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Alex J. Bates

Alex J. Bates, PhD, MD, MPH (he/him), is the senior data analyst for the California Health Interview Survey (CHIS). His responsibilities include directing statistical analyses, interpreting findings, and developing publications that translate data into evidence-based insights and policy recommendations.

Dr. Bates previously worked as a research assistant at the University of Minnesota on multiple NIH-funded studies. In these roles he examined the health and wellbeing of gay and bisexual prostate cancer survivors and investigated the role of state-level policies on experiences of discrimination among transgender and nonbinary populations. His dissertation research focused on understanding heterogeneity within LGBTQIA+ populations and the role of multilevel stressors and resilience factors in shaping their health and wellbeing.

Dr. Bates earned his MD from the Royal College of Surgeons in Ireland and an MPH in Epidemiology from the University of Minnesota, Twin Cities, where he also completed a PhD in Epidemiology.

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Fact Sheet

Fact Sheet

Suicidal Thoughts and Attempts Among American Indian and Alaska Native Adults in California

Using combined data from the 2020–2024 California Health Interview Survey (CHIS), authors of this fact sheet examined the prevalence of suicidal thoughts and attempts among American Indian and Alaska Native (AIAN) adults in California and found that those rates were higher when compared with all California adults.

This study helps fill a crucial gap in representative data on suicidal thoughts and behaviors among AIAN adults in California.

Findings:

  • About 1 in 11 AIAN adults (9%) in California had attempted suicide in their lifetime, nearly double the percentage for all adults (5%).
  • About 1 in 4 AIAN adults (24%) in California had ever seriously thought about suicide, significantly higher than California adults overall (18%).
  • Among AIAN adults in California who reported having had suicidal thoughts, more than 1 in 3 had ever attempted suicide (37%), a rate significantly higher than that for all adults in the state who reported ever having had suicidal thoughts (30%).
     
Fact Sheet

Fact Sheet

Access to Healthcare Among American Indian and Alaska Native Adults in California

American Indian and Alaska Native (AIAN) populations face longstanding barriers to healthcare. 

Using data from the 2020–2024 California Health Interview Survey (CHIS), this fact sheet examines healthcare access among AIAN adults in California across six indicators: health insurance coverage, usual source of care, preventive care visits, emergency department visits, delays in accessing needed medical care, and delays in filling prescribed medication. American Indian and Alaska Native adults in California fared worse on all of them compared with all adults in the state.

Access to timely and appropriate healthcare is a fundamental determinant of health and a crucial component of preventing and managing disease. These results suggest a need to make culturally responsive and geographically accessible primary care more available, especially for rural communities.

Findings:

  • Nearly 1 in 7 AIAN adults (14%) did not have health insurance for all or part of the past year compared with 10% of all California adults. 
  • About 1 in 5 AIAN adults (21%) delayed needed medical care in the past year compared with 18% of all California adults. 
  • More than 1 in 3 AIAN adults (35%) had no preventive care visits in the past year, which was higher than the state average.
  • Nearly 1 in 4 AIAN adults (22%) had no place they usually go for medical care, compared to fewer than 1 in 5 of all adults (19%).
     
Fact Sheet

Fact Sheet

Adverse Childhood Experiences Among American Indian and Alaska Native Adults in California

American Indian and Alaska Native (AIAN) adults in California reported significantly more adverse childhood experiences (ACEs) than adults overall in the state, based on combined data from the 2021–2024 California Health Interview Survey (CHIS).

Experiencing a higher number of ACEs is associated with progressively worse outcomes, with the highest risk found among individuals exposed to four or more ACEs.

Findings:

  • 4 in 5 AIAN adults (80%) in the state reported experiencing at least one adverse childhood experience, significantly more than the 67% of all California adults who reported the same. 
  • More than 1 in 3 AIAN adults (36%) experienced at least four ACEs, and more than 1 in 5 experienced at least five ACEs (22%), roughly double the rates seen for all adults in California (20% and 11%, respectively).
  • More than half of AIAN adults in California (53%) reported experiencing emotional abuse, significantly more than all California adults (39%).
  • All types of ACEs were relatively common: substance use in the household (43%), physical abