, covering a variety of perspectives on the barriers that women face as well as potential solutions to improve care. Interview responses and narrative data led to the discovery of barriers, from high costs of care to lack of support services. View recording of the seminar.

Mar. 24, 2021: "The Impact of the ACA on Cancer Detection Among Older Adults"

Srikanth Kadiyala, PhD, senior economist at UCLA CHPR, shared findings of a study published in Health Affairs on the effects of the ACA on health care use and outcomes, looking specifically at older adults near age 65 and cancer detection rates among this group. 

Using cancer registry data from 2010 to 2016, Kadiyala and his co-authors Fabian Duarte, PhD, associate professor of economics at the University of Chile; Gerald Kominski, PhD, senior fellow at UCLA CHPR; and Antonia Riveros, a graduate student at the University of Chile, found that the ACA reduced the cancer detection spike occurring at age 65 by 45%. More than two-thirds of the newly detected cancers were at the early or middle stages, implying substantial potential for positive health benefits.

Kadiyala will walk through factors, such as how the expansion of Medicaid, private insurance benefits, availability of more affordable individual insurance plans offered in the ACA marketplace, and Medicare had a large positive impact on disease detection. The study builds on research on the older adult population, a group that has not been widely studied when looking at ACA impact, as ACA-related research studies have largely focused on the younger adult, Medicaid population, according to Kadiyala.

His talk will highlight the implications of conducting more research on this near-elderly population, which may guide policies to improve health care and outcomes for this group, as well as the overall key role that health insurance has on disease detection. View recording of the seminar.

Feb. 17, 2021: "The Urban Spatial Structure and Pandemic Inequalities"

More than 1 million Angelenos have been infected with COVID-19, and more than 4 out of 5 of those cases have been racial and ethnic minorities. But, how can we pinpoint the populations most at risk? Can knowledge of underlying spatial structure, factors, and processes, help us prioritize health services and resources, including vaccines, to the most at-risk populations?

Paul Ong, PhD, director of the UCLA Center for Neighborhood Knowledge, has taken an empirical, quantitative approach, and shares his recent studies, which look at available pre-pandemic analytical tools used by public agencies such as the Centers for Disease Control and Prevention and the Health Resources and Services Administration, along with a measure created by UCLA. The tools, he found, have had limited precision, accuracy, and consistency in identifying the residential spaces of disadvantaged racial and ethnic groups, particularly smaller Asian subgroups. 

Ong discussed the critical and immediate need to develop better methodological approaches to better allocate COVID-19 support and other vital resources to the communities most at-risk. View recording of the seminar.  

Jan. 27, 2021: "Youth in Distress: Structural, Social Factors Related to Mental Health of California Adolescents"

D. Imelda Padilla-Frausto, PhD, MPH, a research scientist at the UCLA Center for Health Policy Research; Blanche Wright, MA, a doctoral candidate in the UCLA Psychology Department; and Dr. Ann Crawford-Roberts, a resident physician at UCLA, discussed their new policy brief which found that nearly 1 in 3 California adolescents reported having serious psychological distress and 1 in 7 reported experiencing moderate psychological distress in 2019. Psychological distress, measured by the number and frequency of symptoms reported in the past year, may interfere with adolescents’ social, educational, and occupational functioning and require treatment. View recording of the seminar. 

Nov. 16, 2020: "Overcoming Invisibility: Better Health Data for American Indians and Alaska Natives"

An estimated 5.7 million American Indians and Alaska Natives (AIAN) live in the United States, but they are often underrepresented and even invisible in publicly-accessible health data and research, making it nearly impossible to know what services are needed to improve their health. View a recording of the seminar.

UCLA CHPR Senior Public Administration Analyst Tara Becker, PhD, and Senior Research Scientist Riti Shimkhada, PhD, shared findings from their policy brief (co-authored by Susan H. Babey, PhD; AJ Scheitler, EdD; and Ninez A. Ponce, MPP, PhD) which examined AIAN data availability and the variations in estimates due to differences in coding and tabulating from eight large population health surveys. Becker and Shimkhada will discuss implications of the limited accessibility of AIAN information in population datasets and provide recommendations that may help improve availability of health information and our understanding of disparities within the American Indian and Alaska Native population.
View a recording of the seminar. 


Oct. 29, 2020: 
"California Health Interview Survey (CHIS) 2019 Release"

UCLA CHPR unveiled the findings of the 2019 California Health Interview Survey which are vital for stakeholders to consider in order to improve the health and well-being of adults and youth across California. Ninez A. Ponce PhD, MPP, UCLA CHPR director and CHIS principal investigator, and Todd Hughes, CHIS director, discuss findings from the 2019 survey and share data from brand new questions on sex without consent, public program participation, caregiving, social media use and mental health, and suicide ideation among veterans, and share sampling and data collection redesign. Susan H. Babey, PhD, UCLA CHPR senior research scientist and co-director of the Chronic Disease Program, provide a special look at voter participation findings across the state in advance of the presidential election. View a recording of the seminar. 

Sept. 30, 2020: "California Elder Index 2019 Release: Basic Economic Needs of Older Adults and Profile of Those Struggling to Make Ends Meet"

According to the California Elder Economic Security Standard™ Index (CA Elder Index), older adults in California, on average, need two times the FPL amount  single elders who rent have an economic need of $27,816 for a basic and decent standard of living. The CA Elder Index uses publicly available data on the actual cost of basic living expenses for housing, health care, food, and transportation. It was developed to provide an evidence-based indicator of the actual basic costs faced by older adults ages 65 and over. D. Imelda Padilla-Frausto, PhD, MPH, UCLA CHPR research scientist, and Steven P. Wallace, PhD, UCLA CHPR Associate Center Director, discuss the release the 2019 California Elder Index and trends in the basic cost of living for older adults from 2013 to 2019; uncover the hidden poor  older adults with income above the FPL but not enough income to meet their basic needs; identify gender, racial, and ethnic inequities; and discuss the implications for older adults during COVID-19. This webinar is co-sponsored by the Metta Fund, a private foundation dedicated to advancing the health and wellness of San Francisco's older adult population. View a recording of the seminar.


Aug. 27, 2020: "Hidden No More: Unmasking Data for Health Equity"

So how does a group which has often been masked by a lack of meaningful data become unhidden? The brand-new Native Hawaiian and Pacific Islander (NHPI) COVID-19 Data Policy Lab at the UCLA Center for Health Policy Research (CHPR) is looking to do just that — by revealing targeted data for NHPIs across the nation in order to better deploy resources and other actions to help the disproportionately affected population. UCLA Director Ninez Ponce and scholars from the NHPI COVID-19 Data Policy Lab — Richard Calvin Chang, Corina Penaia, Karla Thomas, Vananh Tran, John Greer, and Nicholas Pierson — discuss findings and data used in testimony before the U.S. House of Representatives Ways and Means Committee, featured in news media, and a Health Affairs blog. This webinar is co-sponsored by the National Pacific Islander COVID-19 Response Team, the Southern California Pacific Islander COVID-19 Response Team, the UCLA Asian American Studies Center, and Asian American and Pacific Islander Civic Engagement Fund, a project of NEO Philanthropy, Inc. View a recording of the seminar.

July 16, 2020: "Combining Traditional Modeling with Machine Learning for Predicting COVID-19"

Global COVID-19 cases surpassed 10 million in late June, with the death toll exceeding half a million people. Here in the U.S., many states have rolled back reopening plans as cases shattered record highs. So what comes next? The recent surge in COVID-19 cases and deaths has prompted an even greater need to understand the disease and its spread among communities in California and throughout the nation, with health care experts, academic centers, researchers, and other agencies using models to help forecast case and death rates, and ultimately identify hot spots and the need for targeted resources in those areas. While most use either SEIR models (compartmental model), curve fitting, or machine learning to model COVID cases and deathsChristina Ramirez, Professor of Biostatistics at the UCLA Fielding School of Public Health, and her colleagues have combined all three techniques into a single comprehensive model to forecast the total number of COVID-19 cases and deaths across the nation.

 

Dr. Ramirez shared her groundbreaking, comprehensive model that combined traditional SEIR models with case velocity and machine learning to get precise, reliable estimates of COVID-19 case and death rates — shining a light on whether the pandemic is gaining speed and if deaths are accelerating or stabilizing. This project also uses the UCLA Center for Health Policy Research’s California Health Interview Survey (CHIS) to obtain an accurate snapshot of California data so that morbidity and mortality rates are based on the known prevalence of sociodemographic factors such as age, race, and co-morbidities or underlying health conditions. View a recording of the seminar.


June 29, 2020: "Pride and Pandemic: Vulnerabilities to COVID-19 Among LGBT Adults in California"

Two reports produced by the Williams Institute at the UCLA School of Law extract data from the UCLA Center for Health Policy Research’s California Health Interview Survey (CHIS), where researchers found that LGBT adults in California are significantly at risk for health and economic harm due to COVID-19. Among those risks, more than 200,00 LGBT people in California have one or more high-risk medical conditions including asthma, diabetes, heart disease, or HIV; 612,000 were living below 200% of the federal poverty level prior to the pandemic; and 134,000 do not have health insurance. Additional health factors include problems paying for medical bills and delaying or forgoing care because of cost or lack of insurance, and economic risks are related to factors such as poverty level, race/ethnicity, gender identity, housing, food security, and employment status.

Kathryn O’Neill, lead report author and policy fellow and analyst at the Williams Institute, shared key report findings that describe the characteristics of the LGBT community in California with an emphasis on those factors which increase vulnerability to harm from the COVID-19 pandemic. View a recording of the seminar.

May 20, 2020: "Health at Risk: Policies Are Needed to End Cigarette, Marijuana, and E-cigarette Secondhand Smoke in Multi-Unit Housing in Los Angeles"

Peggy Toy, director of the Health DATA Program, and Catherine Yount, public policy analyst, shared findings from their study, which highlighted the high level of secondhand smoke in multi-unit housing and gaps in existing voluntary smoke-free policies. Despite an increasing number of smoke-free local laws in the last 10 years, the proportion of Californians reporting exposure to secondhand smoke from tobacco, marijuana, and e-cigarette vapor continues to rise. Residents of market-rate, privately-owned multi-unit housing (e.g., apartments) are particularly at risk of drifting secondhand smoke. In a 2019 study conducted by the UCLA Center for Health Policy Research (CHPR) that included 4,800 tenants and 176 multi-unit housing owners in the City of Los Angeles, 49% of tenants reported exposure to drifting secondhand smoke, including tobacco (39%), marijuana (36%), and e-cigarette (9%). Presenters will discuss the need for a consistent implementation and enforcement plan to prevent exposure to secondhand smoke for all Los Angeles residents. Find the recorded video here.

Mar. 26, 2020: “Census Undercount of Latino Immigrants: Impact on Health and Socials Programs in Los Angeles

Steven P. Wallace, Associate Center Director at the UCLA Center for Health Policy Research, presented findings of a study he conducted with colleagues that looked at funding at risk in Los Angeles County (LAC) for health care and social services. They also did an analysis of services that could be lost if Latinos are undercod in the census. Wallace will discuss the projected funding loss for critical services in LA County, such as the Supplemental Nutrition Assistance Program (SNAP), Housing Choice Voucher Program (Section 8), Head Start early childhood education program, and the Health Center Program, if there is a 2%, 5%, or 10% undercount of Latinos. The study found that a worst-case scenario (10% undercount) would result in missing about 466,000 people in the census count and losing $221 million in federal funding. He will discuss the overall implications of a census undercount on critical programs and services for the county's underserved and underrepresented groups. Find the recorded video here.

Feb. 19, 2020: “Addressing the Aging Population and the Needs of Older Adults

Ritu Sadana, senior health adviser at the World Health Organization (WHO), shared how the WHO negotiated its first global strategy and action plan on ageing and health (2016–2020)She also discussed its extension, a proposal for a Decade of Healthy Ageing (2020–2030) that will be considered by the upcoming World Health Assembly in May 2020, aligned with the Sustainable Development Goals and Agenda 2030. Sadana will focus on how WHO has engaged Ministries of Health in eight countries to increase their commitment to evidence-informed policies and programs through a country-led effort that also reflects a collaboration between the World Health Organization’s three levels (headquarters, regional and country offices) and the UCLA Center for Health Policy ResearchCenter Research Scientist Kathryn Kietzman briefly discussed efforts currently underway in California to develop a Master Plan for Aging and her work as part of the research subcommittee tasked with developing a data dashboard to measure progress made by the state over the next 10 years. Find the recorded video here.
 

Feb. 5, 2020: "Cost of Single-Payer Health Care in the US: A Systematic Review"

Dr. James G. Kahn, a professor in the UCSF Philip R. Lee Institute for Health Policy Studies, and Dr. Michael A. Rodriguez, professor and vice chair in the Department of Family Medicine at the UCLA David Geffen School of Medicine and faculty associate at the UCLA Center for Health Policy Research, discussed findings from a recent study by researchers at UCLA, UCSF, and UC Berkeley that shows that a single-payer health care system would save the U.S. money over time. They looked at 22 economic analyses by government, business, and academic centers across California, New York, and other states and found that 19 of them predicted savings in the first year after implementation, averaging 3.5% of total health care spending. Find the recorded video here.

Dec. 16, 2019: "Identifying Mental Health Needs in California: A Public Health Approach"

Imelda Padilla-Frausto, Center research scientist, presented a study looking at mental health needs in the state. Findings may be used to guide efforts for preventive outreach and early intervention services. By taking a preventive and early intervention approach, Padilla-Frausto presented data comparing two groups: individuals identified as having moderate psychological distress (those who have a lower score on the Kessler 6 screening tool) and those who have serious psychological distress – looking at various factors such as life and work impairment, demographic characteristics, and use of mental health services. Find the recorded video here. and the seminar slides here​.

Oct 24, 2019: California Health Interview Survey 2018 Data Release

Ninez Ponce, Center director, CHIS principal investigator and professor at the UCLA Fielding School of Public Health, and Todd Hughes, CHIS director, shared highlights from the 2017-2018 California Health Interview Survey (CHIS), including newly expanded questions on tobacco, marijuana and e-cigarette use, and important findings and trends in key health topics such as health insurance coverage and mental health. Find the recorded video here

Oct. 7, 2019: “Whole Person Care Improves Care Coordination for Many Californians”

Associate Center Director Nadereh Pourat and Emmeline Chuangassociate professor at the UCLA Fielding School of Public Health, describe the progress of 25 WPC Pilots participating in the statewide Medi-Cal initiative on coordinating medical, behavioral health, and social services. Their evaluation provides a framework for organizations seeking to address the challenges of providing care to high-need patients who frequently use high-cost services such as those without stable housing or with multiple chronic conditions. Find the recorded video here.

May 14, 2019: "Medicare for All: Is it Finally Time for Single Payer in the United States?"

As a continuation of the robust discussion at the recent E. Richard Brown Symposium focused on universal health care in California, UCLA Center for Health Policy Research Senior Fellow Gerald F. Kominski addressed the topic “Medicare for All: Is It Finally Time for Single Payer in the United States?” Find the recorded video here.

March 26, 2019: “Economic Insecurity Among Older Adults of Color: Housing and Health as Cause and Effect”

In the Center’s March Health Policy Seminar, Associate Center Director Steven P. Wallace discussed elder economic insecurity using Elder IndexTM data and how the housing burden borne by elders, particularly those of color, affects health. Find the recorded video here.

Feb. 19, 2019: “Reducing Access Disparities in California by Insuring Low-income Undocumented Immigrants”

Using the latest California Health Interview Survey data on the health insurance, demographics, health status, and access to care of undocumented low-income adults ages 19-64, new research led by Associate Center Director Nadereh Pourat reveals the demographics and characteristics of undocumented adults, how their access to health care compares to documented counterparts, and the implications of extending Medi-Cal eligibility to the last remaining uninsured population who have limited options for coverage. Find the recorded video here.



Jan. 23, 2019: "Improving California's Behavioral Health Workforce for Older Adults"

Center Faculty Associate Janet Frank and Center Research Scientist Kathryn Kietzman recommended training and funding strategies that state policymakers, educational institutions and county mental health/behavioral health departments and their contracted providers can take to improve the state mental health care workforce that serves the unique needs of older adults. Find the recorded video here.


Nov. 7, 2018: "How Proposed Changes to the 'Public Charge' Rule Will Affect Health, Hunger, and the Economy in California"

Ninez A. Ponce, director of the UCLA Center for Health Policy Research; Laurel Lucia; director of the health care program at the UC Berkeley Center for Labor Research and Education; and Tia Shimada, director of programs at California Food Policy Advocates, presented analysis from their report and shared estimates of the health and economic impact the federal "public charge" immigration rule change will have on California, its regions, and its racial and ethnic groups. Under proposed changes to Department of Homeland Security immigration rules, people could be denied status as lawful permanent residents if they receive certain health care, nutrition and other benefits. Find the recorded video here and download the seminar slides here(Note: Updated version as of 11/29/18.)
 
See all previous health policy seminars here.

 
​​
4/25/2022396
  
Approved4/19/2022 1:53 PMNo presence informationi:0#.f|uclachissqlmembershipprovider|venetia4/25/2022 8:25 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesVenetia Laivenetialai@ucla.edu310-794-69631092Y
PublicationThe Future of Health and Wellness: A California 100 Report on Policies and Future Scenarios2284
UCLA Center for Health Policy Research report helps point the way toward greater access and equity as part of statewide initiative

Will all Californians have a chance to enjoy good health in the coming 100 years? What steps can policymakers and health care leaders take to make that happen?


These questions are tackled in a time-jumping research report released today by the UCLA Center for Health Policy Research and supported by a grant from California 100, a new statewide initiative focused on inspiring a vision and strategy for California’s next 100 years that is innovative, sustainable and equitable.


“What health and wellness looks like for our great-grandchildren depends on what steps the state’s leaders take now and in the near future,” said Ninez A. Ponce, PhD, MPP, UCLA CHPR director and lead author of the report.


The UCLA CHPR team examined the state of modern health and health care in California, the historical policy decisions and societal shifts that created the current situation, and trends influencing change in the existing environment. Working with community-based experts and stakeholders, the team focused on seven topic areas: (1) health systems and public programs, (2) insurance coverage and markets, (3) environmental influences, (4) chronic conditions and mental health, (5) child and adolescent health, (6) aging residents and (7) racial justice and immigrant populations.


Two factors that affect future health are whether leaders in the state will define “health” in broad or narrow terms and whether health systems are interoperable, meaning they can exchange and make use of information together, according to the report. Depending on those definitions, the authors say, California has four possible health system scenarios in the future:

  • Scenario 1: Patchwork of well-being 
    (broad definition of health | lower interoperability)
    More than just clinical care limited to an individual, this localized health system recognizes factors that lead to health disparities and supports connections between housing, education, employment and health at the community level.
  • Scenario 2: Uniform health and wellness 
    (broad definition of health | higher interoperability)
    In this system, health and wellness include an understanding of the social determinants of health and are scaled for the whole state population. Health is highly integrated with social needs such as housing and education, and there is little regional variation in health and social services systems.
  • Scenario 3: Sickness systems 
    (narrow definition of health | lower interoperability)
    Health care focuses on clinical care for sick individuals and emphasizes individual responsibility for health. There is little integration with specialty or primary care, limited focus on prevention and no larger interest in community health.
  • Scenario 4: Effective sickness systems 
    (narrow definition of health | higher interoperability)
    Health care focuses on individualized care. A one-stop shop for all health care needs, this approach emphasizes clinical care solutions and individual responsibility to improve health outcomes but does not address community-level health disparities and inequities.

“We began this process with a question: What progress has California made to ensure that all people have reasonably equal access to covered services, and how can the state ensure health equity in the future?” Ponce said. No single policy will improve health for all; rather it is a broad collection of influences that will ultimately determine outcomes.”


Ponce will share details and discuss potential developments from the report in a panel discussion on Monday, April 25.


The research on health and wellness is part of the broader California 100 initiative, developed at the University of California and Stanford University, which seeks long-term innovative and equitable strategies for the state in a number of areas, from health and education to transportation, immigration and the economy. The initiative awarded grants to 18 centers and institutes in California to examine future scenarios that have the potential to shape the state over the next century. The first California 100 reports were released March 29, and remaining reports will be released over the coming months. 


“After months of diligent research by our partners across the state, we are excited to share their findings with the public to kickstart a conversation about the policy options we can take to create an inclusive, equitable and sustainable California,” said Karthick Ramakrishnan, PhD, executive director of California 100. “Our research partners engaged a diverse group of stakeholders in their work, and it will take all of them and all of us to take this work and make it actionable today — to influence tomorrow.”


The California 100 research will later be tested through deliberative polling exercises and engagement sessions directly with Californians in the summer of 2022 and into 2023 to inform a vision and policy strategy for the state’s future. 


The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is affiliated with the UCLA Fielding School of Public Health​.​

4/14/2022395
  
Approved4/13/2022 6:34 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes4/14/2022 3:54 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
PublicationCalifornia’s Biggest Coverage Expansion Since the ACA: Extending Medi-Cal to All Low-Income Adults; The Threat to Coverage and Affordability Gains in Covered California if Congress Fails to Renew Subsidy Enhancements2283; 2282

New research released today by the UC Berkeley Labor Center and UCLA Center for Health Policy Research examines policy decisions that will affect health coverage for nearly one million Californians. Using the California Simulation of Insurance Markets (CalSIM) microsimulation model developed by the centers, the two reports project how the expansion of Medi-Cal eligibility to all low-income adults regardless of immigration status and the discontinuation of enhanced federal subsidies in Covered California would impact Californians.

 

“California is poised to build upon its historic gains in health insurance coverage under the Affordable Care Act (ACA) with the proposed Medi-Cal expansion to cover all undocumented low-income residents. This policy decision would mark the largest single coverage expansion since the implementation of the ACA,” said Miranda Dietz, lead author of the publications and CalSIM project director at the UC Berkeley Labor Center. “But our state's progress is also at risk. Without an extension of enhanced federal subsidies under the American Rescue Plan, hundreds of thousands of Californians will lose coverage and premiums will be more expensive in the individual market.”

 

In the report California’s biggest coverage expansion since the ACA: Extending Medi-Cal to all low-income adults, the authors examine the proposal to expand Medi-Cal to all low-income residents ages 26 to 49 regardless of immigration status. Key findings from this report include:


  • The policy to expand Medi-Cal to all low-income residents regardless of immigration status would mark the largest single coverage expansion in the state since the implementation of the Affordable Care Act; 
  • Nearly 700,000 more Californians would be insured under this expansion, narrowing the uninsured rate for all Californians (9.2% to 7.1%), especially Latinos (15.0% to 10.4%) and undocumented Californians (58.4% to 27.8%);
  • 2.3 million Californians under age 65 (7.1%) would be uninsured by 2024, with this Medi-Cal expansion and if enhanced federal subsidies for Covered California, made possible by the American Rescue Plan (ARP) Act, are also extended. 

 

Starting in 2014, the ACA expanded access to affordable coverage for most Californians, but undocumented residents nationwide were excluded from these gains. California policymakers expanded access to comprehensive Medi-Cal first to low-income undocumented children under age 19 in 2016 and then to young adults under age 26 in 2020. Starting in May 2022, undocumented low-income adults age 50 and over will be eligible for comprehensive Medi-Cal coverage. In the state budget released in January 2022, Governor Gavin Newsom proposed expanding coverage to low-income undocumented residents age 26 to 49, which would complete the state expansion of Medi-Cal eligibility to all low-income residents regardless of immigration status. 

 

The companion report, The threat to coverage and affordability gains in Covered California if Congress fails to renew subsidy enhancements, examines the impact on individual market enrollees in Covered California if enhanced subsidies enacted under the ARP of 2021 are not renewed for 2023 and beyond. Key findings from this report include:


  • If ARP subsidies are not extended, an estimated 220,000 fewer Californians will have individual market insurance in 2023; 
  • Premiums will be less affordable for more than two million individual market enrollees. 

 

Since the enactment of the ACA in 2010, California has reduced the number of uninsured from 6.5 million in 2011 to a projected 3.0 million in 2023. In response to the COVID-19 pandemic, Congress included in the ARP provisions for additional temporary financial help for buying health insurance through the ACA marketplaces. This support substantially improved affordability and increased enrollment in Covered California. According to estimates from Covered California, the ARP subsidies reduce premiums by 20% on average for enrollees.

 

“With California’s strong implementation of the ACA and the federal provision of enhanced premium subsidies through 2022, enrollment in Covered California has grown to record levels and premiums for subsidized enrollees are more affordable than ever,” said Srikanth Kadiyala, senior economist at the UCLA Center for Health Policy and co-author of the reports. “But Congress or the state will need to act to protect the gains we’ve made in coverage and affordability in Covered California.”

###

 

Founded in 1964, the UC Berkeley Labor Center works to address the most critical challenges affecting working families in California and across the nation. The Center provides timely, policy-relevant research on labor and employment issues and carries out training and education programs for labor leaders and students.

 

The UCLA Center for Health Policy Research is one of the nation’s leading health policy research centers and the premier source of health policy information for California. The Center is the home of the California Health Interview Survey (CHIS) and is affiliated with the UCLA Fielding School of Public Health.


Contact: 

Van Nguyen 

vann@berkeley.edu

(415) 506-8054

 ​

4/13/2022391
  
Approved3/22/2022 9:07 AMNo presence informationElaiza Torralba4/13/2022 8:24 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesVenetia Laivenetialai@ucla.edu310-794-69631092Y
PublicationLatinx and Asian Immigrants Face High Levels of Job Exclusion, Workplace Violations in California2275
UCLA study finds those who have been undocumented experience even greater levels of unequal work conditions
Two new studies by the UCLA Center for Health Policy Research explore the link between citizenship status and access to health care among Latino and Asian immigrants in California. The studies are part of the center’s Research on Immigrant Health and State Policy Study, or RIGHTS, which analyzed the experiences of Latino and Asian immigrants in the state from 2018 to 2020.

In the first study, researchers compared job opportunities and workplace conditions for immigrants based on whether they had ever had undocumented status.

Among immigrants who had ever been undocumented, 49.5% said they had been unable to apply for a job because of their status, compared to 21.6% of immigrants who had never been undocumented. In addition, immigrants who had ever been undocumented had significantly higher rates of:

Settling for a job that paid less than what they deserved (47.3% compared with 29.3% for those who were never undocumented).
Being injured at work (36.7% versus 22.1%).
Not getting paid for hours worked (28.1% versus 14.2%).
Being asked to perform dangerous job duties (22.1% versus 8.1%).

“Immigration status is an important factor not only in whether an individual gets hired and gains health insurance, but in terms of how they are treated at work and how that can harm their health,” said May Sudhinaraset, a faculty associate at the center and lead author of the study. “Our research showed that many undocumented immigrants felt pressured to keep working while sick so they wouldn’t lose their jobs.”

The second study examined perceptions of the so-called public charge rule among the state’s Latino and Asian immigrants, based on their immigration status — whether they were naturalized citizens, noncitizens with green cards or and noncitizens without green cards — and race. The federal government defines an immigrant who relies on specific types of public aid as a “public charge,” and that person can be denied a green card and the opportunity to become a U.S. citizen.

The researchers found that 67% of all respondents had negative perceptions and negative experiences related to the public charge rule. The researchers also found:

52% of Latino immigrants had negative perceptions of the public charge policy, but not negative experiences; compared to 44% of Asian immigrants who said they had negative perceptions only.
26% of Latino immigrants reported having both negative perceptions and negative experiences related to the rule, compared to just 11% of Asian immigrants.
21% of Latino immigrants said they had neither negative perceptions nor experiences related to the public charge rule, compared with 45% of Asian immigrants. 

“Some immigrants are afraid to use public aid such as health care and food programs because of the public charge rule,” said Michael Rodriguez, a faculty associate at the center and the lead author of the second study. “Although most immigrants in the U.S. are here legally and ‘public charge’ doesn’t apply to them, this confusing policy leads them to believe they will lose their path to permanent citizenship, and as a result they forgo benefits that affect their health and well-being.”

Both studies demonstrate that restrictive immigration policies affect immigrants’ experiences in California, regardless of their legal status. The authors write that federal and other government officials could tailor policies that avoid having adverse impacts such as deterring access to heath care.

The new study draws data from the 2018, 2019 and 2020 California Health Interview Surveys​ (CHIS), which also were conducted by the center.

In fall 2021, the Center for Health Policy Research published two fact sheets on immigrants’ experiences with law and immigration enforcement and their perceptions of the immigrant experience.​
​​
​The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey​ (CHIS) and is part of the UCLA Fielding School of Public Health​. For more information, visit healthpolicy.ucla.edu​.​​​​​
4/11/2022394
  
Approved4/11/2022 4:52 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes4/11/2022 5:41 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
PublicationOpening Doors for All: Improving Health in Housing and Homelessness2281
California’s homelessness crisis is unprecedented. In early 2020, more than 160,000 people experienced homelessness on any given day, representing a 40% increase since 2015. The health effects on individuals experiencing housing insecurity have been profound, including outbreaks of hepatitis A and typhus in communities experiencing homelessness, as well as the COVID-19 pandemic, which has further impacted our health system, broader community, and economy, and exposed how public health impacts housing and homelessness.

During fall 2021, the UCLA Center for Health Policy Research (CHPR) convened a virtual event to bring together key voices — state and local legislators, academics, nonprofit organizations, advocates, health leaders, and people with lived experience — for two days of thoughtful discussions on past successes, lessons learned, barriers, and potential solutions to create a healthier, more prosperous California for all.

Focused on the intersection of health and homelessness, the 2021 E.R. Brown Symposium, Opening Doors for All: Improving Health in Housing and Homelessness, highlighted evidence-based strategies to help wrestle with this crisis at a time when state lawmakers have a significant budget surplus available to potentially invest in addressing it. 

As local and state leaders consider what investments and policy levers to pull, UCLA CHPR released a policy paper from the symposium that synthesizes key findings, barriers, and potential solutions. The paper describes the need for a well-coordinated effort among policymakers, community-based organizations, people with lived experience, health systems, and government agencies at the federal, state, and local levels to adequately address this crisis. 

Some of the key takeaways of the symposium include:

Good health is not possible without housing. Lack of housing leads to deterioration of mental and physical health due to high stress, exposure to the elements, inadequate sanitation, lack of access to hygiene supplies, and poor nutrition.

Homelessness is often the result of structural issues rather than individual characteristics. The primary driver of homelessness in California is a lack of affordable housing, especially for those earning an extremely low income. Other drivers of homelessness include historical discrimination and structural racism. 

To address the effects of structural racism, any new project should begin with a racial equity analysis to assess the potential effect on different racial and ethnic groups. Such analyses can help reduce existing inequities and avoid unintended negative consequences that affect marginalized groups. 

People experiencing homelessness need privacy, autonomy, and safety. Small single cabins (“tiny homes”) where individuals can secure their belongings; get sleep without interruption; bring a spouse, partner, children, or pets; and be linked with services and permanent housing is a better option than a traditional group shelter.

Permanent supportive housing should be the goal. This model provides long-term housing coupled with intensive case management services linking individuals with medical, psychological, and other important social services.

Policy and program development should always involve people with lived experience. Their historical exclusion from these discussions has resulted in missed opportunities and wasted resources.

The paper also suggests that privately funded initiatives, which have more flexibility than publicly funded programs, may result in more innovation and experimentation. An excellent example is the Keep Oakland Housed campaign, which in its first two years prevented nearly 5,000 households from becoming homeless.

Addressing health and homelessness requires engagement, healing, resources, social change, leadership, and commitment across our society, starting in every community and neighborhood. Most notably, the paper notes that short-term, medium-term, and long-term efforts must be pursued at the same time.

In the short term, confidence-building measures are necessary to get partners together, foster collaboration, and generate political and public support to move forward. People experiencing homelessness must be treated with dignity and respect; they must be given a non-token role in developing programs and policy. The urgent need for additional permanent supportive housing must not only be met, but to house the most people most quickly, current qualification requirements must be modified or even eliminated.

In the medium term, policies, programs, and their implementation must be evaluated in the most impartial and transparent manner possible. Findings must be disseminated widely and quickly to catalyze action. In addition, evidence development must be treated not just as cataloging what worked where, but as an ongoing process that needs constant refinement and adaptation.

In the long term, the systematic and structural obstacles responsible for homelessness must be dismantled. Only through permanent change will we ensure adequate health care and housing be created for all.

3/30/2022393
  
Approved4/7/2022 12:46 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes4/7/2022 12:50 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
None
The Lab, housed at the UCLA Center for Health Policy Research, was created to address gaps in national COVID-19 data reporting and research in overlooked Native Hawaiian and Pacific Islander communities.
“As COVID-19 swept across the United States it became clear that the virus disproportionately affected certain racial and ethnic groups. But the outsized impact of the pandemic on one community  Native Hawaiians and Pacific Islanders  has been largely hidden because of inconsistent data collection and reporting,” says PBS NewsHour anchor Judy Woodruff. 

PBS NewsHour reporter Stephanie Sy sat down with members of the Native Hawaiian and Pacific Islander (NHPI) Data Policy Lab to discuss the critical work the Lab is doing to address striking gaps within data and research for NHPIs. 

"This community is like the canary in the coal mine," said Ninez A. Ponce, PhD, MPP, director of the UCLA Center for Health Policy Research (CHPR) and principal investigator of the NHPI Data Policy Lab.

"When the data first came out about COVID cases and deaths by race/ethnicity, I was, frankly, really shocked," said Ponce. In 14 of the 27 states with available NHPI data, Native Hawaiians and Pacific Islanders have the highest death rates from COVID-19, compared with any other racial or ethnic groups. "Other states didn't even have data on Native Hawaiians and Pacific Islanders."

Grouping them together in a broad category with Asians, a much larger population, hides their uniquely high rates. For example, in California, the COVID death rate for Asian and Pacific Islanders in 2020 was 75 per 100,000. But when the data for the two groups were separated, the rate for Native Hawaiian and Pacific Islanders alone jumped to 123 per 100,000, the highest in the state, while the rate for Asians remained roughly the same.

The PBS piece also features the work of the Arkansas Coalition of Marshallese and Melisa Laelan, who discusses the impact of COVID on the many Marshallese who work in poultry plants. Experiencing both COVID-19 illness and unemployment, the NHPI Data Policy Lab helped the group prepare its case for funding from the federal Coronavirus Aid, Relief and Economic Security (CARES) Act. 

View the PBS NewsHour segment.

Read more about the NHPI Data Policy Lab in UCLA Magazine.

 

3/29/2022390
  
Approved3/16/2022 3:55 PMNo presence informationElaiza Torralba3/29/2022 8:49 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationSecond Interim Evaluation of California’s Health Homes Program (HHP)2273
Findings show decreased use of emergency department visits and hospitalizations, an initial increase in outpatient services, and slower growth in estimated Medi-Cal payments compared to a control group for HHP enrollees in the first year of enrollment
Researchers at the UCLA Center for Health Policy Research (CHPR) have released findings from the second Health Homes Program (HHP) Interim Evaluation report. The report, created by the Health Economics and Evaluation Research Program team at UCLA CHPR and led by Associate Center Director Nadereh Pourat, PhD, provides updates on program participants’ enrollment patterns, demographics, and services received that were reported in the first interim evaluation report. Additionally, this report includes analyses of changes in HHP core metrics, health care utilization, and estimated Medi-Cal payment measures compared to a control group, or a group of patients with similar complex needs not enrolled in HHP.

HHP was implemented by the California Department of Health Care Services (DHCS) with the overarching goal to attain the “Triple Aim” quality improvement initiative of achieving better health outcomes and lowering health care costs. As of September 30, 2020, the program served 48,925 Managed Care Plan (MCP) beneficiaries with complex needs, including individuals with chronic health and/or mental health needs, as well as individuals experiencing homelessness. Extra services were provided at no cost to Medi-Cal members, and provided through care coordination, which as previous studies have shown, may be key to reducing avoidable health care costs.

The UCLA CHPR research team was selected to lead the program’s evaluation efforts, along with other California DHCS Medicaid 1115 Waiver programs such as the Whole Person Care (WPC) and the Public Hospital Redesign and Incentives in Medi-Cal (PRIME) Program.

“The Health Homes Program interim report findings show some promising improvements in how the program impacted service use, and will certainly help inform programs that serve patients who can benefit from various medical and social support services,” Pourat said. “These robust programs are vital in improving health care delivery and reducing cost expenditures.”

Additional features of the second report include the categorization of enrollees based on their use of the emergency departments and hospitals prior to program enrollment. The enrollee population consisted of 6% with super utilization (14.9 emergency department visits and 4.1 hospitalizations on average per year) and 35% with moderate utilization (2.7 emergency department visits and 0.5 hospitalizations on average per year). The report also included analyses of changes in the program’s core metrics, health care utilization, and estimated Medi-Cal payment measures compared to a group of Medi-Cal beneficiaries resembling HHP enrollees, but not enrolled in the program.

The findings indicated some improvements in emergency department and hospital utilization, access to needed outpatient services, screening for depression and follow-up, and overall estimated Medi-Cal payments. For example, HHP enrollees had 19 fewer ED visits and 10 fewer hospitalizations per 1,000 months every 6 months during the program, which were significant declines compared to before HHP and compared to the control group. Other measures that reflected care processes and health outcomes show no significant change after the first year of enrollment. A future report will assess health outcomes beyond the first year of enrollment.

Other report findings include:
  • Of the 48,925 individuals enrolled in HHP between July 1, 2018, and September 30, 2020, 38,228 were enrolled under state plan amendment (SPA) 1 for enrollees with chronic physical health conditions or substance use disorders and 10,697 were enrolled under SPA 2 for enrollees with severe mental illness.
  • MCPs reported that they had developed program delivery networks with 244 unique Community-Based Care Management Entities (CB-CMEs) by September 2020. These entities were primarily community health centers (41%).
  • The majority of HHP enrollees were 50–64 years old (50%), women (59%), and spoke English as their primary language (72%). Nearly half of enrollees were Latinx (46%).
  • Prior to enrollment, the most common chronic conditions among SPA 1 enrollees were hypertension (71%) and diabetes (54%). The most common condition among SPA 2 enrollees was depression (72%).
  • For HHP enrollees, rates of outpatient services increased in the first six months after enrollment and then declined, but rates remained above those levels seen prior to enrollment.
  • Estimated Medi-Cal payments increased as a slower rate for both SPA 1 and SPA 2 HHP enrollees compared to the control group.
HHP was authorized under California Assembly Bill 361 and approved by the Centers for Medicare and Medicaid Services under Section 2703 of the 2010 Patient Protection and Affordable Care Act. It is operated in 12 California counties by 16 MCPs that contract with CB-CMEs or directly provide services to HHP enrollees. The evaluation efforts are supported by the generous contribution of The California Endowment.


The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.
3/9/2022389
  
Approved3/10/2022 10:48 AMNo presence informationElaiza Torralba3/10/2022 11:14 AMNo presence informationElaiza Torralba
Publication
A team led by UCLA CHPR Director Ninez Ponce and Senior Fellow Vickie Mays has received a state grant for COVID-19 data research in Los Angeles County

Four teams of researchers focused on COVID-19 related data analysis and modeling received grants from the University of California Health and California Department of Public Health (CDPH) COVID Modeling Consortium, an innovative consortium launched last year to ensure public health policy makers have timely, relevant analysis and insights to support pandemic-related decision making.

 

The areas of focus for the funding were driven by priorities set by CDPH for gaining deeper understanding of COVID-19 matters, such as disease detection and impact, virus transmission and behavior, mitigation strategies, and social and behavioral considerations.

 

The studies selected for the grants are designed to provide insights on COVID-19 related challenges such as forecasting, understanding disease risk for Black populations, effectiveness of K-12 school mitigation strategies, and disparities in COVID-19 vaccination acceptance. The research proposals, which together received approximately $236,000 in funding, are:


  • An assessment of indicators for COVID-19 risk reduction by UCLA investigators, focused on the Black community in Los Angeles County
  • A study to improve accuracy and precision of COVID-19 forecasts and scenarios through analysis of inputs from multiple data sources by UC Irvine investigators
  • Epidemiologic and model-based assessments of K-12 public health policies for mitigation of SARS-CoV-2 variant transmission in schools by UC Berkeley investigators
  • Examination of factors associated with COVID-19 vaccination uptake disparities by UCSF investigators

 

The grant to UCLA will support a 12-month-long project to assess vaccine uptake and risk reduction measures for Black Californians, focused in Los Angeles County. It will be co-led by Ninez Ponce, PhD, UCLA Fielding School of Public Health (FSPH) professor of health policy and management and director of the UCLA Center for Health Policy Research (CHPR), and Vickie Mays, PhD, UCLA Fielding School of Public Health professor of health policy and management, UCLA College professor, director of the UCLA BRITE Center for Science, Research and Policy, and senior fellow at UCLA CHPR.

 

“We appreciate that the UC Health and CDPH COVID Modeling Consortium has made this award,” Ponce said. “A lesson learned from the pandemic is that many of the current efforts to model and investigate COVID-19 in California's Black population have struggled in the absence of evidence-based data to guide resources and interventions. A Black-focused modeling approach is crucial because vaccine adoptions are occurring most slowly among Blacks.”

 

Mays, who also serves as a distinguished professor of psychology at UCLA’s College of Letters and Science and a special advisor to UCLA Chancellor Dr. Gene Block, pointed out that Los Angeles County records show that for every 100,000 unvaccinated Black residents, more than 15 were hospitalized with COVID-19, which is higher than for other groups in the county’s population.


“This research will help address this very important issue by modeling the complexity of how the social vulnerabilities experienced in the lives of Blacks in California intersect with their behavioral intentions, behaviors and difficulties in following public health advisories such as mask-wearing, physical distancing and hand-washing,” Mays said. “Our models will inform public health and health care strategies for outreach and engagement, messaging, vaccination interventions and testing that can direct equitable measures to reduce the disparities in deaths, hospitalization and rate of infection in the Black community, especially in Los Angeles County - home to the largest Black population in the state.”

 

The funded projects were selected through a multi-step review process following a call for proposals to approximately 150 researchers across UC campuses working on COVID-19 research as well as the 200+ members of the consortium. All of the research projects are reviewed and monitored by the applicable campus institutional review board and follow established protocols for use of health data.

 

“We were pleased that the consortium is able to support these researchers in projects that are advancing our understanding of the virus and the disease. Public health officials and our communities have a critical, ongoing need for research-based information in real-time that can help guide actions and policies,” said Dr. Kirsten Bibbins-Domingo, co-chair of the consortium and professor and chair of the Department of Epidemiology and Biostatistics, and vice dean for Population Health and Health Equity in the UCSF School of Medicine.

 

The funded projects were selected through a multi-step review process following a call for proposals to approximately 150 researchers across UC campuses working on COVID-19 research as well as the 200+ members of the consortium. All of the research projects are reviewed and monitored by the applicable campus institutional review board and follow established protocols for use of health data.

 

“Our partnership with academic experts at University of California Health to provide evidence, data, and projections to inform our public health mitigation strategies and policies has been crucial, and we are thrilled to support these important projects including work to better understand and address disparities to better serve and protect Californian communities,” said Dr. Erica Pan, CDPH State Epidemiologist and co-chair of the consortium.

 

“Conditions in our communities continue to evolve every day, and we must continue to have scientific evaluation of the impact of COVID-19 and effectiveness of prevention and mitigation strategies. It is rewarding to be working with CDPH to align the data research capabilities of the UC system with the needs of the State,” said Dr. Maya L. Petersen, co-chair of the consortium and chair of the Division of Biostatistics at UC Berkeley’s School of Public Health.

 

The University of California Health and CDPH COVID Modeling Consortium is a regular forum in which UC faculty in epidemiology, infectious diseases, economics, statistics, computer science, ecology and data modeling work with CDPH modelers and public health experts to develop information to inform the pandemic response in California.

 

Through the consortium, researchers provide updated analyses and discuss new developments in COVID-19 to provide real-time evidence to inform public health decision making. State public health leaders provide input about the types of information that will be most meaningful in thoroughly understanding the health-related patterns and economic impact of COVID-19 in California.

 

“The pandemic has highlighted the many ways support is needed for public health infrastructure in California and the nation. We’ve seen the importance of building and maintaining robust data systems for research and analysis to inform actionable strategies,” said Dr. Carrie L. Byington, executive vice president of University of California Health and an infectious disease expert. “The learnings from this consortium and UC research go beyond immediate study findings. This work is providing a roadmap for how to effectively structure and leverage disparate data sets to support both pandemic response and public health programs overall.”

 

Release produced by Heather Harper, University of California Office of the President (UCOP) Spokesperson and UC Health.

 


About the UCLA Center for Health Policy Research

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.


About the Consortium

The University of California Health and CDPH COVID Modeling Consortium unites UC investigators and California Department of Public Health leaders in a forum to help guide policy decision-making during the COVID-19 pandemic. The consortium aims to facilitate direct, timely engagement and conversation between policymakers and investigators, with discussions focused on high-priority topics such as vaccinations, health equity, economic impact, challenges of new variants, and epidemiological forecasting and nowcasting. More information is available on the consortium's website

2/28/2022387
  
Approved2/7/2022 5:04 PMNo presence informationElaiza Torralba6/16/2022 10:07 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
PublicationGaps in Health Care Access and Health Insurance Among LGBT Populations in California2272
Difficulty finding providers, getting timely care particularly acute among bisexual women, transgender adults

Lesbian, gay, bisexual, and transgender adults in California face significant barriers in accessing health care despite having similar or better rates of health insurance coverage than heterosexual or cisgender adults, a new UCLA report shows.


These barriers include a lack of timely access to needed care, not having a usual source of care, having trouble finding providers and experiencing unfair treatment, according to researchers from the UCLA Center for Health Policy Research (CHPR) and Williams Institute who conducted the study.


Using data from UCLA CHPR's California Health Interview Survey from 2015 to 2020, the researchers tracked health care access and insurance coverage by sexual orientation and gender identity. They found that bisexual men and women were the most likely of all groups to report not having a usual source of health care (27% and 24%, respectively) and that rates of delaying or not getting needed medical care were considerably higher among bisexual women (33%) and lesbian women (23%) than straight women (16%).


The study also found that transgender adults experienced greater barriers to care than cisgender adults (those whose gender identity matches the sex they were assigned at birth) in a number of areas. Rates of delaying or not getting needed medical care, for example, were more than twice as high among transgender adults (33%) as cisgender adults (14%).


“Our study points out several of the health care access barriers the LGBT community in California faces, including greater difficulty finding providers who will see them and having to delay necessary health care,” said the study’s lead author Susan H. Babey, PhD, senior research scientist and co-director of the Chronic Disease Program at UCLA CHPR. “These findings emphasize the importance of looking more closely at differences within LGBT populations so that actions may be taken to close gaps in health care access and improve health outcomes for sexual and gender minorities.”


Other key findings from the report:

  • Gay men (57%) and lesbian women (54%) were more likely to have employer-sponsored insurance than heterosexual men (48%) or women (44%).
  • Transgender adults (37%) were more likely to have Medi-Cal or other public insurance than cisgender adults (21%).
  • Bisexual women (20%) were twice as likely as straight women (11%) to report having trouble finding a medical specialist.
  • Transgender adults were more likely than cisgender adults to report not having a preventive care visit in the past year (39% vs. 28%) and to have trouble finding a specialist (29% vs. 11%).
  • Bisexual men (22%) and gay men (18%) had higher rates than straight men (12%) of delaying or not getting needed medical care.

Among transgender adults, transportation problems and their insurance not being accepted or not covering the care were cited as the main reasons for delaying or not getting needed care, the researchers noted.


Members of the LGBT community were also more likely to experience unfair treatment when getting medical care, with higher rates of lesbian women (44%), bisexual women (45%), and gay men (32%) reporting such experiences than straight women (32%) and men (23%). Previous negative experiences or discrimination may add to some of the barriers reported by LGBT adults, the authors said.


“The findings show that LGBT Californians remain in need of clinical and structural interventions to improve access to health care. We also need more data to assess the different needs of the various communities within the LGBT population,” said study co-author Jody L. Herman, PhD, a senior scholar of public policy at the Williams Institute, which is based at the UCLA School of Law. “The report also provides further evidence that barriers remain to receiving gender-affirming care, and continued advocacy and support are needed to increase access.”


Researchers will share their findings at a webinar today, February 28, at noon PT.




The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.


The Williams Institute at the UCLA School of Law is dedicated to conducting rigorous, independent research on sexual orientation and gender identity law and public policy. The Institute disseminates its research to policymakers, judges, the media, and other stakeholders to ensure that decisions impacting the lives of millions of LGBT people and families are based on data and facts. For more information, visit williamsinstitute.law.ucla.edu

2/23/2022388
  
Approved2/17/2022 2:07 PMNo presence informationElaiza Torralba2/23/2022 8:54 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
The UCLA Center for Health Policy Research (CHPR) has announced two new faculty appointments: Vickie M. Mays, PhD, MSPH has been named a senior fellow at UCLA CHPR and Daniel Eisenberg, PhD, has been named director of UCLA CHPR’s fast-growing mental health program. Mays is a clinical psychologist whose areas of expertise include mental health disorders in racial/ethnic and sexual minorities populations, as well as mental health treatment and care. Eisenberg’s work focuses on childhood and adolescent mental health.

A distinguished professor of psychology at UCLA’s College of Letters and Science and health policy and management at the UCLA Fielding School of Public Health (FSPH), plus special advisor to the Chancellor, Mays leads the UCLA Bridging Research, Innovation, Training and Education (BRITE) Center for Science, Research and Policy, a National Institutes of Health (NIH)-funded center working to eliminate physical and mental health disparities in racial/ethnic minority populations.

Eisenberg, a professor of health policy and management at UCLA FSPH, is the founder and a principal investigator of the Healthy Minds Network for Research on Adolescent and Young Adult Mental Health, dedicated to improving the mental and emotional well-being of young people through innovative, multidisciplinary scholarship.


Vickie Mays offers decades of experience in minority health research, education, and training

Mays’ research expertise centers around mental and physical health disparities affecting racial and ethnic minority groups. She has extensive experience in research and policy development in the area of contextual factors that surround COVID-19 and HIV/AIDS in racial and ethnic minority communities. Additionally, Mays’ work also looks at topics such as the role of discrimination on mental and physical health outcomes, and the availability and access of mental health services for racial, ethnic, and sexual minorities.

Mays directs the NIH-funded UCLA BRITE Center, which was created to support the innovative use of research, science, and policy development to help eliminate disparities in physical and mental health for communities that are traditionally underserved by academic research. The BRITE Center brings academic and community members from many disciplines — psychology, law, public policy, medicine, sociology, and more — to study and address disparities. It supports graduate and undergraduate students and works with faculty from across the entire UCLA campus, and providers and community-based organizations throughout California. The center is currently focused on the intersection of the epidemics of racism, mental health, and COVID-19.

Additionally, she served as the co-principal investigator of the Center’s California Quality of Life Survey, which studies a cohort of UCLA CHPR’s California Health Interview Survey (CHIS) to understand the prevalence of mental health issues and the contextual factors related to them. This three-wave study of statewide mental health of over 7,000 Californians over several years of the CHIS assessed mental health disorders, experiences with hate crimes and victimization, everyday experiences with discrimination, and levels of social support and involvement.

Her current National Institutes of Mental Health (NIMH)-funded research on violent deaths — homicide and suicide — is designed to identify patterns of risk and to characterize proximal factors associated with violent death due to suicide and homicide, making use of novel, supervised machine-learning techniques.  Using machine learning, the team has identified ways in which language in the death narratives of Black males shot by the police versus white males paints a picture of bias. Her team is also examining how incarceration in Black males impact their mental health as well as the psychological damage of the policing of Black populations.

“I have had the honor of working alongside Dr. Mays for several years, through my partnership with her at the UCLA BRITE Center, and she has been and will continue to be a formidable force in the health equity research field,” said Ninez A. Ponce, PhD, MPP, UCLA CHPR director and FSPH professor. “Dr. Mays will add invaluable expertise to our work on understanding and addressing health and mental health inequities among marginalized groups and minority populations.”

Mays has provided testimony to a number of congressional committees, the National Academy, and other policy-setting groups on her COVID-19 predictive equity model, HIV, mental health, and health disparities research findings. She currently serves as the Co-Chair of the National Committee on Vital and Health Statistics work group on SOGI and SDOH which will send reports to the HHS Secretary advising on the format and collection of this data in clinical encounters, administrative data, research, and survey data.

Mays has received a number of awards including one for her lifetime research on women and HIV from amfAR (The Foundation for AIDS Research), a Women and Leadership Award and Presidential Citation for her lifetime contributions in HIV and COVID from the American Psychological Association, and several Distinguished Contributions to Research in Education awards. In 2021, Mays received the Carl Taube Award for Lifetime Contributions to the Field of Mental Health from the American Public Health Association’s Mental Health Section. At UCLA she received two of the highest  Academic Senate lifetime awards. One for her lifetime contributions in research, teaching and service in Diversity, Equity and Inclusion and another for her lifetime of service to the Academic Senate. Mays has served as the Chair of the Academic Senate — one of its highest accomplishments — as well as chaired Senate committees such as the Undergraduate Council, and the Committee on Committees, the Ad-Hoc group that recommended the creation of the online IRB. She has also served on the responsibility-centered management committees for budget modeling and participated for several terms on the Senate’s Executive Board. Currently she serves on the UC Health Care Task Force.  

“I’m thrilled to join the UCLA Center for Health Policy Research to add even more evidence-based power to affect policy change aimed at reducing and eliminating health and mental health disparities among marginalized groups,” said Mays. “I know the Center has been doing excellent work around understanding health status across various racial and ethnic groups, and one of my first projects in this role involves teaming up with Dr. Ponce to conduct a statewide analysis to understand COVID-related risk and vulnerabilities to improve vaccination education for Black Californians. The CHIS data are a unique resource that allows us to make a difference for many different racial, ethnic, and sexual minorities in the state of California.

Mays teaches courses on mental health services and mental health policies, the health status and health behaviors of racial and ethnic minority groups; research ethics in biomedical and behavioral research in racial/ethnic minority populations; health disparities; research methods in minority research; as well as courses on the social determinants of health and mental health. She holds a PhD in Clinical Psychology from the University of Massachusetts, an MSPH in Health Services from UCLA FSPH, with postdoctoral training in psychiatric epidemiology and survey research as it applies to ethnic minorities (University of Michigan), and health policy (RAND Corporation). She has authored or co-authored over 200 peer-reviewed publications and has spoken on multiple national, state, and local media outlets, including The Los Angeles Times, the Guardian, Forbes, and USA Today. She serves as the health correspondence for the weekly podcast Community Briefings.


Daniel Eisenberg shines a light on child, adolescent, and student mental health

Eisenberg’s research goal is to improve understanding of how to effectively invest in adolescent and young adult mental health. His research focuses on health behaviors, mental health services and policy, economic and policy evaluation, and digital interventions for population mental health. Prior to his role as a professor at UCLA FSPH, Eisenberg served as a faculty member at the University of Michigan from 2004 to 2020.

Eisenberg is a principal investigator for the Healthy Minds Network for Research on Adolescent and Young Adult Mental Health. This research network administers the Healthy Minds Study, a national survey study of student mental health and related factors, and facilitates the development, testing, and dissemination of innovative programs, as well as interventions for student mental health.

Eisenberg is currently writing a book about investments in children’s mental health, in collaboration with NYU Professor Ramesh Raghavan.

The Center’s mental health research has grown significantly in recent years and we are excited to expand on this work with the development of an official Mental Health Program, led by Dr. Daniel Eisenberg,” said Ponce. “Dr. Eisenberg has contributed extensively to young adult mental health research through his work leading the Healthy Minds Network over the last 15 years. He will work closely with Research Scientist Dr. D. Imelda Padilla-Frausto to build on our ongoing efforts to address mental health disparities across different populations, especially among youth and adolescents.”

Eisenberg’s current research grants include an NIMH study focusing on using mobile technology to reduce mental health disorders in college populations. He is also a co-investigator on another NIMH study on improving student mental health through the implementation of school-based cognitive behavioral therapy, as well as the M-CARES Study focusing on Michigan Contraceptive Access, Research, and Evaluation.

He has served as an NIH Study Section reviewer in Services Research, as well as conducted grant reviews for the Blue Cross/Blue Shield of Michigan Foundation and the U.S. Department of Health Resources and Services Administration. Eisenberg earned his bachelor’s degree and PhD in economics from Stanford University and has mental health services research training as a UC Berkeley post-doctoral researcher.

Eisenberg has co-authored over 100 peer-reviewed publications and has been featured in several media outlets, including The New York Times and The Los Angeles Times.

“It is a great honor to be asked to join the Center’s team to expand on the foundation for actionable policy research around mental health, which is greatly needed as it is a vital part of improving the health and well-being of all people,” said Eisenberg. “I am excited at the prospect of the mental health program to elevate crucial mental health data to the public and raise awareness for policymakers, funders, and other stakeholders to invest in improving mental health, especially among disadvantaged communities and our youth and adolescents.”


About the UCLA Center for Health Policy Research
The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

1/31/2022386
  
Approved1/20/2022 9:53 AMNo presence informationElaiza Torralba1/31/2022 8:53 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationThe State of Health Insurance in California: Findings From the 2019 and 2020 California Health Interview Surveys2264
Black and Latinx Californians had the lowest rates of employer-based insurance across all groups, especially among women
In 2020, more than 2.5 million California children, adolescents, and adults (ages 0–64) still have no health insurance coverage, as detailed in a new study by the UCLA Center for Health Policy Research (CHPR), The State of Health Insurance in California: Findings From the 2019 and 2020 California Health Interview Surveys.

With California’s revived attempts to achieve universal healthcare coverage through proposed legislation, the state has long been known as a primary voice in the “health care for all” debate. But even taking smaller steps toward that goal would help Californians who lack insurance, according to the study’s authors.

“Even incremental expansion to health insurance eligibility would help California meet our remaining challenges, although the proposed comprehensive overhaul of our insurance system could also improve access to care for everyone,” said Shana Charles, PhD, UCLA CHPR faculty associate and lead author of the study. “The question remains whether there is both the political will and the public financing needed for any of these steps forward.”

Researchers take a closer look at insurance rates a decade after the enactment of the 2010 Patient Protection and Affordable Care Act, also known as the ACA or “Obamacare.” The new study found that young adults ages 19–25 still have the lowest rates of employment-based insurance (51.7% compared to 61–66% for other age groups), even after the ACA enabled them to continue on their parent’s coverage as dependents. Among women ages 19–64, only 43.1% of Latinx women and 55.6% of Black women had employer-based coverage in 2020, compared to 72% of white women. Men’s employment-based coverage had similar patterns, but rates were slightly higher than women’s coverage across all racial and ethnic groups.

Some of the study’s other data highlights include:
  • Nine in ten (89.1%) people without insurance who experienced delays in needed care reported that cost or lack of insurance was the main reason for delaying care, more than twice as high as those with Medi-Cal (42%) or employment-based insurance (31.2%).
  • Only two-thirds of employers with 50 employees or fewer (68%) are able to offer any health insurance at all to their employees compared to nearly 95% of firms with more than 50 employees, resulting in less than half of employees from smaller firms obtaining coverage through their employers.
  • One in seven (16.6%) children with no insurance experienced a delay in needed medical care compared to just 5% of children covered by employer-based insurance. Among adults ages 19 to 64, more than one-fifth of those with no insurance (22.1%) reported experiencing a delay in needed medical care in the past year.
  • Over three-quarters (77.5%) of uninsured adults who may be eligible for Medi-Cal because of household income are of Latino descent.
The California Health Interview Survey (CHIS) has been asking residents about insurance topics since 2001. This latest State of Health Insurance in California study is the 10th installment of UCLA CHPR's in-depth look at health insurance coverage in California, which is the largest state in the U.S. with over 39 million people. Broken down into four chapters, data look at: insurance rates by different demographic groups such as age, race and ethnicity, income, education, citizenship status, and geographic region; private health insurance markets; Medi-Cal coverage for children and adults under age 65; and access to care.

Researchers note limitations in data which include estimated numbers of Medi-Cal enrollees based on self-reported data not matching administrative data. Additionally, they stress that comparing 2019 and 2020 health insurance data to previous reports for trends should be done with caution as the methods by which CHIS was administered changed from phone to primarily online.

While previous expansions in health coverage were good for California residents, the state can do more to reduce persistent racial and ethnic disparities, reduce or eliminate lack of health insurance, and remove barriers to accessing health care,” said Susan Babey, PhD, senior research scientist at UCLA CHPR and co-author of the report.


The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

1/18/2022384
  
Approved12/16/2021 11:49 AMNo presence informationElaiza Torralba1/18/2022 10:06 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationWhole Person Care Program Successfully Navigated Around COVID-19 Challenges in 20202257
Study finds fewer emergency department visits and hospitalizations, and more outpatient telehealth visits in 2020

Nearly 2.3 million confirmed COVID-19 cases and 25,986 related deaths were reported in 2020 in California alone. Larger numbers of cases and deaths were among lower-income populations, including Medi-Cal beneficiaries. Researchers at the UCLA Center for Health Policy Research (CHPR) examined how the pandemic impacted service utilization under the Whole Person Care (WPC) Program, a statewide Medi-Cal demonstration launched in 2016 to integrate medical, behavioral health, and social services for high-utilizing Medi-Cal beneficiaries. Authors also reported how WPC implementation changed in 2020.


The authors found that 4.1% of WPC enrollees or 8,738 program participants had at least one COVID-19-related service. Findings showed demographic and health differences between those with and without the COVID-19 diagnosis. For example, more of those with severe mental illness or substance use disorders (5.5%) had COVID-19 diagnoses. In addition, patients with the diagnosis had higher use of primary care (42%) vs. emergency department visits (33%).


Researchers also found reduced use of primary and specialty care services following stay-at-home orders in 2020 and compared to 2019, followed by an increase in number of telehealth visits later in the pandemic. Data show a reduced use of emergency department visits and hospitalizations following the stay-at-home orders and to the end of 2020.


The changes in service use occurred with 25 Whole Person Care Pilots, or sites participating in the program. Pilots reported challenges in delivering WPC services because of pandemic-related shutdowns and physical distancing requirements that hampered abilities to deliver in-person services (20 pilots); hiring freezes (17); reduced ability to conduct field-based outreach to engage patients experiencing homelessness (16); and safety concerns and staff being reassigned to other COVID-response activities (17). Despite these challenges, pilots reported continued enrollment under WPC, easier access to enrollees at their homes (18 pilots), increased opportunities to house enrollees, and improved relationships with community partners to deliver care to individuals at higher-risk of contracting COVID-19.


“Our findings highlighted how the pandemic impacted health care utilization of WPC enrollees in 2020 and the efforts undertaken by pilots to manage pandemic-related disruptions to delivery of WPC services,” said Nadereh Pourat, PhD, lead author of the study and associate director at UCLA CHPR. She also leads the Center’s Health Economics and Evaluation Research Program, which is in charge of evaluating the Whole Person Care Program and other Medi-Cal demonstrations by the California Department of Health Care Services.


Other key findings from the study include:

  • Overall enrollment increased by 25.1% from December 2019 through December 2020  77,198 vs. 96,563 enrollees, respectively.
  • Patients with a COVID-19 diagnosis were more often women (47% vs 44%), ages 50 to 64 (35% vs 31%), and Latinx (42% vs 26%) compared to those without.
  • The number of emergency department visits declined in April 2020 compared to April 2019 (202 vs. 143 visits) and stayed lower in December 2020 compared to December 2019 (198 vs. 141 visits).
  • Trends in daily hospitalizations from COVID-19 mirrored trends in confirmed cases, peaking at 18 and 52 hospitalizations per 100,000 in July 2020 and December 2020, respectively.
  • Before the pandemic, less than 0.1% of primary care and specialty health services were delivered via telehealth. This rate increased to 2% of primary and 3% of specialty services in March 2020, and 9% of primary and 10% of specialty services in December 2020.

Pourat stated that the pandemic-related disruptions would not be a major barrier to evaluating the impact of WPC in California. The program evaluation findings are used by Medi-Cal to guide the implementation of the upcoming Enhanced Care Management benefit under a major overhaul of Medi-Cal starting in 2022.


“These findings show the value of Whole Person Care’s infrastructure and that it serves as an effective model for future Medi-Cal programs,” she said. “Our broader evaluation findings also support the possibility that beneficiaries enrolled in this program may have less demand for care coordination and housing support services than Medi-Cal beneficiaries not enrolled during the transition to the California Advancing and​ Innovating Medi-Cal initiative, better known as CalAIM, starting this month.”


The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

1/13/2022385
  
Approved1/14/2022 2:40 PMNo presence informationElaiza Torralba1/14/2022 4:53 PMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
The UCLA Center for Health Policy Research is leading the Health Equity Challenge, in collaboration withThe MolinaCares Accord
Many students are imagining a future where they can change the world, often starting with their local community. For those with a vision of improving health equity, a new competition from the UCLA Center for Health Policy Research (CHPR) conducted in collaboration with MolinaCares will provide that opportunity in 2022 — the Health Equity Challenge.

The last two years of the COVID-19 pandemic have shone a light on significant inequities in many aspects of health: insurance coverage and affordability, social determinants of health, and structural barriers to high-quality care. With the signs of inequity more obvious than ever, the increased focused has also spurred ideas from those who are closest to the problems.

Beginning on January 13, 2022, UCLA graduate students are invited to propose solutions that community-based organizations (CBOs) can implement. The Health Equity Challenge imagines a better world with improved health for all. Students will be encouraged to turn their ideas into full proposals and, for two winners and their community partners, funded projects.

“We know students can bring new insights and ideas to address some of our most pressing challenges,” said Kathryn Kietzman, PhD, project lead and director of the UCLA CHPR Health Equity Program. “With support from mentors across the university and California public health community, students will fully develop their ideas and have the chance to turn these ideas into action. We’re very excited to get to work with UCLA students in this way and give them a unique opportunity to make an impact on issues they care about.”

MolinaCares understands from our work across California, and across the country, that health disparities are widespread and require ongoing resources and solutions to resolve. We are excited to partner with UCLA to invest in the public health leaders of tomorrow and spur creative thinking on how to solve persistent issues faced by vulnerable communities across California,” said Abbie Totten, Plan President of Molina Healthcare of California.

The competition will have two rounds. Starting in January 2022, UCLA graduate students are invited to complete a two-page application outlining an intervention that could be executed by a local CBO to address a health inequity in the greater Los Angeles area or other California community in need. Proposals can span direct interventions, program development, policy changes, or other innovative ideas. Concept proposals are welcome from many disciplines that intersect with health including policy, education, law, urban planning and others. Ten students will be selected by an Independent Review Committee to participate in round two.

The 10 students selected for the second round will receive a $2,500 stipend and 10 weeks of mentorship to help identify community partners and develop a full project proposal on their community-based solution to the identified Health Equity Challenge. Projects must be feasible and have measurable outcomes to improve an identified community health issue.

Two final proposals will be selected by the Independent Review Committee and two associated CBOs will receive funding of up to $50,000 for implementation. The winning students will receive an additional $2,500 stipend to continue documenting the impact of the project’s implementation.

UCLA CHPR and MolinaCares will also host a Health Equity Challenge Information Session on Thursday, January 27, 2022, from noon to 1 p.m. PT on Zoom, where UCLA graduate students will have the opportunity to get additional details about the program and ask questions.


Key Dates

January 13, 2022: Applications open.

February 14, 2022: Applications due by 5 p.m. PT.

March 8, 2022: Ten (10) UCLA graduate students will be selected to receive a $2,500 stipend and a mentor.

March 28–June 10, 2022: Students will work with their mentors to develop their full project proposal.

Late June 2022: Two (2) winners will be announced at an awards ceremony. Each student will receive an additional $2,500 stipend and $50,000 to their community organization to implement their proposal.

Visit the Health Equity Challenge website.

--

About the UCLA Center for Health Policy Research:
The 
UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

About The MolinaCares Accord:

Established by Molina Healthcare, Inc., The MolinaCares Accord oversees a community investment platform created to improve the health and well-being of disadvantaged populations by funding meaningful, measurable, and innovative programs and solutions that improve health, life, and living in local communities.

About Molina Healthcare of California:

Molina Healthcare of California has been providing government-funded care for over 40 years. The Company serves members through Medi-Cal, Medicare, Medicare-Medicaid (Duals) and Covered California (Marketplace). Molina’s service areas include Sacramento, Los Angeles, San Bernardino, Riverside, San Diego, Orange County, and Imperial counties. Through its locally operated health plans, Molina Healthcare, Inc., a FORTUNE 500 company, served approximately 4.8 million members as of September 30, 2021. For more information about Molina Healthcare of California, visit MolinaHealthcare.com

1/11/2022392
  
Approved4/7/2022 10:44 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopes4/7/2022 10:44 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesTiffany Lopestlopes@ucla.edu310-794-09301682Y
PublicationTrust In Governments And Health Workers Low Globally, Influencing Attitudes Toward Health Information, Vaccines (Health Affairs)2194

Trusting health advice from governments and health workers, and feeling positively about vaccines, are strongly associated with trust in institutions, according to a peer-reviewed study from UCLA researchers published in the August edition of the journal Health Affairs.

 

“Trust is essential for effective health care delivery and health policy implementation,” said Corrina Moucheraud, ScD, MPH, associate center director at the UCLA Center for Health Policy Research (CHPR), professor of health policy at the UCLA Fielding School of Public Health (FSPH), and lead author of the study – Trust in Governments and Health Workers Low Globally, Influencing Attitudes Toward Health Information, Vaccines – which drew on surveys of more than 149,000 people in 144 countries.

 

In the midst of a global pandemic that has claimed more than 4.2 million lives, according to the World Health Organization, and where basic preventive measures depend heavily on trust in government leaders and healthcare professionals, the findings are a sober reminder of the need for effective public health communications to control the crisis, Moucheraud said.

 

“What we’ve learned through this research is that trust in government may be critical for trust in health messages, and for feeling that vaccines are important, effective and safe – but only one-quarter of respondents globally meet this bar,” she said. “And fewer than half of respondents globally said that they trust doctors and nurses a lot.”

 

The findings are based on analysis of responses to the 2018 Wellcome Global Monitor survey, which is the most recent and comprehensive (across all geographic regions and income levels) global assessment of people’s opinions of health and medical topics, including trust and attitudes toward vaccines.

 

“People’s trust in these institutions (governments and healthcare professionals) was correlated with trust in health or medical advice from them, and with more positive attitudes toward vaccines,” said Huiying Guo, a UCLA FSPH doctoral student and co-author of the study. “Vaccine attitudes also varied substantially worldwide, with safety being the most common concern.”

 

There were significant differences by geographic region: positive attitudes toward vaccines  feeling that they are safe, effective, and important — varied widely, with more than 70% of South Asian respondents, but fewer than 40% of European or East Asian respondents, strongly agreeing with these sentiments. In some regions (East Asia, Europe, and North America), respondents were particularly unlikely to strongly agree that vaccines were safe.

 

Positive vaccine attitudes were about 39% more common among those who trust the government and 59% more common among those who trust health advice from the government. Those who trust doctors and nurses, as well as those who trust health advice from medical workers such as doctors and nurses, were also more likely to report positive vaccine attitudes.

 

Although the survey pre-dates the SARS-CoV-2 outbreak by roughly one year, the researchers found elements that may be relevant to the current pandemic. Trust in government was positively associated with rural residence and negatively associated with educational attainment, and was highest among those who were older. The researchers also identified gender differences - women expressed greater trust in medical advice from the government and from medical workers, compared with men. These suggest potential areas for prioritizing or focusing interventions and public health messaging.

The analysis found three key findings that are especially relevant to policymaking:

  • First, in settings where public trust in governments is especially low, public officials might not be the optimal “face” of public health messages.
  • Second, family physicians may be more effective at communicating health advice and vaccine messages, rather than local or national public health officials.
  • Third, understanding the sources of vaccine attitudes is essential to boosting vaccination rates.

 

The relative priority of vaccine safety found in the survey, for example, suggests that information on this topic could be emphasized, instead of focusing on vaccine importance or effectiveness.

 

“Policy makers should understand that the public may have varying levels of trust in different institutions and actors,” said UCLA FSPH Professor and co-author James Macinko, PhD. “Although much attention is paid to crafting public health messages, it may be equally important, especially during a pandemic, to identify appropriate, trusted messengers to deliver those messages more effectively to different target populations.”

 

The study was named to Health Affairs' 2021 Top 10 Editor's Picks.

 

Data availability statement: Available at https://wellcome.org/reports/wellcome-global-monitor/2018.

 

Funding: Moucheraud is supported by the National Center for Advancing Translational Science (Grant No. KL2TR001882), part of the U.S. National Institutes of Health.

 

Methods: The team used nationally-representative survey data from 144 countries to assess people’s degree of trust in institutions (governments, and doctors and nurses) and health advice from them, and how each type of trust is associated with attitudes toward vaccines. Sources include the Wellcome Global Monitor survey, which collects information on trust and respondents’ individual-level characteristics. In total, 149,014 respondents from 144 countries completed the Wellcome 2018 survey.​

12/9/2021382
  
Approved12/6/2021 4:13 PMNo presence informationElaiza Torralba12/9/2021 4:27 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationCOVID-19 Rapid Response: How the California Health Interview Survey Adapted During the Global Pandemic (American Journal of Public Health)2253
CHIS researchers outline how survey methods were modified to meet the demand for timely data and making data available prior to annual release
How was the California Health Interview Survey (CHIS) team able to release early data for the first time in the survey’s history? An article published yesterday by the American Journal of Public Health looks at how CHIS was able to adapt to the COVID-19 pandemic by releasing timely data on how Californians navigated the pandemic’s conditions and challenges. As a large, well-established statewide population survey, CHIS researchers released early data from the 2020 survey through the CHIS COVID-19 Preliminary COVID-19 Estimates Dashboard beginning in September 2020. These included questions in a COVID-19 module that began in May 2020. The team finalized the module in April 2020 and included indicators on COVID-19 concerns, testing, and diagnoses, as well as financial and social impacts of the pandemic and personal acceptance of the vaccine.

Decades of survey collection, the survey’s redesign in 2019 to dual-mode administration by web or telephone and stakeholder engagement were the main contributing factors as to how CHIS successfully adapted to the pandemic and produced timely data related to Californians’ response to the pandemic.

As the pandemic glaringly exposed inequities across sociodemographic groups in health access and outcomes across the state and nationwide, our goal was to provide timely, equity-focused data in a more rapid processing timeframe to meet the demand for insights needed during this unprecedented time,” said Ninez A. Ponce, PhD, MPP, UCLA Center for Health Policy Research director and CHIS principal investigator.

With the support of CHIS’ data partner, SSRS, and questions from COVID-19 surveys conducted by agencies such as the Centers for Disease Control and Prevention (CDC), researchers were able to report preliminary monthly estimates from methods that typically support annual data metrics. Authors note that challenges did occur in that samples may not have been representative of certain geographic areas or demographic groups due to response rates within certain areas or groups, inability to compare data on a month-to-month basis, and statistical instability of some of the data estimates.

Overall, CHIS successfully demonstrated the possibility of releasing data from the annual survey in rapid time and the ability to respond to a crisis by providing crucial, actionable data to various stakeholders, such as policymakers, program managers, community health workers, and the general public, to help identify residents most impacted by the pandemic. Beginning July 2021, CHIS began releasing preliminary COVID-19 data from the 2021 survey.

“By looking at various factors in risk-reduction behaviors, vaccine views, and personal and financial impacts, CHIS will continue to help tell the story of how Californians navigated their way through the COVID-19 pandemic,” said Todd Hughes, CHIS director.

Published by the American Public Health Association, the American Journal of Public Health is the preeminent peer-reviewed public health journal aimed at advancing public health research, policy, practice, and education.
12/7/2021383
  
Approved12/7/2021 10:58 AMNo presence informationElaiza Torralba12/8/2021 8:12 AMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-0930Elaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-097516821612YN
Publication
Arturo Vargas Bustamante, PhD, MPP, and Mark A. Peterson, PhD, have been named senior fellows at the UCLA Center for Health Policy Research (CHPR). Bustamante is a professor of health policy and management at the UCLA Fielding School of Public Health (FSPH) and director of faculty research at the Latino Policy and Politics Initiative (LPPI). Peterson is a professor of public policy, political science, and law at the UCLA Luskin School of Public Affairs, UCLA College, and UCLA School of Law.

“We are elated to bring two renowned experts who’ve been making waves in the health policy field through their research and advocacy both in the political and health equity sphere,” said Ninez A. Ponce, PhD, MPP, UCLA CHPR director and FSPH professor. “Their work aligns with the center’s work in highlighting actionable data as a way to create the necessary change to move towards health care for all.”

Arturo Vargas Bustamante sheds light on health disparities and inequities among immigrant and Latino communities

Bustamante’s broad background in health policy includes specialized training and expertise in health care disparities research; survey research and data analysis; health care cost analysis; and program design, implementation, and evaluation. His research focuses on unexplored or underexplored topics on access to and use of health care, predominantly among the Latino/Hispanic community and immigrants in the United States, who are overwhelmingly uninsured or have limited access to health care.

“Dr. Arturo Vargas Bustamante’s commitment to health equity and his deep understanding of the critical role of data in identifying and eliminating health disparities perfectly aligns with our mission and values,” said Ninez A. Ponce, PhD, MPP, UCLA CHPR director and FSPH professor.The Latino community is now the largest racial or ethnic group in California, making up 39.4% of the state’s population, yet persistent inequities in the health system, including lack of adequate health insurance coverage and access to quality health care have made this community disproportionately at risk. Dr. Bustamante’s research is not only shining a spotlight on these inequities, but developing actionable policy recommendations.”

Bustamante is currently the principal investigator on several research grants including two COVID-19 grants measuring racial and ethnic disparities in the transition to telehealth during the COVID-19 pandemic and evaluating the role of health outreach services for undocumented immigrants at the onset of COVID-19.

His work on immigrant and border health care has also been extensive. His work on immigrant health care investigates different pathways that citizenship/nativity status, length of U.S. residence and exposure to economic recession impact health care use, health insurance coverage and health spending among immigrants, particularly undocumented immigrants. His work in border health has examined the motivations for U.S. residents to seek health care in Mexico and the potential policy options to regulate this flow of patients.

“I have used the UCLA Center for Health Policy Research’s California Health Interview Survey (CHIS) in my immigrant and border health care research and truly believe in the Center’s mission of providing credible and comprehensive data to help eliminate health care disparities,” said Bustamante. “I look forward to working with Dr. Ponce and the rest of the UCLA CHPR team in a broader capacity, building on the exciting research going on at the center, and identifying new opportunities for collaborative research projects, so that we can ensure equal access to health care for all.”

Bustamante previously served as a faculty associate at UCLA CHPR since 2011, and in his new role as senior fellow he will advise on emerging research priorities within the Latino community, provide mentorship to staff and students and foster cross-disciplinary research with UCLA CHPR staff and other centers across the UCLA campus.

The UCLA CHPR senior fellow role will complement his role as LPPI director of faculty research, where he participates in LPPI's research and programmatic activities, and works with LPPI's faculty affiliates to distill their peer-reviewed research into policy-friendly formats that are digestible for public consumption. Bustamante also directs the health and health care module of the Latino Data Hub, which is intended to become a go-to resource for national, state and local data on demographics, socioeconomics and civic participation that will help policymakers, community organizations, philanthropists and businesses design and promote policies that benefit Latino communities.

Bustamante has authored 65 peer-reviewed papers and articles that appeared in reputable health journals such as Health AffairsHealth Services ResearchSocial Science and Medicine, Medical Care, American Journal of Public Health, among others. He has also authored 20 policy reports for LPPI, the Center for U.S.-Mexico Studies and the California Health Benefits Review Program, among others. He recently served as editorial advisor for the July 2021 special issue of Health Affairs, focused on health and health care issues relating to immigration and border health in the United States. He curated more than a dozen research studies that provide an in-depth understanding of the effects of U.S. immigration policy on the care, coverage, and health outcomes for immigrants and residents along the U.S.-Mexico border.

Mark Peterson brings expertise on U.S. public policy and systems

Peterson specializes in American national institutions and the federal government, and the interactions between the roles of the Presidency, Congress, and interest groups in creating public policy — both nationwide and in domestic settings. His policy expertise spans far and wide, covering national health care policy, Medicare reform, and HIV/AIDS politics and policy. Peterson also studies the role of research evidence in policymaking, including the contextual factors that promote or inhibit its influence.

“Dr. Peterson holds a critical and influential voice that encompasses the broad realm of health policy, looking at how political and health systems interact to create the conditions we have around health care and access,” said Ninez A. Ponce, PhD, MPP, UCLA CHPR director and FSPH professor. “As a long-time partner and faculty associate of the Center, his decades-long work in looking at how political bodies of power in the U.S. operate and how various political, economic, and institutional settings impact policy building and collaboration go hand-in-hand with our efforts to democratize data and get it into the hands of individuals who have a top-down influence.”

Peterson has served as a faculty associate at UCLA CHPR since 2003 and has also served as an organizer and facilitator of the Center’s annual E.R. Brown Symposium. He was a founding team member of the UCLA-based multidisciplinary Blue Sky Health Initiative to transform the U.S. health and health care system, which advised Congress and the executive branch on the inclusion of population health strategies in the Affordable Care Act. As an American Political Science Association (APSA) Congressional Fellow, he was a legislative assistant for health policy for U.S. Senator Tom Daschle.

As a long-time faculty associate of the UCLA Center for Health Policy Research, I am absolutely delighted and honored to take on the new role of senior fellow at one of the nation’s premier institutions that uses rigorous evidence to advance excellence and equity in health and health care for all populations from Los Angeles to California and the nation,” said Peterson.

An elected member of the National Academy of Social Insurance, Peterson has served on the Academy’s Study Panel on Medicare and Markets and on the Health Policy Advisory Committee for the Barack Obama for President Campaign. He chaired the National Advisory Committees for the Robert Wood Johnson Foundation's Scholars in Health Policy Research program and its Changes in Health Care Financing and Organization (HCFO) program, and was a member of the National Advisory Committees for RWJF’s Investigator Awards in Health Policy Research Program and Center for Health Policy at the University of New Mexico. Peterson was a founding member of the American Political Science Association’s Organized Section on Health Politics and Policy, previously served as president of its Organized Section on Public Policy, and was a member of the APSA Presidential Task Force on Coronavirus. He has also chaired the University of California Academic Senate's Health Care Task Force.

Peterson has authored or co-authored books including Legislating Together: The White House and Capitol Hill from Eisenhower to Reagan (Harvard University Press); Institutions of American Democracy: A Republic Divided (Oxford University Press); and edited or co-edited Institutions of American Democracy: The Executive Branch (Oxford University Press); Healthy Markets? The New Competition in Medical Care (Duke University Press); Uncertain Times: Kenneth Arrow and the Changing Economics of Health Care (Duke University Press); and the four-volume series, Health Politics and Policy (SAGE Publishing). He is currently completing a comprehensive book manuscript on the politics of health care reform, “American Sisyphus: Health Care and the Challenge of Transformative Policymaking.”  For nearly a decade, he served as editor of the Journal of Health Politics, Policy and Law (Duke University Press) and has authored or co-authored dozens of chapters and journal articles in peer-reviewed journals, such as the American Political Science Review, Tax Law Review, the Journal of Community Health, and Presidential Studies Quarterly.

Peterson is the recipient of numerous awards including the Richard E. Neustadt Award from the APSA's Presidents and Executive Organized Section, the APSA's E. E. Schattschneider Award, the Pi Sigma Alpha Award from the Midwest Political Science Association, and a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

A nationally-recognized expert, Peterson has made many appearances in radio, print, and television media interviews, including CBS News, National Public Radio and state public radio networks, CNNMoney.com, The New York Times, Washington Post, Los Angeles Times, USA Today, Christian Science Monitor, U.S. News & World Report, The Hill, Kaiser Health News, American Medical News, Internal Medicine News, The Lancet Oncology, and much more including global media outlets in Latin America, Europe, and Asia.


About the UCLA Center for Health Policy Research

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

11/29/2021375
  
Approved11/15/2021 11:04 AMNo presence informationElaiza Torralba11/29/2021 2:55 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationWho Is Caring for the Caregivers? The Financial, Physical, and Mental Health Costs of Caregiving in California2252
Researchers outline physical, mental, and financial burdens among millions of the state’s family and friend caregivers

Nearly half or 44.4% of California’s estimated 6.7 million adult caregivers reported experiencing some level of financial stress in 2020 due to their role, according to a new study published by the UCLA Center for Health Policy Research (CHPR). In that same year, 13.5% of all caregivers, which refers to adults who reported providing care in the last 12 months to a family member or friend with a serious or chronic illness or disability, said they suffered from a physical or mental health problem due to caregiving.

The study used data from UCLA CHPR’s 2020 California Health Interview Survey (CHIS), which is the first set of data in over a decade on this group, and found that caregivers across different demographic backgrounds were struggling financially or mentally, and that the severity also varied based on factors such as the amount of time spent caregiving per week. Researchers also note that caregivers were given little, if any, financial support for their responsibilities, citing that 1 in 4 California caregivers provided 20 or more hours of care per week. Yet only 1 in 11 caregivers received payment for any of the hours spent doing so, and often incurred out-of-pocket costs.

“Because they provide a significant portion of care for people with chronic needs and disabilities, it is vital that we assess caregivers’ financial and mental health needs in order to support the creation or expansion of policies that can alleviate any kind of burden they are experiencing,” said Sean Tan, lead author of the study and senior public administration analyst at UCLA CHPR.

Researchers outline a variety of characteristics among caregivers and care recipients, stating that a majority of caregivers in California are women (57.7%), middle age or ages 26 to 64 (67.5%) and provide care to mainly older adults ages 65 and older (64.7%). By racial and ethnic group, about 40.7% of caregivers are white, 37.4% are Latinx, 11% are Asian, 6.3% are Black or African American, 0.5% are Native Hawaiian or Pacific Islander, 0.7% are American Indian or Alaska Natives and 3.4% are two or more races.

Some of the main findings from the study include:

  • About 1 in 5 (20.9%) caregivers reported that caring for their relative or friend was somewhat to extremely financially stressful. The level of reported financial stress increased as the number of hours providing care increased.
  • Caregivers who identified as Black (28%), Asian (23.4%) or Latinx (21.9%) were more likely than those who were white (17.7%) to report that caregiving was “somewhat” to “extremely” financially stressful.
  • Caregivers who provided 30 or more hours of care per week and 20–29 hours of care per week reported the highest percentages of suffering physical or mental problems due to caregiving in the past 12 months — 21.5% and 21.1%, respectively.

The study’s authors outline several proposed policies and assembly bills which, if passed into law, could help substantially with providing sufficient income replacement and job protection, which are currently limited under California’s Paid Family Leave Act. They propose recommendations to respond to caregivers’ financial, physical and mental health needs.

“Dedicated efforts to raise awareness of paid family leave benefits in the state through employment or employer agencies, resource centers and media can be made so that the state can provide critical aid to an ever-growing population of adults who shouldn’t have to compromise their own health,” said Kathryn Kietzman, one of the study’s authors and director of the UCLA CHPR’s Health Equity Program. She’s also a senior research scientist at UCLA CHPR and associate researcher at the UCLA Fielding School of Public Health. “Moreover, health and social service providers can implement policies that require the assessment of caregiver needs and create more targeted programs that respond to the multiple challenges that many caregivers are facing.”

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

11/24/2021374
  
Approved11/10/2021 3:46 PMNo presence informationElaiza Torralba11/24/2021 2:12 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-0975AJ Scheitler, Ed.D.ajscheitler@ucla.edu(310) 794-828616125NY
Publication

Ninez A. Ponce, PhD, MPP, director of the UCLA Center for Health Policy Research, principal investigator of the center’s California Health Interview Survey, and professor of health policy and management at the UCLA Fielding School of Public Health, received a one-year $250,000 grant from the U.S. Department of Health and Human Services’ Office of Minority Health to serve as a data intermediary, helping to bridge the gap between community-based organizations and data on social determinants of health. 

Under the grant, a team at the center’s Native Hawaiian and Pacific Islander (NHPI) Data Policy Lab will create a tool to break down the community’s barriers to accessing and utilizing disaggregated data, or data which are broken down by racial and ethnic subgroups, to inform advocacy efforts and programs. Historically, data on the NHPI community are “hidden” because it is absorbed into other racial groups when data are reported. The lab was launched in August 2020 and aimed to address striking gaps within COVID-19 data and research for NHPIs, including adding more states to report disaggregated cases. Since its founding, the lab team has expanded its project reach to beyond the pandemic. The new project will help identify and parse disaggregated data specific to the community and provide community-based organizations serving the NHPI community with a user-friendly health data access tool featuring social determinants of health data.

“The grant will enable the NHPI Data Policy Lab team to bring much-needed data to organizations who are providing a breadth of on-the-ground resources and aid — in places where they live, work, go to school, and socialize — to this historically underserved community,” said Ponce.

During the grant period, the lab will survey these community-based organizations across California about their data use and needs, then construct a user-friendly data platform that brings together key data sources on social determinants of health. The project will further create trainings on data access and analysis to ensure the community gains access that was previously reserved for communities that have not faced the past data barriers.

“As a Sāmoan woman in public health, one of the most rewarding aspects of the lab has been working with community organizations, and this grant will help us continue our dedicated efforts to healing the community not only from the pandemic, but other long-standing health issues,” said Karla Thomas, MPH, policy director and co-founder of the NHPI Data Policy Lab and UCLA alumna.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu

11/24/2021376
  
Approved11/23/2021 1:00 PMNo presence informationElaiza Torralba11/24/2021 2:12 PMNo presence informationElaiza Torralba
Publication
Interdisciplinary research team will explore locally suitable solutions to vaccine acceptance and uptake strategies in Kenya during COVID-19 pandemic

The UCLA Center for Health Policy Research (CHPR) announced today that an interdisciplinary research team has been selected as a partner for the Sabin Vaccine Institute’s Vaccine Acceptance & Demand Initiative 2021 Social and Behavioral Grants Program. The team, led by Corrina Moucheraud, ScD, associate director at the UCLA Center for Health Policy Research and associate professor of health policy and management at the UCLA Fielding School of Public Health (FSPH), is one of 10 selected projects from around the world that will apply a range of social and behavioral science approaches to investigate locally suitable solutions to support COVID-19 vaccine and routine immunization acceptance and uptake over the next year.

“The COVID-19 pandemic has upended health systems and services worldwide, including the delivery of routine childhood vaccines. We need to better understand disruptions to vaccination programs in Africa, in order to design strategies for making up for these losses. We are so proud to have been selected as a 2021 Social and Behavioral Grant Partner to study the effect of the pandemic on routine childhood vaccination in Kenya,” said Moucheraud, principal investigator of the grant.

The Sabin Vaccine Institute grant will build on an existing collaboration with the Kenya Medical Research Institute (KEMRI) and Innovations for Poverty Action (IPA) to create new and expanded data to better understand the magnitude of under-vaccination, assess potential determinants, and collaborate with Kenyan women, policymakers, and other key stakeholders to design evidence-based solutions to address these barriers. Through the ongoing collaboration, the team is working to understand how the COVID-19 pandemic has affected maternal and child care utilization in Kenya.

“Childhood vaccinations are crucial for good public health. If babies born during the pandemic are substantially under-vaccinated, we cannot take a passive approach to vaccination catch-up and need evidence-based strategies to ensure that these gaps are closed quickly and equitably,” said Moucheraud.

Moucheraud will be joined by UCLA colleagues May Sudhinaraset, PhD; Beth Glenn, PhD; and Ashley Gromis, PhD; as well as researchers from KEMRI and IPA.

Established in 2019, the Social and Behavioral Research Grants Program initially funded three on-the-ground research projects exploring childhood and routine vaccination acceptance among communities in low- and middle-income countries (LMICs). Now in its third year, the program has expanded to 10 grant partners located in eight LMICs, with research reprioritized to account for and respond to the impact of the pandemic on vaccine acceptance and uptake. Central to the objectives of the 2021 grant partnership are efforts to develop and disseminate evidence-informed knowledge and solutions-based strategies from the research. 

“The COVID-19 pandemic remains a challenge to global communities through its continued waves of infection, emergence of variants and infodemic; all of which also impact upon routine immunization programs, requiring a closer look at how we approach vaccine acceptance and uptake worldwide,” said Kate Hopkins, Sabin’s Director of Research, Vaccine Acceptance & Demand. “We look forward to supporting the exciting and diverse work of the 2021 grant partners as they explore how different community-centric approaches may serve to improve public health responses, particularly in terms of vaccine equity, marginalized populations and implementation of effective social media and messaging strategies to tackle misinformation.”    

Learn more about the Sabin Vaccine Acceptance & Demand Initiative Social and Behavioral Research Grants program. 


About the Sabin Vaccine Institute

The Sabin Vaccine Institute is a leading advocate for expanding vaccine access and uptake globally, advancing vaccine research and development, and amplifying vaccine knowledge and innovation. Unlocking the potential of vaccines through partnership, Sabin has built a robust ecosystem of funders, innovators, implementers, practitioners, policy makers and public stakeholders to advance its vision of a future free from preventable diseases. As a non-profit with more than two decades of experience, Sabin is committed to finding solutions that last and extending the full benefits of vaccines to all people, regardless of who they are or where they live. At Sabin, we believe in the power of vaccines to change the world. For more information, visit www.sabin.org and follow us on Twitter, @SabinVaccine.

About the UCLA Center for Health Policy Research

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

11/15/2021373
  
Approved11/10/2021 3:42 PMNo presence informationElaiza Torralba11/15/2021 3:09 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
New August 2021 data continue to highlight residents’ willingness to adhere to safety guidelines by their vaccination and testing status, and negative impacts to personal and financial well-being
Over the last four months, the UCLA Center for Health Policy Research (CHPR) began to share early data from the 2021 California Health Interview Survey (CHIS), which shed light on how residents were navigating the pandemic through engaging in risk reduction behaviors, getting tested or seeking medical advice about the virus, perceptions about the vaccine, as well as financial and personal impacts related to employment, ability to pay for basic necessities and rent, and mental health stressors. The survey team’s final CHIS Preliminary COVID-19 Estimates Dashboard update of the year adds data from August 2021, which included responses from 3,124 Californians. There was a total of 20,724 respondents in the 2021 data shared from March through August.

The data show that California adults who said they had ever received a positive COVID-19 test result were more likely to engage in risk reduction behaviors such as wearing face coverings and avoiding gathering with members outside of their household. Additionally, people who had not received the vaccine, but were planning to, were also more likely to follow safety guidelines than people who said they would not get the vaccine and individuals who already received the vaccine.

 

“Even the slightest risk reduction behavior changes are important because they are part of several factors that contribute to the spread of COVID-19 and can support evidence for policies such as vaccine mandates or proof of vaccination, or getting tested regularly and ensuring a negative result prior to entering a public establishment,” said UCLA CHPR Director and CHIS Principal Investigator Ninez A. Ponce, PhD, MPP, who also serves as a professor at the UCLA Fielding School of Public Health. “As the state begins to enforce different mandates, we will continue to provide actionable data that policymakers, community organizations, public health officials, and other stakeholders can use to guide the state’s recovery plan.”

 

Key findings from the August 2021 data include:

 

Risk Reduction Behaviors

 

California adults varied in their risk reduction behaviors based on their test result status.

  • About half (52.2%) of California adults who had ever received a positive test result for COVID-19 gathered with people not living in their household compared to more than two-thirds (68.1%) of adults who never tested positive.
  • 66.3% of California adults who had ever received a positive test result for COVID-19 always wore face coverings when leaving their homes compared to 58.7% of adults who never tested positive.

 

California adults not planning to get vaccinated reported higher levels of engaging in risk reduction behaviors.

  • Individuals who did not plan to get vaccinated were more likely to say they never followed state and local safety guidelines when gathering with people outside of the household  29% vs. 4.4% who received at least one dose of the vaccine in August.

 

Californians reported wearing their face coverings less from March through August.

  • Adults who said they always wore face coverings when leaving their homes decreased by more than 30% between March (84.8%) and August 2021 (58.2%). The percentages declined by 40% from March/April (84.8%) to July (50.2%), but increased from July to August.

 

Personal and Financial Impacts

 

Nearly 1 in 8 (12.1%) California adults said they lost their jobs during the pandemic.

  • Nearly 1 in 3 (29%) adults within 0–99% of the federal poverty level (FPL) experienced job loss, compared to 6.2% of adults 300% FPL and above.
  • More than 1 in 4 (28.5%) non-U.S. citizens said they lost their jobs, compared to 13.1% of U.S.-born citizens.
  • More than 1 in 5 (21.6%) adults in the San Joaquin Valley and more than 1 in 6 (17.1%) adults in Los Angeles County said they lost their jobs.
  • 1 in 4 (25.5%) adults who were uninsured lost their jobs compared to 13.4% of adults who had health insurance.

 

More than 1 in 7 (13.7%) California adults had difficulties paying for basic necessities in August 2021.

  • Adults with serious psychological distress were much more likely to have difficulties paying for basic necessities than adults who did not have serious psychological distress (30.7% vs. 11.5%, respectively).
  • 17.3% of adults who had a child or teen living in their household experienced difficulties paying for basic necessities compared to 11.7% without children or teens in their household.
  • Multiracial (30%), Black or African American (22.1%), and Latinx (18.3%) adults were more likely than white adults (7.6%) to experience difficulties paying for basic necessities.

 

“It has been alarming to consistently see the personal and financial impacts of the pandemic on Californians, hitting the already at-risk communities the hardest,” said Todd Hughes, CHIS director. “We look forward to releasing the entire 2021 dataset in Fall 2022 and hope that the dashboard will continue to be useful in identifying groups who are most in need of assistance.”

 

Note: The California Health Interview Survey Preliminary COVID-19 Estimates Dashboard can be filtered by a range of sociodemographic factors such as age, race/ethnicity, and educational attainment, as well as other health indicators and risk factors.

 

The California Health Interview Survey, the nation’s largest state health survey, covers numerous categories, including general health status, health conditions, neighborhood and housing, health insurance, child care, employment, income, and other measures, such as race and ethnicity, marital status, sexual orientation, and citizenship.
11/8/2021371
  
Approved10/25/2021 3:15 PMNo presence informationElaiza Torralba11/8/2021 12:12 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
Researchers find negative perceptions and experiences with law enforcement, workplace discrimination and health care access

California’s Latinx and Asian immigrants have varied perceptions and experiences at the workplace, accessing health care, encountering law or immigration enforcement, and using public benefits, according to new data released by the UCLA Center for Health Policy Research (CHPR).

Findings were published in two fact sheets — one on Latinx and Asian immigrants’ negative perceptions of the immigration experience in California  and one that focused on their experiences with law and immigration enforcement — as part of a series of studies that will come out of the Research on Immigrant Health and State Policy Study (RIGHTS), a follow-up survey of the Center’s 2018 to 2019 California Health Interview Survey.

In the first fact sheet, which looks at Latinx and Asian immigrants’ perceptions of immigrant experiences, researchers found that 70% of the 2,000 individuals surveyed perceived that immigrants experienced discrimination at the workplace due to skin color or accent. Additionally, 65% felt that they would be prevented from gaining legal U.S. immigration status if they used government benefits such as income assistance, health care, food programs and housing aid.

Researchers explain that they looked at these groups because California is home to a quarter of the nation’s immigrants, the largest immigrant population of any state, with Latinxs and Asians as the largest subgroups.

“It’s critical for policymakers, community organizations and other stakeholders to understand immigrants’ experiences and how these experiences may impact their health and overall well-being. Such experiences contribute to health inequity overall,” said Nadereh Pourat, associate director at the Center and lead author of one of the reports.

“Previous studies have shown that aggressive federal immigration enforcement sparks fear among the immigrant population, and leads to forgoing of needed health care and other important services, even in states such as California that support immigrant rights,” she added.

Latinxs and Asians had negative perceptions of various immigrant experiences

This fact sheet showed that more Latinx than Asian immigrants perceived that immigrants experience discrimination in the workplace, unequal access to health care, barriers to getting legal status, safety risks when calling the police for help and risk being stopped by immigration officials while traveling. In contrast, Asian immigrants were more likely than Latinx immigrants to perceive that immigrants were not safe from immigration officials in their neighborhoods.

Negative experiences also reported with law or immigration enforcement

The second fact sheet took a closer look at Latinx and Asian immigrants’ experiences with local law and federal immigration enforcement policies and practices. It identified differences between three California regions: the Bay Area, Los Angeles and Southern California and the San Joaquin Valley. The authors found that higher percentages of respondents reported direct experiences with immigration and law enforcement in the San Joaquin Valley compared to the Bay Area and the Los Angeles and Southern California regions. For example, 17% of San Joaquin Valley residents reported being racially profiled by law enforcement, compared to 14% in the Los Angeles and Southern California region and 12% in the Bay Area.

The study also outlines differences between Latinxs and Asians in their experiences with law enforcement. Latinx immigrants reported higher percentages of knowing someone who had been deported (42% vs. 13%) and being racially profiled (16% vs. 10%). Among Asian immigrants, these were the most common law enforcement experiences.

“The data from the RIGHTS study highlights the importance of understanding the range of experiences that immigrants have encountered under our state policies,” said Maria-Elena De Trinidad Young, one of the Center’s faculty associates and an assistant professor at UC Merced. “California advanced many policy efforts to protect immigrants. Yet, immigrants’ experiences are varied and understanding their perceptions sheds light on the drivers of persistent health inequities in the state.”

The UCLA Center for Health Policy Research will release more findings from the RIGHTS study in spring 2022.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health.

10/28/2021372
  
Approved10/28/2021 6:33 PMNo presence informationElaiza Torralba11/5/2021 3:35 PMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
Ninez A. Ponce, director of the UCLA Center for Health Policy Research and a professor of health policy and management at the UCLA Fielding School of Public Health, joined government, community, health, business, and other Filipino leaders from across the country at the White House Filipino American History Month event on Thursday, October 28.

“Filipino Americans contribute significantly to our health care workforce and have been disproportionately impacted throughout the COVID-19 pandemic, and yet these disparities are often masked due to a lack of adequate data on AA and NHPI communities,” said Krystal Ka'ai, executive director of the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders, during her introduction of Ponce, who was selected to provide remarks on health. 

A “health data revelator,” Ponce outlined her three key roles: data producer, data equity advocate and coalition and pipeline builder.

First, through her work as principal investigator of the California Health Interview Survey, Ponce produces disaggregated race and ethnicity data that has provided scholars, advocates, legislators, and other decisionmakers the evidence to address the unmet needs of Filipino Americans.

Filipinos are overrepresented in the provision of health and long-term care services in the United States,” said Ponce. “Our [UCLA] Center for Health Policy Research has provided technical assistance and examples for other federal, state and local health surveys to follow the values that we have in California with CHIS.”

A data equity advocate, Ponce helped develop the first CHIS in 2001 and has led numerous pioneering efforts in multicultural survey research, including measures of racial/ethnic identity, acculturation, generational status, and discrimination. She also devised the rationale and implementation of Asian ethnic oversamples and the cultural and linguistic adaptation of the survey in Chinese (Cantonese and Mandarin), Korean, Vietnamese and Tagalog. Today, CHIS is a national model for data collection on race/ethnicity and on the meaningful inclusion of Asian Americans and Pacific Islanders.

Ponce, who has conducted research on the disproportionate toll of COVID-19 on various communities since the start of the pandemic, pointed to how a lack of data disaggregation in health systems, including aggregating Asian Americans together, has masked health disparities and contributed to health inequities. Through her recent research, which has been published in JAMA Health Forum, Ponce has found that Filipinos, which represent a large proportion of health care workers, have been disproportionate impacted by COVID-19, and advocates for Filipinos to be considered a priority population.

“It’s important to stress that as we are losing Filipinos in the front lines of fighting the pandemic, that we were simultaneously lost in the data, and consequently lost in policy priorities,” she said.

Lastly, Ponce emphasized the importance of building coalitions to advance Filipino American health, including the Filipinx/a/o Community Health Organization, a multigenerational, multidisciplinary collective of Filipino leaders, which Ponce co-founded to continue the fight for visibility in data.

“When the data is available, to not just let it sit on a shelf, but to generate the insights on Filipinos and connecting these insights to informing policy so we can ultimately address the unmet need and advance the health and well-being of Filipino Americans,” said Ponce. 

Hosted by the White House Office of Public Engagement and the White House Initiative on Asian Americans, Native Hawaiians, and Pacific Islanders, the event featured Air Force Undersecretary Gina Ortiz Jones, San Antonio Mayor Ron Nirenberg, California Attorney General Rob Bonta, various Filipino American Biden-Harris appointees, and other community leaders in celebration of Filipino changemakers in the United States.

A recording of the event can be viewed on the White House Initiative on Asian Americans and Pacific Islanders' YouTube page.

10/20/2021369
  
Approved10/4/2021 2:56 PMNo presence informationElaiza Torralba10/20/2021 8:09 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationMissed Opportunities: Up to 9 in 10 Women Eligible for Public Health Services in California Have Unmet Mental Health Need2215
UCLA CHPR study shows unmet needs particularly high for women of color, noncitizens, those who don’t speak English

Among women in California who have recently experienced mild to moderate psychological distress and are eligible for public health services, 4 out of 5 said they received no treatment, a policy brief published today by the UCLA Center for Health Policy Research (CHPR) shows.


Those who qualify for these public services — a third of all women over the age of 18 — were also more likely than their privately insured counterparts to have experienced moderate or serious psychological distress (31% vs. 21%), according to the study, which analyzed data from the center’s California Health Interview Survey (CHIS) from 2018 and 2019.


The researchers say that the findings point to an urgent need to expand and improve access to public programs aimed at addressing the mental health needs of these women — particularly women of color, who reported the highest levels of unmet needs. If untreated, mild to moderate psychological distress has the potential to become progressively more severe and disabling.


“A public health-focused approach is vital because it can help to promote mental well-being and may prevent more severe impacts on individuals’ lives, their educational goals and their employment pursuits,” said D. Imelda Padilla-Frausto, a research scientist at UCLA CHPR and a lead author of the study.


Overall, the researchers found that women who were eligible for Medi-Cal or other public care programs had high degrees of unmet mental health needs across all levels of psychological distress, with roughly 90% of those with mild distress, 70% with moderate distress and 50% with serious distress reporting that they hadn’t accessed professional care within the previous 12 months.


The role of social and economic factors in unmet mental health needs


The researchers also sought to identify how socioeconomic factors like race, ethnicity, language, citizenship, family type, education and employment status, among others, may influence whether women are uninsured or reliant on public insurance, as well as how these factors may present barriers to accessing needed mental health care.


They found that women of color were two to four times as likely as white women to be eligible for public health coverage, and that those without a high school education were more than four times as likely as those with a graduate degree to be eligible. While only 18% of married women with no children were eligible, 68% of single women with children qualified for public health coverage. And 54% of noncitizen women with a green card were eligible, compared with 28% of U.S.-born citizens.


The authors discovered that when these women were surveyed about their mental health status, many of the same social and economic determinants appeared to influence whether those experiencing distress had accessed treatment or support services. Among the findings:


  • Asian and Latina women were more likely to report unmet needs for mild and serious psychological distress than white women; Asian women experiencing mild psychological distress also had the highest overall percentage of unmet needs (95%). Among those experiencing serious distress, the percentages of those with unmet needs were: Asian women (66%), Latinas (55%), Black women (52%) and white women (42%).
  • Noncitizen women without a green card were more likely to report unmet needs for mild and serious psychological distress than women who are U.S.-born citizens, with a particularly large difference for serious distress (75% vs. 52%).
  • Women who speak only an Asian language had a higher percentage of unmet needs across all levels of distress than women who speak only English. Among those with serious distress, 73% of those who speak only an Asian language had unmet needs, compared with 44% of women who speak only English.
Examining these social and demographic factors helps pinpoint which groups of women are experiencing unmet mental health needs and at which levels of distress, information that in turn can aid in developing tailored approaches for these specific populations, Padilla-Frausto said.

Interventions focused on women are critically important, she noted, given that previous analyses by the center have shown that while women and men are equally likely to experience mild and moderate psychological distress, women are more likely to experience serious distress.

“The data highlight the need to develop and promote preventive strategies to identify and help women with mild or moderate mental health problems who are at-risk of their symptoms becoming more severe and disabling,” she said. “And policies that center on racial equity and gender equality are needed to reduce inequities in the social determinants that lead to poor mental health.”

Among the policies recommended by the researchers are the implementation of national standards for culturally and linguistically appropriate health services, large-scale efforts that promote mental health literacy and outreach, supporting equitable social and economic policies that reduce inequities in care for women, and expanding screening services into spaces where women live their everyday lives.

“In addition to large-scale interventions, we need to provide mental health resources to at-risk communities in non-clinical settings such as at faith-based organizations, beauty salons, grocery stores, libraries and community resource centers,” Padilla-Frausto said.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health.
10/14/2021370
  
Approved10/13/2021 8:32 PMNo presence informationElaiza Torralba10/14/2021 11:39 AMNo presence informationElaiza Torralba
Publication
Latest dashboard includes new July 2021 data and features varied responses among residents who tested positive for COVID-19 versus those who didn’t
With over 4.8 million cases and over 70,000 deaths due to COVID-19 in California, the UCLA Center for Health Policy Research (CHPR) is continuing to track whether residents engaged in risk reduction behaviors such as wearing face coverings or maintaining physical distancing, impacts on personal and financial well-being, and their views on the vaccine. The latest update to the 2021 CHIS COVID-19 Preliminary Estimates Dashboard, which adds responses from 3,932 Californians in July 2021, builds on previously released data collected from March through June of this year. The most recent data show declines in following safety guidelines, including an increase in gathering with members outside of the household, during a month when cases had spiked again. It also showed that Californians who tested positive for COVID-19 were more likely to experience difficulties paying for basic necessities and rent or mortgage than residents who tested negative. Being able to filter impacts by respondents “ever testing positive for COVID-19” was an added feature in the latest dashboard update.
 
“Given the unpredictable course of case and death rates that are rising and falling in different areas, there is a real need to keep tracking pandemic impacts and related changes in behaviors in California,” said Todd Hughes, CHIS director. “For example, as public health practitioners continue to urge following safety guidelines and getting the vaccine, it’s important to examine whether Californians are still engaging in practices that would mitigate the spread and continue the state’s fight against the pandemic.”

Key findings from the July 2021 data include:
 
Risk Reduction Behaviors
 
California adults who said they always wore face coverings when leaving their homes decreased by more than 40% between March and July 2021.
  • Among all California adults, 50.2% said they always wore face coverings when leaving their homes in the past week in July 2021, compared to 67.8% in June 2021, 79.1% in May 2021, and 84.8% in March/April 2021.
  • By race and ethnicity: White adults were the least likely to always wear face coverings at 27.1%, compared to 72.2% of Black or African American adults, 68.4% of Asian adults, and 63.8% of Latinx adults.
  • By vaccine acceptance: Adults who indicated they will not receive the COVID-19 vaccine were the least likely to always wear face coverings at 36.7%, compared to 49.5% of adults who had received at least one dose of the vaccine and 66.4% of adults who had not received the COVID-19 vaccine, but would get it. Nearly 1 in 5, or 18.2% of, adults who said they will not receive the COVID-19 vaccine indicated they never wore face coverings when leaving their home in July, compared to 6.4% in June.
 
California adults who always maintained 6 feet distance from others when leaving their home in the past week dropped from 54% in March/April to 36.2% in July 2021.
  • More than half of Black or African American adults said they always maintained six feet distance from others when leaving their homes compared to 1 in 5 white adults. Asian (41.6%), Latinx (48%), and Black or African American (52.4%) adults were more than twice as likely as white (20.7%) adults to always maintain six feet distance from others when leaving their homes.
 
69.9% of all California adults indicated they gathered with people not living in their households in the past 30 days in July, compared to 53.1% in March/April 2021.
  • Adults who indicated they had a risk factor (asthma, diabetes, or high blood pressure) were just as likely as adults who didn’t have a risk factor to gather with people outside of their households, at 71.5% and 68.8% respectively.
 
Among adults who gathered with people not living in their households, 38.5% said they always followed state and local guidelines in July and 28.1% said they never or sometimes followed guidelines.
  • Adults who said they will not receive the COVID-19 vaccine were more than four times more likely to say they never followed state and local guidelines when gathering with people not living in their household than those who had received at least one dose of the vaccine, 28.1% vs. 6.4% respectively.
 
Personal and Financial Impacts
 
Adults who tested positive for COVID-19 were more likely to experience difficulties paying for basic necessities and rent/mortgage, have reduced job hours/income, and lose their jobs than adults who tested negative for COVID-19.
  • Adults who tested positive for COVID-19 were nearly twice as likely as adults who tested negative for COVID-19 to have difficulties paying for basic necessities (23% vs. 12.7%, respectively) and difficulties paying rent/mortgage (19.1% vs. 10.7%, respectively).
 
Personal and financial impacts, such as reduced job hours/income and difficulty paying for basic necessities and rent/mortgage varied by race/ethnicity, citizenship status, and other factors.
  • White adults were the least likely to experience reduced job hours/income (14.8%) compared to multiracial (29.8%), Black or African American (28.7%), Latinx (23%), and Asian (18.9%) adults.
  • Latinx (17.4%) and Black or African (16.8%) adults were more than twice as likely as white (7%) adults to experience difficulties paying for basic necessities.
  • Non-citizens were nearly twice as likely as citizens to have reduced job hours/income, 35% vs. 17.9% respectively, and experience difficulties paying their rent/mortgage, 19.7% vs. 9.7% respectively.
 
“The data we collected and are continuing to collect are being used to inform policymakers, community leaders, and other advocates so that they are able to effectively reach communities that are most in need,” said UCLA CHPR Director and CHIS Principal Investigator Ninez A. Ponce, PhD, MPP, who also serves as a professor at the UCLA Fielding School of Public Health. “This actionable data can assist with outreach efforts to get more people vaccinated or enforce safety protocols to slow down and stop the spread of the disease and get the state on track for a complete recovery. It’s also critical to note that these data can be viewed and used by everyone — whether you’re a data analyst for the state, a grant writer for a nonprofit, a program manager for a community organization, on-the-ground outreach worker, or a concerned Californian.”

The California Health Interview Survey, the nation’s largest state health survey, covers numerous categories, including general health status, health conditions, neighborhood and housing, health insurance, child care, employment, income, and other measures, such as race and ethnicity, marital status, sexual orientation, and citizenship.
9/22/2021368
  
Approved9/9/2021 1:50 PMNo presence informationElaiza Torralba10/6/2021 8:32 AMi:0#.f|uclachissqlmembershipprovider|celesteElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationCalifornia Reached Health Coverage Milestone With 94% of People Insured in 2020, but Access to Care Remains a Challenge During the COVID-19 Pandemic2210
New data show how the COVID-19 pandemic, racial tensions, and other challenges may have impacted health care access and status

Nationwide, various reports on COVID-19 cases and deaths, racial injustice, and a presidential election flooded the media circuit throughout 2020. As the U.S. continues to grapple with the pandemic’s toll on countless lives, findings from the California Health Interview Survey, or CHIS, are taking a closer look at statewide impacts among 39.5 million Californians.

The just-released data from the survey, which is led by a team at the UCLA Center for Health Policy Research, shows a range of results on how the pandemic, along with other unprecedented factors, may have affected residents’ health. The research team quickly adapted the survey to add a series of COVID-19 questions last year. A total of 22,661 households were included in the 2020 data, including 21,949 adults, 1,365 adolescents, and 3,548 children.

For example, the survey found that COVID-19 was a primary reason why people delayed or decided to go without medical care in 2020. In contrast, it may have been a surprise that there were a record number of Californians  94% — who had health insurance coverage last year. Differences in health care access, especially across racial and ethnic groups, were more likely to have been magnified during this time period. This was confirmed by an accompanying policy brief, which estimated that about 1 in 10 or 11% of Black and African American respondents said that they did not have a usual place to go when sick or needing health advice in 2020, a 26% jump from 2019, despite almost 90% of this group being insured.

Data on pandemic impacts, health status and behaviors along with other health-related topics are part of the center’s annual CHIS data release, which takes place online today at noon PT.

“This is one of the most important data releases in the survey’s 20-year history because it sheds light on how impactful the pandemic was on multiyear trends in California for health-related behaviors and access to health care, as well as unfair treatment due to race or ethnicity” said Todd Hughes, CHIS director. “These findings are building on the CHIS preliminary COVID-19 monthly estimates we released starting in September 2020, more than a year in advance of this year’s full release, that provided early monthly data on COVID-19 treatment and vaccine acceptability, as well as personal and financial impacts of the pandemic to aid in the state’s response to the ongoing crisis.”

Among the 2020 survey results:

COVID-19 was cited as a primary reason why Californians delayed or decided to go without medical care in 2020. More than 1 in 5 or 21.6% of all Californians who reported delaying or forgoing medical care cited COVID-19 as the main reason. Older adults ages 65 and up were more likely among all age groups to cite COVID-19 as the main reason for delaying or forgoing care at 44.2%.

Reports of unfair treatment based on race and ethnicity were more pronounced among certain groups. Black and Asian adults were more likely to report experiencing unfair treatment compared to all racial and ethnic groups at 6.4% and 4.2%, respectively. Black adults were more than three times as likely and Asian adults more than twice as likely to report unfair treatment compared to all California adults at 1.9%. Adults who reported being treated unfairly due to race and ethnicity were also more likely to say they had thoughts of suicide compared to individuals who said they did not experience unfair treatment due to race — 19.3% vs. 12.1%.

Essential workers reported at higher rates that they ever had or thought they had COVID-19, but were less likely to say in 2020 that they would get the vaccine compared to nonessential workers. 15.1% of essential workers ever had or thought they had COVID-19 compared to 12.1% of nonessential workers. 73.6% of essential workers said they would get the COVID-19 vaccine compared to 76.7% of nonessential workers.

Stay-at-home orders in 2020 led to improvements for youth in eating a healthy diet and avoiding binge drinking, but led to worsening in other behaviors like sedentary activities and nearly constant internet usage. In 2020, 2.6% of adolescents ages 12 to 17 said they engaged in binge drinking in the past month compared to 7% in 2019. The percentage of adolescents who said they ate five or more servings of fruits and vegetables daily was 26.1% in 2019 and 33.3% in 2020. There was a 51% increase from 2019 to 2020 of adolescents reporting that they were “almost constantly” on the internet — 28.6% in 2019 vs. 43.2% in 2020. The percentage of children and adolescents ages 2 to 17 who spent 5 or more hours on sedentary activities increased from 2019 to 2020 — 35.4% in 2019 vs. 40.8% in 2020.

“Seeing how COVID-19 affected the physical, mental, and emotional health of Californians benefits not only researchers, but also individuals and groups engaged in policy and on-the-ground efforts across the state,” said Ninez Ponce, UCLA CHPR director and CHIS principal investigator. “Because the targeted data can be acted on, it enables those in power to determine which Californians most need help.”

The new survey results are available to the public for free through the center’s AskCHIS website. In addition, public use files with the new data are downloadable from the website, and researchers may access confidential data files from the study by applying to the center’s Data Access Center.

The California Health Interview Survey, the nation’s largest state health survey, covers numerous categories, including general health status, health conditions, neighborhood and housing, health insurance, child care, employment, income, and other measures, such as race and ethnicity, marital status, sexual orientation, and citizenship.

9/2/2021367
  
Approved9/2/2021 9:40 AMNo presence informationElaiza Torralba9/2/2021 12:52 PMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
Corrina Moucheraud, ScD, MPH, a global health policy, systems, and services researcher, has been named an associate center director at the UCLA Center for Health Policy Research (CHPR).

Moucheraud brings over 15 years of experience in global public health research — focusing on areas including HIV/AIDS, women’s health, malaria, and non-communicable diseases such as hypertension — with projects in many lower-resource countries in sub-Saharan Africa and south Asia. She has been a UCLA CHPR faculty associate since April 2016, and will share expertise on how global health policies can be used to inform U.S. health policies.

“I am thrilled to welcome Dr. Corrina Moucheraud to the UCLA Center for Health Policy Research leadership team,” says UCLA CHPR Director Ninez A. Ponce, PhD, MPP. “We are at a critical point in time for global health. And today’s global health challenges require commitment and collaboration. Dr. Moucheraud’s vast experience in global health research, coupled with her passion for health equity and deep knowledge of global health policy and health systems, make her the right person to help us enhance the center’s impact globally.” 

“I am honored to join the UCLA Center for Health Policy Research in this role, and to have the opportunity to engage more deeply with the Center’s work on health equity, data democratization, and evidence-based policymaking,” said Moucheraud. “In our interconnected global community, there are endless opportunities for bidirectional learning and insights, and I am excited to engage in UCLA CHPR’s ongoing work as well as develop new projects together. The Center’s vision and values align with my own in really inspiring ways, and I am thrilled to be taking on this new role.”

An Associate Professor in the Health Policy and Management Department at the UCLA Fielding School of Public Health (FSPH), Moucheraud was recently named director of the department’s PhD and MS programs, where she will work with and help develop the next generation of leaders in public health and health care.

Working with students is one of the most rewarding parts of my job. I mentor a diversity of students, from undergraduates to medical students to master's and doctoral students at FSPH,” says Moucheraud. “I enjoy developing multi-year relationships with mentees, as this allows me to adjust roles, skills-building, and responsibilities as students' own interests evolve. I’ve also worked with various students on many of my research projects — both here in Los Angeles and around the world.

Conducting both quantitative and qualitative research, Moucheraud focuses on the issue areas concerning the delivery of high-quality, equitable, and sustainable care in under-resourced settings.

Her research spans across the world — from using equity-based approaches to decreasing the incidence of HIV/AIDS here in Los Angeles County and throughout California; to addressing the significant cervical cancer burden in Malawi, Africa; to evaluating health systems to improve hypertension outcomes among adults in Thailand; to reducing provider bias towards adolescents seeking family planning services in Tanzania, Burkina Faso, and Pakistan. Her work has been supported through more than a dozen grants from organizations such as the Bill and Melinda Gates Foundation, National Cancer Institute, California HIV/AIDS Research Program, and more.

Over the last 10 years, Moucheraud has authored or co-authored more than 40 peer-reviewed articles, which have appeared in journals such as Health Affairs, JAMA Cardiology, BMC Public Health, AIDS and Behavior, and many more. She also serves as the chairperson of the AcademyHealth Global Health and Health Care Interest Group Advisory Committee, a network of researchers, practitioners, policymakers, and trainees committed to fostering the global development, dissemination, and use of health services research to improve the quality, efficiency, effectiveness, and outcomes of care and the health status and quality of life globally.

In a recent Ask the Expert Q&A with UCLA CHPR, Moucheraud sheds light on the deeper implications underscoring the intersection of global and U.S. health policies, noting that a lot can be learned from global health researchers about culturally-competent data measurement for diverse populations.

Moucheraud earned her MPH at the University of North Carolina at Chapel Hill and her ScD in Global Health and Population from the Harvard T.H. Chan School of Public Health. In 2021, she was named a visiting scholar by the National Center for Advancing Translational Sciences (NCATS) branch of the National Institutes of Health (NIH) Clinical and Translational Science Awards Program.

UCLA CHPR has also appointed two esteemed researchers to leadership positions:

Ying-Ying Meng, Dr.PH, has been named Director of Research at UCLA CHPR. Meng previously served as a senior research scientist and co-director of the Chronic Disease Program at the Center for over 20 years. She has worked to establish UCLA CHPR as a recognized source of important analyses of population-based data for understanding the relationship between physical and social environments and chronic disease morbidities. Meng has served as principal investigator/project director for numerous groundbreaking studies to examine the complex relationships between health and social position (e.g., poverty level, race/ethnicity), environmental context (e.g., policy, traffic/air pollution, access to care), and behavior (e.g., smoking); as well as heterogeneities in their relationships. She has advanced expertise in linking and analyzing health and environmental data to research the causes of and solutions to inequities in health and health care delivery from a holistic perspective.

Meng is currently leading a statewide evaluation of the collective impact of the California Department of Public Health California Tobacco Control Program’s Priority Populations Initiative. She is also a principal investigator for various grants, including a high-impact research project studying state and local policies on smoking behaviors and disparities, and a study that evaluates the impacts from short-term particulate matter exposures on work loss days in normal times or during and after wildfires.

In her new role, Meng will facilitate and guide UCLA CHPR’s research endeavors, support research staff, and build on UCLA CHPR’s nearly 30-year history of innovative research through promoting research partnerships.


Kathryn G. Kietzman, PhD, has been named director of UCLA CHPR’s Health Disparities Program. A senior research scientist at UCLA CHPR and an associate researcher in the Department of Community Health Sciences at the UCLA Fielding School of Public Health, Kietzman’s research focuses primarily on the long-term health and social care needs of physically, socially, and financially vulnerable populations, including older adults and people with disabilities.

Kietzman currently leads the California Health Interview Survey Long Term Services and Support study aimed at understanding the needs of Californians who experience difficulties with certain activities of daily life, such as dressing, bathing, walking, or doing errands. These data have helped inform Governor Gavin Newsom's Master Plan for Aging Research Subcommittee, which Kietzman was tapped to serve on in 2020. The group has worked to identify data sources and needs, recommended measures to include in a data dashboard, and developed a proposal for a research agenda — all designed to support and measure progress as the state implements its master plan.

Other recent studies include an evaluation of how older adults with serious mental illness are served through California’s public mental health delivery system, and an investigation of how dual eligible health care consumers (i.e., those insured by both Medicare and Medi-Cal) access and use information to make decisions about their health care options.

In her new role, Kietzman will oversee some of UCLA CHPR’s key initiatives, including older adult health and immigrant health, including the Research on ImmiGrant HealTh and State policy (RIGHTS) study, designed to understand the experiences that Latino and Asian immigrants who live in California have encountered in health care and other socioeconomic factors that may impact their health status and outcomes.

8/10/2021366
  
Approved8/9/2021 11:03 AMNo presence informationElaiza Torralba8/10/2021 8:39 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
New data from the California Health Interview Survey Preliminary Estimates Dashboard show varied support for safety measures and other personal or financial impacts
Did Californians continue to follow COVID-19 state and local safety guidelines as case and death rates declined? The UCLA Center for Health Policy Research (CHPR) has released May 2021 data from the California Health Interview Survey (CHIS) that sheds more light on whether individuals continued to follow suggested safety protocols such as wearing face coverings and gathering with people outside of the household. The 2020 survey also included questions on how the pandemic impacted people personally and financially.

The latest update to the 2021 CHIS COVID-19 Preliminary Estimates Dashboard, which includes CHIS 2021 data collected from March through May, has questions on risk reduction behaviors — frequency of wearing face masks, handwashing or sanitizing, maintaining physical distancing, gathering with individuals outside of the household and following safety guidelines during those times — as well as questions on views of the vaccine, testing and treatment. The March and April estimates were released in July 2021.

“In an effort to update the public and stakeholders on how the pandemic impacted people’s lives, we are releasing monthly estimates to gauge the status on whether Californians are adhering to either mandated or suggested safety guidelines put forth by federal, state, or local agencies and understanding where there may continue to be gaps in vaccine acceptance,” said Ninez A. Ponce, PhD, MPP, director of UCLA CHPR and CHIS principal investigator. “This data provides the latest updates to health and community organizations, as well as policymakers, on where targeted efforts can be made to ensure that we can safely navigate out of the pandemic, especially amidst the surge of the new Delta variant.”

Key findings from the May 2021 data include:

Risk reduction behaviors

Californians reported slightly lower rates for “always” wearing a face covering when leaving their homes: 79.1% of adults said that they “always” wore a face covering, compared to 84.8% in the March and April months of 2021. 65.8% of adults who didn’t plan on getting the vaccine reported “always” wearing a face covering when leaving their homes.

Californians also reported higher rates of gathering with people outside of their household in the past 30 days: 58.7% of adults said they gathered with people outside of their household, compared to 53.1% in March and April. 61.7% of individuals who had received at least one dose of the vaccine gathered with people outside of their homes, compared with 56.8% of adults who did not plan to get vaccinated.

Vaccine attitudes

Fewer people reported that they would not get the vaccine: 10.3% said they did not plan on getting the vaccine in May vs. 12% in March/April.

Adults in different geographic regions had differences in whether or not they would get the vaccine: Californians in the Northern/Sierra counties were nearly 10 times more likely to say they would not receive the COVID-19 vaccine compared to the Greater Bay Area — 27.4% vs. 2.8% in May. Individuals in the Northern/Sierra counties were also less likely to receive at least one dose of the vaccine when compared to the Greater Bay Area — 61.3% vs. 85.5%, respectively.

COVID-19 testing and treatment

Disparities persisted in which racial and ethnic groups were more likely to report testing positive for COVID-19: Latino adults reported the highest rates of testing positive at 24.7% in May and 25% in March/April. They were also one of the more likely racial and ethnic groups to report continuing to work in essential positions at 26.5% in May and 28.3% in March/April.

Personal and Financial Impacts

Adults in regions that were less likely to report planning to get the vaccine were most likely report continuing to work in essential roles: 32.9% of adults in the Northern Sierra region said they continued to work in essential jobs and were also most likely out of all of the regions to say they wouldn’t get the vaccine.

Adults reported similar rates regarding being treated unfairly due to race/ethnicity: 2.6% reported being treated unfairly in May and 2.8% in March/April.

“We want the 2021 CHIS data to provide a clearer picture  to help various groups in the state to safely navigate out of the pandemic as well as help individuals who are most in need of medical, personal, and financial support. The data we’re compiling sheds light on  areas and groups that need help, and how to assist them,” said Todd Hughes, CHIS director.

UCLA CHPR is providing regular updates to another tracking dashboard that looks at COVID-19 infection and death rates across racial and ethnic groups in the Native Hawaiian and Pacific Islander communities. Check out the latest statistics in our Native Hawaiian and Pacific Islander (NHPI) COVID-19 Data Policy Lab Dashboard.


The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health.

7/22/2021363
  
Approved7/7/2021 3:25 PMNo presence informationElaiza Torralba7/22/2021 8:31 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
UCLA studies reveal many don’t believe they need help, even if they report having psychological symptoms

A pair of new UCLA studies suggest that mental health needs for some ethnic communities may be going unmet in part because people in those groups don’t see themselves as needing care — despite the fact that they are reporting in surveys that they are experiencing symptoms of mental health distress.

The studies, by the UCLA Center for Health Policy Research, are based on data from the center’s own California Health Interview Surveys from 2015 to 2019.

As part of the surveys, researchers asked Californians whether they had experienced symptoms of depression, anxiety or other mental health challenges. Separately, the researchers asked people whether they believed they had a need for mental health services, and whether they had actually received mental health care services within the prior year.

The new studies focus on findings among Latino and Asian Americans, two of the state’s most ethnically diverse groups. In the surveys, 20% of Latino adults and 18% of Asian American adults reported that they had serious or moderate psychological distress.

But measurably smaller percentages — 17% of Latinos and 14% of Asian Americans — reported that they believed they needed to see a professional for problems with mental health, emotions or nerves, or for the use of alcohol or drugs.

According to Susan Babey, co-author of the studies and senior research scientist at the center, other racial and ethnic groups in California likely also experience gaps in unmet mental health needs. But while previous studies have treated Latino and Asian American groups as monoliths, these reports take the unusual step of analyzing variation in those disparities within the state’s Latino and Asian ethnic subgroups.

Those disparities — the gaps between the number of people who might need help and the number who realize or acknowledge that they need help — might seem small, but they suggest that state and local mental health agencies may need to do more to provide certain California communities with better information about recognizing and seeking help for mental health issues.

“The data also show that unmet need for services is higher among adults reporting symptoms associated with serious or moderate psychological distress than it is for adults who report that they know they need to see a professional, which is the strongest predictor of seeking care,” said D. Imelda Padilla-Frausto, one of the lead authors of both studies and a research scientist at the center. “This is where mental health education can play a significant role: making sure people are aware of when and how to seek the care they need.”

While the reports cover differences between Latinos and Asian Americans, the authors also emphasize that the numbers break down differently among the subgroups within the larger ethnic communities — a fact that could suggest more specifically where new mental health literacy resources should be deployed.

For example, they found, Californians of Filipino descent were more likely than those of Asian descent overall to report serious or moderate psychological distress (23%), as well as more likely to report that they needed care (19%).

The papers also include recommendations for improving access to mental health care for the state’s Latino and Asian residents. Policymakers, the authors write, should implement outreach programs to better inform certain communities about how to recognize mental health issues and how to seek psychological care. Mental health information and resources should be available in culturally appropriate settings and using residents’ primary languages. And officials should support better data collection that would help researchers identify community needs and help mental health educators and providers better tailor their services.

Padilla-Frausto said another critical step would be including members of the Latino and Asian American communities in developing and delivering mental health services.

The studies reinforce that California can improve state- and local-level data collection,” she said. “There are also opportunities to increase representation of these ethnic groups as part of a diverse mental health workforce and as decisionmakers when these types of programs and services are created.”

View the policy brief on mental health among Latino groups

View the policy brief on mental health among Asian groups

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health.

7/20/2021365
  
Approved7/19/2021 8:09 AMNo presence informationElaiza Torralba7/20/2021 1:41 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
New data show Californians' risk reduction behaviors and who is and isn't getting vaccinated

With state vaccination rates slowing, and guidelines on mask wearing and social gatherings changing, the UCLA Center for Health Policy Research (CHPR) has released new data from the 2021 California Health Interview Survey (CHIS) that sheds light on Californians’ views on getting the vaccine and following suggested safety protocols.


The 2021 CHIS COVID-19 Preliminary Estimates Dashboard, which uses CHIS 2021 survey data collected during the months of March and April, introduces questions on risk reduction behaviors such as frequency of wearing face coverings, hand-sanitizing or washing, and whether respondents practiced physical distancing or gathered with people who weren’t in their household. The survey also continued to ask about whether they would get the vaccine and if they had already received at least one dose. Personal impact questions, such as whether respondents lost their job or had difficulties paying for rent or mortgage and basic needs were also asked.


“Policymakers, health experts, community organizations, researchers, and others look to the California Health Interview Survey for credible and comprehensive data on the health of Californians. Last year, for the first time in CHIS history, we released preliminary survey estimates, looking at COVID-19 testing and personal and financial impacts of the pandemic. This year's findings, in addition to personal and financial impacts, explore vaccination status and risk reduction behaviors,” said Ninez A. Ponce, PhD, MPP, director of UCLA CHPR and CHIS principal investigator. “Following various safety precautions is a vital part of the state’s recovery from COVID-19, so the information provided can help groups who are trying to increase vaccination rates, give financial assistance, or simply access resources on staying healthy as we make our way out of this pandemic.”

 

Key findings include:

 

Risk reduction behaviors

 

More than half of California adults said they did gather with people outside of their household when the state guidelines were still in effect. 53.1% of adults said they gathered with individuals not living in their household in the past 30 days, including 53.6% of adults who said they would not get the vaccine. 

 

More than 1 in 5 California adults said they never or sometimes followed state guidelines. Nearly 4 in 5 or 78.9% of adults said they always or usually followed state and local guidelines regarding gatherings with persons not living in their households in the past 30 days, while more than 1 in 5 or 21.1% of adults sometimes or never did.

Adults who would not get the vaccine were less likely to follow state and local guidelines. Among adults who said they would not get the vaccine, nearly half (45.5%) reported that they “never” or “sometimes” followed state and local guidelines when gathering with persons not living in their household, more than twice the noncompliance rate reported among adults who would get the vaccine or who had already received at least one dose of the vaccine.  Adults who said they would not get the vaccine were also less likely (68.6%) to say they “always” wore a mask when they left their home during the statewide mask mandate than adults who had received at least one dose of the vaccine or planned to receive the vaccine (86.9% and 87.2%, respectively).

 

Vaccine attitudes

 

More than 1 in 10 adults (12%) stated that they would not get the vaccine. Adults in the Northern/Sierra and San Joaquin regions were more likely to report that they would not get the vaccine at 20.6% and 20.5%, respectively.

 

There were differences among racial and ethnic groups on whether they would get vaccinated. Groups that reported the highest rates of being unwilling to get the vaccine were Blacks (22.1%), multiracial adults (21.1%) and Latinos (13.6%). *American Indian and Alaska Native (AIAN) and Native Hawaiian and Pacific Islander (NHPI) data are not reported due to small sample size. 

 

The poorest adults were more likely to report that they would not get the vaccine, compared to adults with the highest income levels. 18.1% of adults with incomes of 0–99% of the federal poverty level (FPL) said they would not get the vaccine, compared to 9.4% of adults with incomes at or above 300% FPL.

 

Adults with a high school degree or less than a high school degree were more likely to report that they would not get the vaccine, compared with adults who had higher educational attainment. 15.7% of adults with less than a high school degree and 18.3% with a high school degree said they would not get the vaccine, compared to adults with a bachelor’s degree (7.7%) or a graduate degree (3.2%).

  

COVID-19 testing and treatment


Latinos were more likely than whites to ever receive a positive test result for COVID-19. 25% of Latinos ever received a positive test compared to 7.7% of white people.


Adults with the lowest incomes were more than twice as likely as those with highest incomes to ever test positive for COVID-19. 25.1% of adults under the federal poverty level (FPL) ever received a positive test result for COVID-19, compared to 12.0% of those with incomes at 300% FPL or higher.

 

Uninsured adults were more likely to have a positive test result. 24.8% of uninsured adults ever received a positive test result for COVID-19, compared to 14.2% of those with health insurance.


Individuals with health insurance were twice as likely to contact a health professional when they thought they had COVID-19. Nearly two-thirds (62.0%) of adults with health insurance contacted a health professional when they thought they had COVID-19, whereas only one-third (31.3%) of uninsured adults did so.


“Whether looking at different racial and ethnic groups, or other demographic factors such as income, education, or geographic region, we continue to see disparities among COVID-19 impacts especially after the winter 2020–2021 case surge. By staying on the pulse of the latest numbers, we can inform policymakers, program officials, community organizations, and advocates on actionable data to bridge the gap in needs and services for every group to fulfill our mission to equity,” said Todd Hughes, CHIS director.


UCLA CHPR is continuously updating tracking dashboards that look at COVID-19 infection and death rates across racial and ethnic groups, as well as data across various health and socioeconomic factors. These include the Native Hawaiian and Pacific Islander (NHPI) COVID-19 Data Policy Lab Dashboard, COVID-19 Rates and Risk Factors by California County Dashboard, and the COVID-19 Rates and Risk Factors by California County Data Table.


The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. 

7/19/2021364
  
Approved7/15/2021 4:48 PMNo presence informationElaiza Torralba7/19/2021 7:32 AMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
The UCLA Center for Health Policy Research (CHPR) has been named the recipient of a research award from California 100, an ambitious statewide initiative to envision and shape the long-term success of the state. The award, along with technical assistance from the Institute for the Future, will enable UCLA CHPR to evaluate current facts, origins, and future trends health and wellness will play in California’s next century. UCLA CHPR’s research will be led by Ninez A. Ponce, PhD, MPP, center director and professor at the UCLA Fielding School of Public Health, and will begin this summer.

“California has the largest economy in the U.S. — fifth largest in the world, if it were its own nation — and is the most populous and diverse state. Though often recognized as a leader in implementing federal health care reform and a model for national policy, the state has many challenges that have been heightened during the COVID-19 crisis. Through the California 100 Initiative, we will focus on health and wellness in the state: where we are, how we got here, where we’re going, where we want to go, and how we’ll get there,” says Ponce. “We are excited to be part of this important project to begin to chart a path forward for California’s next century.”

Informed by a health equity framework, UCLA CHPR will review the history and current landscape of health care coverage and access, and its implications on the health of Californians, with a special focus on marginalized communities.

The team, which comprises more than a dozen public health experts and public policy analysts, will address the issue of health and wellness by examining two overarching questions: what progress has California made in achieving universal effective health coverage (that all people have timely access to high-quality covered services that they need) and how can the state ensure population health equity (that all people have the opportunity to be as healthy as possible) in the future? To answer these questions, researchers will focus on the following topic areas of health and wellness in California: health systems and public programs, insurance coverage and markets, environmental influences, chronic conditions and mental health, child and adolescent health, aging residents, and racial justice and immigrant populations.

“A critical driver of equitable health and wellness in California will be universal effective coverage and an integrated system that not only delivers care but addresses social determinants of health. This is vital to move beyond reactionary systems that result in costly and inefficient approaches to care and towards mitigating and preventing the production of inequities in health,” adds Ponce. “Achieving health equity through universal effective coverage requires consideration of not only insurance and access to care, but the specific needs for an aging population, youth and young adults, communities of color, immigrant communities, mental health, environmental impacts, and effective and integrated systems of health care.”

The research will be complete by December 2021, and will lead to a set of policy alternatives for the future of California. The policy alternatives will be developed in conjunction with research teams from 12 other issue areas and will be coordinated by Henry Brady, director of research of the California 100 Initiative and former dean of the Goldman School of Public Policy at the University of California Berkeley. “We are excited to work with our research partners that are international experts in their issue areas,” Brady noted. “We will not only develop a comprehensive knowledge base on various policy issues, but we will also offer actionable recommendations for the California 100 Commission and the larger public to consider.”

The California 100 Commission is a multigenerational advisory body that will develop recommendations for the state’s future and test those recommendations across a broad set of policy areas by directly engaging Californians. Karthick Ramakrishnan, executive director of the California 100 Initiative, is tasked with assembling and engaging the Commission, and ensuring that the research stream intersects with the initiative’s other activities including advanced technology, policy innovation, and stakeholder engagement.

“From climate change, to aging populations and rapid changes in industry, California will face enormous challenges in the years ahead,” Ramakrishnan noted. “We are fortunate to be able to draw on the deep talent of researchers in California to produce evidence and recommendations that will inform robust public engagement and set the state on a strong, long-term trajectory for success.”

About the California 100 Research Grants

California 100 is a new statewide initiative being incubated at the University of California and Stanford University focused on inspiring a vision and strategy for California’s next century that is innovative, sustainable, and equitable. The initiative will harness the talent of a diverse array of leaders through research, policy innovation, advanced technology, and stakeholder engagement. As part of its research stream of work, California 100 is sponsoring 13 research projects focused on the following issue areas: 

  • Advanced technology and basic research
  • Arts, culture, and entertainment
  • Education and workforce, from cradle to career and retirement
  • Economic mobility and inequality
  • Energy, environment and natural resources 
  • Federalism and foreign policy
  • Fiscal reform
  • Governance, media, and civil society
  • Health and wellness
  • Housing and community development
  • Immigrant integration
  • Public safety and criminal justice reform
  • Transportation and urban planning

About the UCLA Center for Health Policy Research

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS), the nation’s largest state health survey, and is part of the UCLA Fielding School of Public Health.

6/30/2021362
  
Approved6/14/2021 10:01 AMNo presence informationElaiza Torralba6/30/2021 10:10 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopesElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationDevelopmental Screening Among Children Ages 1–5 in California2159
Despite gains, data from UCLA CHPR’s California Health Interview Survey show disparities in screening rates for children ages 1 to 5 across various groups

According to a new policy brief published by the UCLA Center for Health Policy Research (CHPR), developmental assessments for young children ages 1 through 5 increased from 2007 through 2018. Whether health care providers asked parents about developmental concerns also increased.

The study, funded by First 5 California, used data from UCLA CHPR’s California Health Interview Survey. Findings showed a significant increase from 2007 to 2018 — 72% of California parents reported that their child was assessed for possible developmental delays in 2018 compared to 29.5% in 2007, and 64.3% of parents stated that a doctor or other professional asked if they had concerns about their children’s learning, development, or behavior in 2018 compared to 47.2% in 2007.

“The study’s findings show promising improvements in developmental screening rates in the state over the past several years, but more work must be done to increase access among at-risk communities,” said Camille Maben, Executive Director of First 5 California. “Findings from this report identify opportunities for outreach to health care and preschool settings to boost screening rates across California. Improved screening rates will support better health outcomes for all young children.”

The brief looked at the prevalence of screenings across demographic characteristics, and found differences by household income, insurance type, parental education, as well as race and ethnicity.

  • Parents were more likely to report that their children received developmental screenings and were asked about developmental concerns if they had higher household incomes, employment-based insurance, a usual source of medical care, higher educational levels, spoke only English at home, and identified race/ethnicity as non-Hispanic White.​
  • By contrast, low rates of screening were found for families with Medi-Cal insurance, without a usual source of medical care, with incomes less than 300% of federal poverty level, educational attainment of a High School diploma or less, reported race/ethnicity of Hispanic or African American, and dual language learner children in the home. Parents identifying as Asian also reported less frequently being asked about developmental concerns.

The brief cites support for universal developmental surveillance and screening as recommended by the American Academy of Pediatrics and for future research to help identify more barriers to assessment.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. It is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. 

First 5 California is dedicated to improving the lives of California’s young children and their families through a comprehensive system of education, health services, childcare, and other crucial programs.

The Public Health Institute generates and promotes research, leadership and partnerships to build capacity for strong public health policy, programs, systems and practices.

Note: This study and findings reflect data collected prior to the COVID-19 pandemic.

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6/21/2021360
  
Approved5/25/2021 2:50 PMNo presence informationElaiza Torralba6/21/2021 8:37 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationThe Challenge of Meeting the Dental Care Needs of Low-Income California Adults With the Current Dental Workforce2158

policy brief by the UCLA Center for Health Policy Research identifies three of the most important factors that have led to disparities in Californians’ access to dental care.

  • There are fewer dentists per capita in some parts of the state.
  • About 79% of the state’s dentists did not provide care for low-income patients who rely on Medi-Cal.
  • Only 8% of the state’s dentists are Latino or Black, compared with 60% of the state’s low-income adult population overall. 

The authors also note that a shortage of dentists is looming: Some 23% of dentists are 60 years old or older and nearing retirement age, while only 9% of dentists graduated from dental school within the past five years. That imbalance is likely to place additional strain on access to oral health care for all Californians, and for lower-income residents in particular.

According to the center’s 2019 California Health Interview Survey, 32% of the state’s residents are adults with incomes under 200% of the federal poverty level (the income level at which people are generally considered to be low-income). And in previous studies, the authors reported that lower-income Californians have poorer oral health and less access to oral health care than residents with higher incomes.

The latest report, accompanied by an infographic, highlights regions in the state where there is a recipe for poor access to oral health care — a relatively small number of dentists per capita, a large proportion of low-income adults and a small percentage of dentists who see patients with Medi-Cal. In San Joaquin County, for example, there are just 2.2 dentists per 5,000 residents, and while 65% of the area’s low-income adults have Medi-Cal, only 2% of dentists see Medi-Cal beneficiaries.

The availability of dentists willing to provide care to the low-income and uninsured population of California is crucial in ensuring access to oral health care and improved oral health status,” said Nadereh Pourat, the center’s associate director and lead author of the study. “Our findings indicate regional disparities in where low-income populations live and where California dentists practice. We also found low participation of dentists in Medi-Cal and limited numbers of dentists from communities of color.

These factors perpetuate income disparities in both access to oral health care and oral health status of low-income Californians.

The researchers analyzed data from the Dental Board of California, the California Dental Association and California Health and Human Services. They also found:

  • Thirty-nine percent of low-income California adults reported that their oral health was “fair” or “poor,” and 41% reported not having visited the dentist in the previous year.
  • Twenty-three percent of the state’s dentists were 60 or older.
  • Although 53% of the state’s low-income adults were Latino and 7% were Black, only 6% of practicing dentists were Latino and 2% were Black.

 “The data clearly show the importance of increased participation of dentists in Medi-Cal,” Pourat said. “Policy tools to incentivize participation have been used for low-income children and can be tailored for low-income adults.”

The paper offers other possible suggestions, including expanding the roles of hygienists and dental therapists to reduce the burden on dentists, encouraging dentists to use “mobile clinics” to bring oral health care into underserved neighborhoods, and offering at least some appointments — particularly for consultations or basic diagnoses — through web-enabled devices for people who cannot immediately visit a dentist’s office.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

6/1/2021361
  
Approved6/1/2021 3:47 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopes6/2/2021 8:45 AMi:0#.f|uclachissqlmembershipprovider|tiffanylopes
None
5/27/2021359
  
Approved5/25/2021 2:26 PMNo presence informationElaiza Torralba5/27/2021 9:49 AMNo presence informationElaiza Torralba
Publication
Researchers found that Medi-Cal enrollees experienced a reduction in air pollution exposure and better health outcomes

FOR MORE INFORMATION:

Dan Greenbaum (dgreenbaum@healtheffects.org),

Elaiza Torralba (elaiza.torralba@ucla.edu)
Los Angeles, CA — A new study led by UCLA researchers and published today by the Health Effects Institute (HEI) has found that a series of actions taken to reduce pollution from California goods movement activities — targeting emissions from various marine, on-road, and off-road vehicles used to transport traded goods into, out of, and across the state — resulted in reduced exposure to air pollution and emergency room visits for individuals enrolled in Medi-Cal. Data showed that people who had asthma and chronic obstructive pulmonary disease had the most improvements. The study is the latest report from HEI’s Accountability Research program, which studies whether actions taken to improve air quality have reduced pollution and improved health.

In the study entitled Improvements in Air Quality and Health Outcomes Among California Medicaid Enrollees Due to Goods Movement Actions, Dr. Ying-Ying Meng of the UCLA Center for Health Policy Research, and colleagues compared changes from the pre- and post-policy periods, when a series of actions to reduce air pollution from the movement of goods were implemented. They tested effects in three areas based on proximity to major goods movement transit routes: areas near ports and freeways with truck traffic, areas near freeways without truck traffic, and control areas not near ports or freeways. Results from this study showed that actions to reduce emissions related to goods movement may be effective in improving local air quality levels and health care use among lower-income, disadvantaged, and underserved communities.

Our study could be the first of its kind to show that the California Air Resources Board’s 2006 Emission Reduction Plan for Ports and Goods Movement have not only improved air quality but also improved health, especially for the at-risk, disadvantaged population. These findings shed light on health disparities and can help reduce unequal exposures to environmental hazards,” said Ying-Ying Meng, co-director of the Chronic Disease Program at the UCLA Center for Health Policy Research and lead author of the study.

Diesel emissions related to the movement of traded goods into, out of, and across California contribute to higher air pollution levels in communities located next to or nearby ports and freeways. These communities are also more likely to consist of lower-income households which may be more at-risk for exposure to air-pollution-related health effects. To address this issue, the California Air Resources Board implemented a multiyear plan to reduce goods movement emissions through both mandatory and voluntary actions, which included requiring electric shore power for ships, repowering harbor crafts with a compliant engine, switching cargo handling equipment to low-sulfur fuels, and incentives for retrofitting truck fleets with higher efficiency, cleaner engines.

“The data can serve as key evidence that limiting emissions from the movement of goods in the state can positively impact the health of individuals living around the port and freeway transit areas, and may also guide efforts in other states and countries that are looking into air pollution exposure and health outcomes,” said Daniel S. Greenbaum, president of the Health Effects Institute.



The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

 

The Health Effects Institute (HEI) is an independent, non-profit research institute funded jointly by the U.S. Environmental Protection Agency, industry, foundations and development banks to provide credible, high quality science on air pollution and health for air quality decisions. HEI’s research is selected, overseen, and peer reviewed by leading subject matter experts on environment and health without involvement of HEI’s public or private sponsors.

5/26/2021357
  
Approved5/10/2021 10:53 AMNo presence informationElaiza Torralba5/27/2021 3:20 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationDisaggregating California’s COVID-19 Data for Native Hawaiians and Pacific Islanders and Asians2135
Understanding death rates for specific communities could help officials better allocate resources

According to a new UCLA report, COVID-19 death rates for Californians from Native Hawaiian, Pacific Islander and Asian ethnic groups varied widely in 2020.

But those variations were not readily apparent to the public because federal and state reports generally present COVID-19 data for all of those groups as a whole, rather than for each of the subgroups individually.

The study, by the UCLA Center for Health Policy Research, suggests that breaking out the data for each of the racial and ethnic groups analyzed by the authors would enable public health officials and policymakers to identify the hardest-hit communities and more effectively deploy appropriate outreach and resources, such as vaccinations, testing and treatment.

“Public-facing data systems benefit from having disaggregated data,” said Ninez Ponce, the fact sheet’s lead author of and director of the center. “With clearer information about their communities, policymakers and public health organizations can not only identify the needs of overlooked, at-risk groups, but also can better distribute resources to give those groups a better chance to recover from this health emergency.”

California is home to more Native Hawaiians and more U.S. residents of Pacific Islander descent than any other U.S. state other than Hawaii. California is also home to more Asians than any other U.S. state.

Using data from the California Department of Public Health and the nationwide American Community Survey, the researchers found that mortality rates for various subgroups of Native Hawaiians and Pacific Islanders as well as individuals of Asian descent varied widely when compared with California’s overall mortality rate of 84 per 100,000 — as well as versus aggregate rates for all ethnic subgroups combined. For all Californians of Native Hawaiian and Pacific Islander descent, the figure was 123 deaths per 100,000; for individuals of Asian descent, the figure was 74 per 100,000.

Among Native Hawaiians and Pacific Islanders:

  • Individuals of Samoan descent had the highest death rate of all Native Hawaiian and Pacific Islander subgroups at 182 deaths per 100,000, more than double the average for California.
  • The death rate among people of Tongan descent was 124 per 100,000.
  • Among those with Chamorro or Guamanian descent, it was 107 per 100,000.

For Asian American groups:

  • Californians of Japanese descent had the highest death rate at 119 per 100,000, more than 1.5 times the aggregate rate for all individuals of Asian descent.
  •  Among individuals of Cambodian descent, the death rate was 114 per 100,000.
  •  Among those of Filipino descent, it was 107 per 100,000.
  • The lowest death rates were among residents of Taiwanese descent (41 per 100,000) and of Indian descent (24 per 100,000).

“Parsing the data sheds light on the real-life and devastating impact of COVID-19 among Asian Americans and the Native Hawaiian and Pacific Islander communities, which at this point has only gained traction in the media and among special interest groups,” said Riti Shimkhada, a co-author of the study and senior research scientist at the center.

“Too often we’ve seen that aggregate data is masking what’s really going on, and we saw that combining data for all of these subgroups into a single racial and ethnic category substantially underestimates the rates for many Native Hawaiians and Pacific Islanders and people of Asian descent.”

’Alisi Tulua, co-author of the study and project director at the center’s Native Hawaiian and Pacific Islander Data Policy Lab, said the report highlights an issue that could be addressed across the U.S. The challenge created by grouping various ethnic subgroups’ data together is not just isolated to California.

Looking at data for some other states, we saw that case rates for Native Hawaiians and Pacific Islanders are five or six times higher than they are for the white population,” she said. “That reflects the striking disparity in states’ responses to COVID-19 and in the aid that was provided to those communities.”

Tulua, who is of Tongan descent, said the research hits home for her. “I’ve seen the pandemic’s toll firsthand, and having data on all of the racial and ethnic subgroups is a crucial step to identifying and accessing much-needed health and social support.”

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

5/26/2021358
  
Approved5/25/2021 10:02 AMNo presence informationElaiza Torralba5/26/2021 8:25 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
The Robert Wood Johnson Foundation (RWJF) has named Ninez A. Ponce, PhD, MPH, director of the UCLA Center for Health Policy Research (CHPR) and professor of health policy and management at the UCLA Fielding School of Public Health, to its newly-established National Commission to Transform Public Health Data Systems. The group, which consists of health care, community advocacy, government, business, public health experts, is tasked with identifying novel ways in which data are collected, shared, and used, as well as opportunities for collaboration among both public- and private-sector organizations.

An expert on immigrant and global health, survey-based research, social determinants of health, and health disparities, Ponce is the principal investigator of the California Health Interview Survey (CHIS), the nation's largest state health survey, which has been recognized as a national model for data collection on race/ethnicity, sexual orientation and gender identity (SOGI), and immigrant health.

“The COVID-19 pandemic continues to expose the striking disparities that exist within our healthcare system, with issues such as differential access to testing, vaccinations and treatment, and outside of the system with issues such as getting resources related to food and housing support,” said Ponce.

Modernizing or reimagining how our public health data infrastructure works is absolutely vital in improving health equity, and I’m grateful to be able to join a team that tackles this issue head-on.”

UCLA CHPR has been conducting extensive work on COVID-19 data tracking since the onset of the pandemic. Throughout 2020, the center created several tools to track COVID-19 and various risk factors such as chronic diseases and underlying conditions, as well as looking at factors such as insurance status, food insecurity, and more by California county. The aim was to shed light on factors related to case and mortality rates and for use by decisionmakers on identifying and making health and economic support policies across California communities. In addition, a series of COVID-19 questions on topics such as treatment and vaccine acceptability, personal and financial impacts of the pandemic, and more across a range of demographic and socioeconomic factors was added to the 2020 CHIS and, for the first time in history, preliminary estimates were released more than a year before release.

Data disaggregation, an objective on the commission’s list, has been a large focus of the UCLA CHPR data team, including the Native Hawaiian and Pacific Islander Data Policy Lab, housed under the center. Bringing hidden data to light answers questions of who, specifically, is being impacted by the pandemic, what resources are needed, and where to deliver the support.

The nation’s largest philanthropy focused solely on health, the Robert Wood Johnson Foundation has a history of supporting UCLA CHPR data projects and research, most recently the NHPI Data Policy Lab; the National Network of Health Surveys’ Addressing Health Equity through Data Disaggregation workshop series, which is providing technical assistance workshops to increase population representation in health data sources; and a study on how California counties responded to COVID-19 under the Whole Person Care (WPC) Medicaid Pilot Program.

In addition to the previously mentioned objectives, the commission will take on a multi-pronged approach to explore issues and opportunities for new data sources and measures, data collection on at-risk communities, communicating data to the public, community participation in informing how data systems are formed, and the ability for data to be shared across various systems.

RWJF has challenged the commission to identify improvements in data systems that will better address social determinants and structural factors that result in equitable health outcomes and make recommendations to the nation. The commission, which expects to release recommendations in fall 2021, includes some of the nation’s leading experts from organizations such as the National Collaborative on Health Equity; National Academies of Sciences, Engineering, and Medicine; Google; and the Centers for Disease Control and Prevention (CDC).
5/11/2021356
  
Approved4/15/2021 7:58 AMNo presence informationElaiza Torralba5/11/2021 8:44 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationA Snapshot of California’s Whole Person Care Pilot Program: Implementation Strategies and Enrollees2133
Findings may inform models to improve health care quality and outcomes for high-need, at-risk groups

California in 2016 introduced its Whole Person Care program, a pilot project designed to integrate medical, behavioral health and social services for Medi-Cal patients who frequently accessed health services, incurred disproportionately high costs and had poor health outcomes.

 

With that program scheduled to end next year, the UCLA Center for Health Policy Research has published a policy brief that presents a detailed overview of the program — one the authors say could help inform future efforts to address the needs of high-risk groups.

 

The brief highlights several key characteristics of Whole Person Care — which comprises 25 local pilot programs covering 26 counties — including the populations targeted for enrollment, how each program identified and enrolled eligible individuals, how care coordination teams were structured, the types of services provided and the characteristics of enrollees.

 

“The data provide a roadmap for the creation of similar programs intended support low-income patients with high levels of unmet needs for nontraditional health services, such as care coordination,” said Nadereh Pourat, associate director at the center and lead author of the brief. “Many of the strategies used by Whole Person Care pilots were innovative and have succeeded in engaging those enrolled in their care and addressing their needs.”

 

Whole Person Care was implemented in late 2016 by the California Department of Health Care Services and focused on high-need, high-cost patients populations, including individuals with multiple emergency department visits and hospitalizations, multiple chronic conditions, and severe mental illness or substance use disorders, as well as people who had been recently incarcerated and those who were experiencing homelessness.

 

The pilot program was scheduled to end in December 2020 but was extended for an additional year due to the COVID-19 pandemic. Successful Whole Person Care strategies and services will ultimately be incorporated into a multiyear Department of Health Care Services statewide initiative called California Advancing and Innovating Medi-Cal, or CalAIM, which is set to launch in January 2022.

 

The UCLA policy brief provides key details on the operations of the 25 pilot programs throughout the state:

 

Services provided

 

  • 16 programs provided services to multiple target populations.
  • 16 used street- or shelter-based outreach approaches to identify eligible program participants.
  • 21 used a community health worker or staff member whose life experiences were similar to the targeted participants and enrollees.
  • 12 offered tenancy support, landlord incentives and funds to support housing placement.

 

Patient enrollment

 

  • More than 109,000 individuals were enrolled (as of December 2018).
  • Prior to enrollment, participants had an average of 2.1 emergency department visits per year.
  • 66% had at least one chronic physical health condition.
  • 46% were experiencing homelessness.
  • 6% had previously been incarcerated.

 

Data from the brief show how pilots in different counties tailored their approaches to address community-specific needs. Los Angeles County, for instance, focused on all target patient groups and used several programs and forms of outreach, while Riverside County focused solely on the individuals involved with the justice system, promoting coordination with probation staff to enroll those in jails and prisons prior to their release and using a dedicated care coordinator.

 

“Our goal is to provide data to bolster planning efforts for CalAIM, particularly those components such as Enhanced Care Management and In-Lieu of Services that seek to utilize a whole-person care approach to health,” said Emmeline Chuang, an adjunct associate professor at the UCLA Fielding School of Public Health and co-author of the brief. “Under CalAIM, Medi-Cal–managed care plans will provide these services statewide, and lessons learned from WPC pilots will play an important role in ensuring the success of this initiative.

 

“Overall,” Pourat added, “the findings of the Whole Person Care evaluation show that addressing the fragmentation of our health care delivery system will take significant effort.”

 

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

4/28/2021354
  
Approved3/31/2021 3:39 PMNo presence informationElaiza Torralba5/20/2021 2:40 PMi:0#.f|uclachissqlmembershipprovider|tiffanylopesElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationBarriers to Metastatic Breast Cancer Care in California: A Report to the California Breast Cancer Research Program2101
UCLA team recommends state-level policy changes to improve health insurance coverage, participation in clinical trials and access to palliative care

Drawing on a series of studies and interviews with patients and caregivers, UCLA researchers from the UCLA Center for Health Policy Research and the UCLA Jonsson Comprehensive Cancer Center have published recommendations for California policymakers and patient advocates aimed at improving care and outcomes for women with metastatic breast cancer.

More than 30,000 women in California are diagnosed each year with this cancer, which has spread from the breast to other parts of the body. Survival rates are low, and patients often face significant hurdles to care — particularly in the areas of health insurance, clinical trials and palliative care — that could be remedied through policy changes, the researchers say.

“Battling metastatic cancer is difficult enough for any person, and we should be breaking down the barriers that stand in the way of providing the best care possible,” said lead author AJ Scheitler, director of stakeholder relations at the health policy research center. “Our work aims to offer state-level policy solutions that should be further explored.”

These potential solutions emerged, in large part, from the researchers’ 2020 study of barriers to care, which was presented to the California Breast Cancer Research Program and incorporated insights from interviews with a broad range of patients, health care providers and other stakeholders, as well as from patients’ social media discussions. The interview responses and narrative data led to the discovery of a variety of obstacles, from high costs of care to a lack of support services.

The team then distilled their findings into informational policy sheets — available in English, Spanish and Chinese — that provide policy recommendations in those areas where improvements are most critical: 

Removing health insurance obstacles

·       Obtaining approvals for treatment from insurance companies was cited as a major stressor by both patients and health care providers, due primarily to the time requirements and complexity of the process and patient fears that switching insurance plans could reduce their coverage. “I trust that if a drug has been approved for stage 4 cancer and an oncologist want to use it on me, we should just get it,” said one patient. “But that’s not how the world works.”

·       Recommendations: Because of the need for timely treatment, prior authorization requirements and step therapy procedures should be eliminated altogether for metastatic cancers — and should be improved for other cancers. (Read the fact sheet in English | Spanish | Chinese)

Improving participation in clinical trials 

·       Trials aimed at evaluating new medical treatments are crucial to patients, but many respondents cited a lack of awareness and user-friendly information about trials, difficulties getting to trial sites and confusion over whether the costs are covered by insurance. The authors further note that enrolling diverse racial and ethnic groups has been a persistent challenge. 

·       Recommendations: Increase investment in programs that boost trial participation among Black and Latino patients and expand insurance assistance to cover costs associated with trials, such as travel expenses. (Read the fact sheet in English | Spanish | Chinese)

Increasing access to palliative care

·       Often misinterpreted as just end-of-life care, palliative care — including pain management, psychological and social support, nutrition guidance and functional rehabilitation — helps patients manage their symptoms and improve their quality of life. 

·       Recommendations: Better integrate palliative care and support services with cancer treatment, provide palliative care training to clinicians and educate patients about the benefits of this type of care. (Read the fact sheet in English | Spanish | Chinese) 

“Overall, the insights we gained from patients and others who had a wide variety of perspectives showed us that there’s a lot that can be done to improve the cancer care experience for this group. Removing the barriers to care is vital — and doable,” said co-author Riti Shimkhada, a senior research scientist at the health policy research center. “By improving access to and awareness of clinical trials and palliative care programs, and removing the hoops patients and clinicians face in accessing treatment, we have the potential to improve quality of life for patients with metastatic breast cancer.”

The UCLA Center for Health Policy Research hosted a webinar on barriers to metastatic breast cancer care on April 28. Watch the webinar on YouTube.


The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

4/5/2021355
  
Approved4/5/2021 12:04 PMNo presence informationElaiza Torralba4/5/2021 12:13 PMNo presence informationElaiza Torralba
Publication
Dear friends,

 

It is with immeasurable sadness that we announce that our beloved Associate Center Director Steven P. Wallace, PhD, passed away unexpectedly on Tuesday, March 30. Dr. Wallace served as associate director since 1996 and was essential to building the UCLA Center for Health Policy Research (CHPR) into the successful policy research center it has been for more than two decades.

 

Dr. Wallace was an internationally-renowned scholar on health, health disparities, and health policy of older adults, immigrants, and communities of color including Latinx, American Indian and Alaska Natives, African Americans, and Asian Americans.  

He was a brilliant researcher, a tireless champion for health equity, and a committed and passionate educator and mentor to countless students, researchers, and colleagues who will carry on his legacy. Above all, Steve Wallace was a devoted husband, father, and brother who cherished his wonderful family: his wife Trudy, son Brian, and sister Lisa.

 

Dr. Wallace’s wide-ranging contributions to public and community health span over 40 years, including 25 years at the UCLA CHPR, where he led the Health Disparities Program and trailblazing research on health issues among immigrants, older adults, and marginalized groups.

 

His interest in immigration started at an early age, listening to his grandfather’s stories about coming to the U.S. through Ellis Island, and his father’s memories of growing up in the immigrant neighborhood of Boyle Heights. But it was an undergraduate summer internship in 1977 at a community health center where most of the patients were recent immigrants from Mexico that sparked his interest in an academic approach to the study of immigration and evolved into a storied career.

 

Dr. Wallace was the principal investigator of the RIGHTS (Research on ImmiGrant HealTh and State policy) Study, funded by the National Institutes of Health (NIH) and National Institute on Minority Health and Health Disparities (NIMHD). The RIGHTS Study aims to understand the experiences of exclusion that Asian and Latin American Californians have encountered in the areas of health care, social services, employment, education, and law enforcement; how the state’s policies and programs have shaped these experiences; and how such experiences influence people’s ability to seek the health care they need. In late 2020, the NIH awarded additional funding to Dr. Wallace and his colleagues to study the multilevel influences on access to health care for Latinx youth.

 

He pioneered new approaches to elder economic security through the California Elder Economic Security Standard™ Index, a tool that measures the actual cost of basic necessities for older adults, which was adopted into law (Assembly Bill 138) and was used by the World Health Organization in its 2020 Decade of Healthy Ageing report and will be used in California’s Master Plan on Aging.

 

Committed to fostering an academic research community that is reflective of the diversity of the U.S., Dr. Wallace served as the director of the Resource Centers for Minority Aging Research (RCMAR) National Coordinating Center, supporting the National Institute on Aging (NIA) and its RCMAR grantees in increasing the diversity of the workforce on aging research. 

 

A nationally lauded researcher, Dr. Wallace’s work has been supported through more than 100 grants from federal agencies and private foundations, including the NIH, Centers for Disease Control and Prevention, Health Resources and Services Administration, the California Endowment, and many others. Through this support, he led teams that developed innovative, community-based methods to increase the use of clinical preventive services among older adults of color in Los Angeles; enhanced community organization capacity to advocate for better air quality in their neighborhoods; and established resources for Los Angeles neighborhoods to increase smoke-free rental housing.

 

He authored more than 100 articles in peer-reviewed journals such as the American Journal of Public Health, Journal of Gerontology, and Social Science and Medicine; more than 30 book chapters; and dozens of timely policy briefs and reports that have been used by advocates and legislators as evidence for key decisions. Most recently, in February 2021 he co-authored an editorial in the American Journal of Public Health, which outlined priorities for the new presidential administration in taking an equity-focused approach to immigration reform, as well as making the call to action for researchers and advocates to work together with the goal of improving immigrant health and policies.

 

Dr. Wallace’s work has appeared in The New York Times, Los Angeles Times, National Public Radio, and dozens of other outlets for which he served as a sought-after and trusted media resource. He testified at state legislative hearings and in other forums, and his research has informed state laws.

 

Throughout his distinguished career, Dr. Wallace received various fellowships and awards, including a Fulbright fellowship to research and lecture in Chile where he studied the impact of public policies on health equity for the elderly, and awards from the American Public Health Association (APHA), the Gerontological Society of America, California Council on Geriatrics and Gerontology, Health Initiative of the Americas, among many others. In 2018, he was awarded the Lifetime Achievement Award from the APHA Aging & Public Health Section.

 

Though his accomplishments are numerous, his influence as a profound mentor and educator is unmatched. A professor in the Department of Community Health Sciences at the UCLA Fielding School of Public Health, department chair from 2011–2017, and vice chair from 2005–2010, Dr. Wallace has mentored hundreds of students who have gone on to successful careers as researchers in immigrant health, older adult health, and health disparities. For many people, including several of our leading UCLA CHPR researchers, when they look at the PhD or MPH at the end of their names, they’ll always remember Dr. Steve Wallace’s impact on their lives. 

 

Over the last few days, many of his students, colleagues, and mentees have shared their stories of Steve Wallace — how he lifted them up and created space for them to thrive on their own strengths, his commitment to creating opportunities for women of color and other marginalized communities, his kindness and compassion, his beautiful soul, his smile and laugh that filled a room, his boundless generosity of spirit. While each story is unique, they all share a common thread: Steve Wallace’s impact is forever.

 

In lieu of flowers, Dr. Wallace's family invites contributions to The Steve Wallace Fellowship Fund at the UCLA Fielding School of Public Health, which we hope will continue his deep commitment to mentoring first-generation students to become leaders in advancing public health policy. Contributions may be made securely online.

 

Gifts may also be sent by check, made payable to “The UCLA Foundation” with the “Steve Wallace Fellowship Fund #16030” noted in the memo line and mailed to The UCLA Foundation, P.O. Box 7145, Pasadena, CA 91109-7145.

 

As a Center, we are committed to continuing Steve Wallace’s legacy. And while his passing leaves a tremendous hole in our hearts, his work will continue through the many students he’s mentored, the colleagues he’s inspired, and the advancements in research that bear his name.

 

Sincerely,

Ninez A. Ponce, PhD, MPP

Director, UCLA Center for Health Policy Research


3/2/2021353
  
Approved3/2/2021 1:32 PMNo presence informationElaiza Torralba3/4/2021 2:56 PMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
UCLA CHPR announces two webinars to train the general public and media, legislators, and policymakers on how to use CHIS’ free online data tools

At the UCLA Center for Health Policy Research, we are committed to putting data into the hands of people who need it. The California Health Interview Survey (CHIS), the nation's largest state health survey, is hosting two data user training webinars to demonstrate how to use CHIS' free online data tools to get data on a wide range of health topics across many sociodemographic factors.

The webinars will be held on Zoom as follows:

CHIS Data User Training Webinar for the General Public

Wednesday, March 10
12:30 p.m.–2:00 p.m. Pacific Time (PT)

CHIS Data User Training Webinar for Legislators, Policymakers, and Media

Friday, April 9
10:00 a.m.–11:30 a.m. PT

The webinars will feature:

  • AskCHIS™: an online health query system that allows you to search for health statistics on your county, region, and state.
  • AskCHIS Neighborhood Edition™: a GIS search tool for health indicators by ZIP code, city, county, legislative districts, and census tracts. New data and four vulnerability indices at the census tract level released in 2021, including a Preexisting Health Vulnerability Index that captures risk of COVID-19 infection and death due to preexisting health conditions.
  • COVID-19 data dashboards: tools to track COVID-19 and various risk factors across California counties, as well as preliminary monthly estimates from new COVID-19 questions in CHIS 2020, including COVID-19 treatment, personal and financial impacts of the pandemic, and much more.
  • Health Profiles: find quick and easy health statistics on adults and children for your county, region, legislative district, and more.

These trainings are presented by Peggy Toy, director of the Health DATA Program, and Jacob Rosalez, California Health Interview Survey (CHIS) data dissemination manager.

We'd love your input! Let us know what health topics you're most interested in learning about (diabetes, COVID-19, food insecurity, racial and ethnic disparities, etc.) at the sessions. Email us at
healthpolicy@ucla.edu with your topic of interest and the webinar you will be attending.

3/1/2021351
  
Approved2/16/2021 4:06 PMNo presence informationElaiza Torralba3/1/2021 9:31 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationOne in 4 Low-Income Immigrant Adults in California Avoided Public Benefit Programs, Likely Worsening Food Insecurity and Access to Health Care2072
One-quarter of low-income immigrants in California have avoided public programs due to fear of jeopardizing immigration status
Immigration policies like the Trump-era expansion of the “public charge” rule that made it harder for immigrants on public assistance to obtain legal residency can have a chilling effect on the health and well-being of immigrant communities in California, according to a study released today by the UCLA Center for Health Policy Research.

The study, based on data from the center’s 2019 California Health Interview Survey, shows that 1 in 4 low-income immigrant adults in the state have avoided accessing public assistance like health, food or housing programs at some point for fear of jeopardizing their own or a family member’s immigration status. More than half of them indicated they had shunned these programs in the time between the Trump administration’s proposed rule changes in 2018 and their implementation in 2020.

The new public charge legislation penalized immigrants who rely on Medicaid, food stamps or housing vouchers — even for short periods — by decreasing their chances of getting a “green card,” or lawful permanent residency.

Immigrants’ avoidance of these public programs was linked to worse access to care and higher food insecurity, the researchers say. They found that among California immigrants who had reported avoiding programs over the past year, 37% were uninsured and 54% were food insecure, compared with 16% and 36% of immigrants who didn’t avoid them.

In addition, those who had avoided public programs in the past year were twice as likely as those who hadn’t to report delays in receiving needed medical care and prescription medication, as well as not receiving mental health treatment — all of which suggest negative health outcomes for this group.

Surprisingly, the authors also found that the proposed public charge changes seemed to have an adverse impact on immigrants who weren’t even subject to the rule. More than one-quarter, 27%, of those who were already lawful permanent residents reported avoiding public assistance programs.

“Policies that sow fear and confusion around immigration status contribute to the avoidance of public programs, which can have serious implications for health and well-being,” said Susan Babey, a senior research scientist at the center and the study’s lead author.Programs like Medi-Cal and CalFresh, for food assistance, serve as a crucial safety net for California families, and inclusive policies that provide access to public programs could help protect the health of Californians, particularly during a pandemic.”

While in February 2021 President Biden called for an immediate review of the public charge rule and the Supreme Court agreed to take up a case challenging the legislation, the researchers noted that complex and sometimes confusing immigration policies have long prevented eligible immigrants from seeking public assistance.

Although this is true for many segments of the immigrant community, avoidance was found to be particularly high among noncitizens who are not permanent residents (42%), those between the ages 18 and 34 (34%), Latinos (30%), those who are married with children and single with children (36% and 32%) and those who do not speak English well (29%).

The study data adds to the evidence of how the public charge rule, in particular, had a negative impact on immigrant communities and forced individuals to make tough choices about their health and well-being — choices made even more difficult by widespread uncertainty about which public assistance programs were included, who the rule applied to and how it might affect citizenship applications.

“The findings suggest the crucial need to provide accurate and easy-to-understand information about immigration rules and the impact they may have on public health,” said Ninez Ponce, director of the center and a co-author of the study.

The authors say that information campaigns led by legal and advocacy organizations, with resources available in various languages, can help immigrants overcome misinformation and confusion related to immigration policies. They also recommend avoiding policies — and reversing existing policies — that negatively impact participation in health and food programs that serve as important safety nets for Californians.

“California is home to over 10 million immigrants and about a quarter of the immigrant population in the U.S., more than any other state in the nation,” Ponce said. “The COVID-19 pandemic, fraught with catastrophic life events and economic loss, further amplifies the need to preserve vital services for all residents.”

This study was supported with a grant from The California Endowment.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

2/23/2021352
  
Approved2/19/2021 4:33 PMNo presence informationElaiza Torralba2/23/2021 8:44 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationA Window of Opportunity Is Opening to Improve Immigrant Health: A Research and Practice Agenda (American Journal of Public Health)2071
President Biden and the Democrat-controlled Congress have started boldly with immigration. On Feb. 18, Democrats introduced the U.S. Citizenship Act of 2021, which would rollback many of Donald Trump’s policies and bring comprehensive immigration reform, including a pathway to citizenship for the estimated 10.5 million undocumented immigrants in the United States. Researchers and community advocates are recognizing a renewed opportunity to use public health research and advocacy lenses to inform the dialogue — and ultimately the policies — surrounding immigration reform.

In this Q&A, Steven P. Wallace, associate director at the UCLA Center for Health Policy Research and a professor of community health sciences at the Fielding School of Public Health, and his colleague Maria-Elena De Trinidad Young, a faculty associate at the center and assistant professor of public health at UC Merced, shared their recommendations to promote inclusive policies influenced by the public health mission to ensure the health and well-being of all people.

Wallace’s interest in immigration comes from listening to his grandfather’s stories about coming to the U.S. through Ellis Island, and his father’s memories of growing up in the immigrant neighborhood of Boyle Heights. An undergraduate summer internship in 1977 at a community health center where most of the patients were recent immigrants from Mexico sparked his interest in a more academic study of immigration, and since the mid-1980s he has published regularly on the subject.

For Young, immigrant inclusion has been central to her personal and professional experiences. Her mother’s family came to the U.S. from Nicaragua in 1950 and faced many challenges, but also economic and educational opportunity. As a youth in California, she observed the fear and division that resulted from the passage of Proposition 187. She became specifically focused on issues of immigration policy about 10 years ago when rules enacted under the Obama administration sharply increased deportations and she realized how immigration policy is a form of health policy.

They recently co-authored an editorial in the American Journal of Public Health, which outlines priorities for the new administration in taking an equity-focused approach to reform, as well as making the call to action for researchers and advocates to work together with the goal of improving immigrant health and policies.

What is the relationship between immigration and health, and why is it crucial in the current talks about immigration reform?

Wallace: “Immigrant” is a political status given to those who move their primary residence from Vancouver to Seattle, or Tijuana to San Diego, but not to those who move from Boston to L.A. Depending on how people move their permanent residence they are subject to different sets of social and political pressures and resources that will impact their health. For example, according to an analysis of the California Health Interview Survey, an estimated 90% of undocumented immigrant adults ages 18-64 did not have comprehensive health insurance because they are in families with low-wage workers who are not provided insurance at work and they do not qualify for public programs. Even documented immigrants who live in families that include undocumented members — called mixed-status families — often report not obtaining benefits or seeking care they are eligible for because of their concerns about putting their undocumented family members at risk. And the chronic stress these families live under has negative health outcomes.

Young: The relationship between immigration and health is critical to current policy proposals because immigrants’ day-to-day experiences are shaped by immigration policies. Today, immigrants are less likely to have a place to receive health care — and the insurance to pay for that care — and more likely to work in low-wage, and often less safe jobs, than those born in the U.S. Across the U.S., they also report experiencing xenophobia and discrimination due to race, religion, citizenship and other factors.

We know that having access to health care, economic opportunities, educational advancement and living free of racism and discrimination are key determinants of good health. Federal, state and even some local policies have an enormous impact on whether immigrants are able to access those resources and protections and the extent to which they may be targeted by enforcement. Unfortunately, over time policymakers in the U.S. have largely created a system that excludes many noncitizens from critical resources and actively authorized their policing and surveillance. The public health evidence shows that this policy approach has been bad for the well-being of immigrants and people of color across the nation. There’s an opportunity to start to change that now.

The Biden administration has proposed changes to immigration policies which involve creating a task force to reunify families, addressing migration patterns, and restoring faith in the legal immigration system. What do inclusive immigration policies look like to public health researchers and advocates, and how can the current administration take inclusion into account?

Wallace: State and local policies on education, health care, employment, drivers’ licenses and law enforcement impact immigrants’ everyday lives, but federal policy sets the tone that can hinder, or help, these policies. For example, last year the Trump administration expanded the number of reasons an immigrant could be denied lawful permanent resident status, because they’d be considered a “public charge,” someone primarily dependent on government assistance. The additional reasons included services to provide health care, food and housing. Both the new policy and public discussions about this have deterred many immigrants from using public programs they’re legally qualified for.

In that way, a draconian federal policy to exclude people overshadowed many inclusive state and local policies, such as those to provide prenatal care to undocumented women whose permanent home is in the U.S., food assistance to lawful permanent residents, and other programs designed to help immigrants who are an integral part of our communities and economy.

Our research can inform federal policy makers on the benefits of not only reversing some of the punitive actions of the previous administration, but by establishing new national initiatives to help immigrants and refugees become fully incorporated into the society. Our work has shown that inclusive policies at the state level improve immigrant outcomes, independent of exclusionary policies that may also exist. An example of this is a study we conducted in 2018, which found that inclusive state immigrant policies may reduce immigrant poverty by fostering economic advancement.

Young: As we describe in our current piece, key priorities that can advance equity are to decriminalize immigrants by dismantling and eliminating our enforcement infrastructure and creating a path to citizenship for all that is not contingent on increased enforcement against some groups. Within the public health field, we also should work to eliminate categories of “good,” or deserving, versus “bad,” or undeserving immigrants.

Biden’s initial proposals are an encouraging start. But new policies shouldn’t simply be made in response to Trump’s anti-immigrant agenda. For example, Biden has ended the construction of a wall at the U.S.-Mexico border, but indicated there would be investment in a “virtual wall” which likely will increase surveillance of all people living at the border, whether citizens or not. Similarly, he is reviewing enforcement priorities, but even a shift in priorities does not address how enforcement arrests, detentions and deportations have led to stress, instability and discrimination in communities across the country. Public health researchers and advocates are ideally positioned to push the administration to make inclusion a central criterion for changes to the immigration system.

How can researchers and advocates work together to ensure that the pathway to immigration reform is fair and equitable?

Wallace: Where evidence is limited or dated, it invites ideological and harmful, or at best, only partially effective, responses to issues. Researchers need to work with affected communities to identify where solid, empirical data can help inform policies and efforts to improve policies. A few examples of where additional data might be useful include debunking the myths that health care programs are a “magnet” that attract immigrants and that some immigrants are more “deserving” of public services than others.

Young: It’s critical for researchers to work with advocacy groups, such as the California Immigrant Policy Center and the National Immigration Law Center, to support their current advocacy efforts. Public health researchers have established really critical evidence about the harms of restrictive immigration policies and the potential benefits of inclusive policies. That evidence should be translated into effective advocacy information, such as through better dissemination of the academic research to the advocates who are meeting directly with policymakers or through researchers’ direct involvement in talking to policymakers.


2/10/2021350
  
Approved2/10/2021 12:30 PMNo presence informationElaiza Torralba2/10/2021 2:06 PMNo presence informationElaiza TorralbaTiffany Lopestlopes@ucla.edu310-794-09301682Y
Publication
UCLA CHPR's California Health Interview Survey (CHIS), the nation's largest state health survey, provides accessible data at the census tract, ZIP code, city, county, and legislative direct levels
15.9% of adults in California have been diagnosed with asthma. 26.8% are obese. In LA County, that number is 27.9%. Compton? 36.4%. Whether you’re a policymaker interested in understanding the health needs of your diverse legislative district, a community organization advocating for a healthy food program, a journalist looking to uncover factors that lead to COVID-19 risk, or a concerned citizen, AskCHIS Neighborhood Edition (NE)™ has your data needs covered.

Today, the UCLA Center for Health Policy Research’s California Health Interview Survey (CHIS) unveiled new updates to AskCHIS NE, a data dissemination and visualization platform that provides health estimates at sub-county geographic regions in California. With AskCHIS NE, you can access and visualize reliable health data at census tract, ZIP code, city, county, and legislative district levels.

Drawing upon the responses of more than 20,000 Californians interviewed each year by CHIS, AskCHIS NE covers a wide range of health topics — from chronic conditions like asthma and diabetes, to access to health care and mental health, physical activity, food insecurity, and so much more. The new update, which includes data from the 2018 CHIS, includes several new indicators that are modeled small area estimates from CHIS to our new 2018 data: adults without dental insurance, adult dental visits in the past year, adults with teeth in fair/poor condition, adults using e-cigarettes in the last 30 days, and adults performing volunteer work or community service in the past year.

In addition to the new indicators, this release includes the following vulnerability indices at the census tract level only:

Preexisting Health Vulnerability Index: captures risk of COVID-19 infection and death due to preexisting health conditions. This index comprises six different 2016 AskCHIS NE variables: adult diabetes, obesity, heart disease, health status, psychological distress, and food insecurity. This index was featured in a UCLA Center for Neighborhood Knowledge study released earlier this week.

Area Deprivation Index: based on a measure created by the Health Resources and Services Administration (HRSA). It allows for rankings of neighborhoods by socioeconomic disadvantage in a region of interest.

Healthy Places Index: created for the Public Health Alliance of Southern California. This index combines 25 community characteristics into a single indexed score.

Social Vulnerability Index: created for the Centers for Disease Control and Prevention (CDC) to help public health officials and emergency response planners identify and map communities that will most likely need support before, during, and after a hazardous event.

AskCHIS NE is one of several free online tools offered by CHIS. AskCHIS™, our online health query system that allows you to quickly search for health statistics by county, region, and state, is also used by policymakers, media, community organizations, and researchers.

“Last year, more than 100,000 queries were run in AskCHIS and AskCHIS NE. That’s nearly 275 queries per day,” says Todd Hughes, director of the California Health Interview Survey. "Now, more than ever, we need access to reliable data to identify COVID-19 vulnerabilities, protect the most at-risk communities, support decision-making, and inform policy."

Using AskCHIS NE is simple:

  • Log onto http://askchisne.ucla.edu and create a free account. If you have previously used AskCHIS, you can use your existing user name and password.
  • Select a topic from the panel on the left.
  • Search for geographic areas of interest and select the “create a table” button.
  • The search results are quickly displayed in a table, bar chart, and interactive map.
Want to see these tools and more in action? UCLA CHPR will host a data user training on Wednesday, March 10, from 12:30 p.m. – 2:00 p.m., where our staff will demonstrate how to use CHIS' free online data tools to get data on a wide range of health topics across many sociodemographic factors. Can't make the session? Check out our tutorial videos on YouTube.
2/8/2021348
  
Approved2/7/2021 8:41 AMNo presence informationElaiza Torralba2/8/2021 6:01 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationVulnerability Indicators and At-Risk Smaller Populations in California and Los Angeles: American Indians, Pacific Islanders, and Select Asian Ethnic Groups2070
Researchers propose that using models may help find the most high-risk groups for pandemic relief and other vital resources
Current data suggests that small ethnic populations in California ─ American Indians and Pacific Islanders, Cambodians, Filipinos, and Koreans ─ may have higher than average COVID-19 infection and death rates, but how can policymakers identify where to allocate needed resources, such as vaccines?

Using a combination of measures created by public agencies and UCLA can help guide efforts to identify at-risk groups for emergency conditions such as the pandemic, according to two new research reports by the UCLA Center for Neighborhood Knowledge, UCLA Center for Health Policy Research, and Ong & Associates. The latest report, Vulnerability Indicators and At-Risk Smaller Populations in California and Los Angeles: American Indians, Pacific Islanders, and Select Asian Ethnic Groups, which was released today, takes a closer look at the performance of vulnerability indicators to spot high-risk smaller populations in California and Los Angeles County.

It would be great to pinpoint for state and local policymakers where the vaccines should go to help these vulnerable populations, said Paul Ong, PhD, director of the UCLA Center for Neighborhood Knowledge and co-lead author of a new study that analyzed where at-risk populations live. Unfortunately, it's not that easy, because they are a hidden diaspora and not tied to a geographic place.

The study, supported by a grant from the Robert Wood Johnson Foundation through the center for health policy research’s National Network of Health Surveys, looks at factors such as poverty and pandemic-related job risks among these racial and ethnic groups compared across various census tracts that are identified as the most high-risk areas in California and LA County. Three pre-pandemic indicators, built by the Centers for Disease Control and Prevention, Health Resources and Services Administration, and the Public Health Alliance of Southern California are used.

The UCLA Pre-Existing Health Vulnerability (PHV) index, based on data from the California Health Interview Survey (CHIS) and created with the UCLA BRITE Center for Science, Research and Policy, led by Vickie Mays, PhD, to capture risks of COVID-19 infection and death due to pre-existing health conditions, was also used by the researchers to look at simulations that indicate which racial and ethnic groups in vulnerable state and county areas may be most in need of services such as health care and other resources. This index is made up of six different 2016 AskCHIS Neighborhood Edition™ variables  adult diabetes, obesity, heart disease, health status, psychological distress, and food insecurity, and is currently being used by practitioners at UCLA Health.

“The data we’ve been compiling show that Pacific Islander and other smaller Asian groups are two to three times more likely than non-Latinx white workers to be essential workers, who are at a higher risk of being exposed during a pandemic. But they have received less attention because their numbers are fewer, which is why we are promoting more ways to use data to address striking disparities,” said Ninez Ponce, PhD, director of the UCLA Center for Health Policy Research and CHIS principal investigator.

Percentage scores in the simulation models show which rates of the overall population live in high-risk census tracts and what part of the population is captured as high-risk across each vulnerability indicator. The data show that 25% of all California and Los Angeles County residents live in highly vulnerable census tracts. As in the previous report, the findings note that there are limitations in each indicator in getting at underlying racial disparities and social and economic vulnerabilities. For example, one indicator may capture a certain racial and ethnic group at a higher rate due to high poverty rates or other representative data on state and county levels.

With the exception of the American Indian group, the smaller racial groups were found to be underrepresented in the riskiest areas that the four indexes identified. When researchers separated Asian American groups into three ethnicities Cambodians, Filipinos, and Koreans only Cambodian residents were identified as having a higher percentage of residents in vulnerable areas.

While each tool was good at identifying a specific need, such as post-disaster help or help with hunger, together they failed to clarify where the small vulnerable groups live and how we can more accurately deliver them needed resources, Ong said. “We need to look at more than just geographic factors, and other measures such as multigenerational housing, disability status, and occupation, that get at the social and economic factors related to health in order to address specific pandemic-related goals and relief efforts should be considered.”

Report authors emphasize that these measurement tools can be used as a starting point for policymakers, researchers, and other community stakeholders, and can be finetuned to identify which groups and places are considered vulnerable, as it shows the strengths and weaknesses of each indicator by looking at the potential gap in needs and services across these delicate racial lines.

The UCLA Center for Health Policy Research (CHPR) is one of the nation’s leading health policy research centers and the premier source of health policy information for California. UCLA CHPR improves the public’s health through high quality, objective, and evidence-based research and data that informs effective policymaking. UCLA CHPR is the home of the California Health Interview Survey (CHIS) and is part of the UCLA Fielding School of Public Health. For more information, visit healthpolicy.ucla.edu.

The UCLA Center for Neighborhood Knowledge is dedicated to translating its research to inform actionable neighborhood-related policies and programs that contribute to positive social change. We specialize in empirical spatial analysis and emphasizes the study of diversity, differences, and disparities among neighborhoods, and explicitly cover immigrant enclaves, low-income neighborhoods and minority communities.

2/3/2021349
  
Approved2/9/2021 1:49 PMNo presence informationElaiza Torralba2/9/2021 2:19 PMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
Publication
CHIS Preliminary Estimates dashboard covers specific questions on hate incidents, views on governments’ handling of the pandemic, financial challenges, and more
On the heels of President Biden’s executive order condemning and combating racism, xenophobia, and intolerance against Asian Americans and Pacific Islanders related to COVID-19, the UCLA Center for Health Policy Research (CHPR) has released new data on its California Health Interview Survey (CHIS) Preliminary COVID-19 Estimates Dashboard that takes a closer look at the impact of the pandemic on Asians, Native Hawaiians, and Pacific Islanders. The estimates are pooled data from July 2020 through September 2020 and represent a subset of questions that were asked in the 2020 CHIS to these racial and ethnic groups only.

We wanted to pull specific data to add to evidence from our advocacy partners on not only the negative health impact COVID-19 is having, but also get at some of the resulting social and behavioral impacts,” said Ninez Ponce, PhD, director of UCLA CHPR and CHIS principal investigator.

“Throughout the pandemic, CHIS efforts have been devoted to providing data on overlooked racial and ethnic groups, and we feel that it’s important to bring to light reported abuses, attacks, or unfair treatment, so that decision-makers can create the necessary policies to protect at-risk groups. According to the White House memorandum, an estimated 2 million Asian Americans and Pacific Islanders have served on the front lines of this crisis as health care providers, first responders, and in other essential roles. President Biden’s executive order condemning xenophobic language and racism toward Asian Americans and Pacific Islanders in the United States during COVID-19 aligns with the data in our dashboard.”

Key findings include:
Hate incidents — 6.8% of Asian and Native Hawaiian and Pacific Islander adults reported directly experiencing a hate incident due to COVID-19 over the last 12 months. Of those who reported a hate incident, 63.7% reported a verbal abuse or attack and 22.4% reported cyberbullying.

1 in 4 (26%) Asian and Pacific Islander adults reported witnessing another Asian or Pacific Islander person being treated unfairly due to their race, ethnicity, or national origin.

Views on government during the pandemic — 51.5% agree or strongly agree that the city or local government has done a good job managing the COVID-19 outbreak; 21.9% disagree or strongly disagree.

On the other hand, only 18.8% agree or strongly agree that the national government has done a good job managing the COVID-19 outbreak; 63.3% disagree or strongly disagree.

Please check out our other tracking dashboards: COVID-19 Rates and Risk Factors by California County Dashboard, COVID-19 Rates and Risk Factors by California County Data Table, and the NHPI COVID-19 Data Policy Lab Dashboard, which include COVID-19 infection and death rates across racial and ethnic groups, as well as data across various health and socioeconomic factors. You can access the Asian and Pacific Islander COVID-19 questions and data on the Estimates Dashboard.

The California Health Interview Survey (CHIS) is the nation's largest state health survey and a critical source of data on Californians as well as on the state's various racial and ethnic groups. Policymakers, researchers, health experts, members of the media and others depend on CHIS for credible and comprehensive data on the health of Californians.
1/27/2021346
  
Approved1/12/2021 8:48 AMNo presence informationElaiza Torralba1/27/2021 8:39 AMNo presence informationElaiza TorralbaElaiza Torralba, MPHelaiza.torralba@ucla.edu310-794-09751612N
PublicationNearly 1 in 3 Adolescents in California Reports Serious Psychological Distress2043
Rates are higher among poor, multiracial, female, gender-nonconforming and foreign-born young people, UCLA CHPR study finds

Mirroring a national trend, 45% of California youth between the ages of 12 and 17 report having recently struggled with mental health issues, with nearly a third of them experiencing serious psychological distress that could interfere with their academic and social functioning, according to a UCLA policy brief released today.

The UCLA Center for Health Policy Research study also highlights the elevated incidence of mental health distress among certain segments of the adolescent population — including poor, multiracial, gender-nonconforming and foreign-born young people — and recommends policies to address these inequities and boost access to mental health services.

“With almost half of California’s adolescents experiencing moderate to serious psychological distress, there is an urgent need to protect their psychological and emotional well-being by addressing the structural and social factors related to inequities in mental health,” said D. Imelda Padilla-Frausto, the study’s co-lead author and a research scientist at the center.

Using data from the center’s 2019 California Health Interview Survey, the study authors looked at social determinants of health — non-medical factors such as family income, insurance, race and ethnicity, and citizenship status — to determine which adolescents were most affected by mental health distress. They also examined the impact of adolescents’ physical health and behavior in areas such as eating habits, physical activity, social media use and substance use, including drinking and smoking. 

The study’s key findings include:

  • Poverty
    58% of adolescents whose family incomes were below the federal poverty level reported moderate to serious psychological distress in the past year — the highest across all income groups.
  • Gender and gender identity
    Female adolescents were one-and-a-half times more likely than males to report experiencing serious psychological distress (36.6% vs. 22.4%). Gender-nonconforming teens were also more likely to report serious distress than gender-conforming teens (36.4% vs. 27.7%)
  • Race and ethnicity
    Among adolescents who identified as multiracial, 42.9% said they had experienced serious psychological distress — the highest among all racial and ethnic groups.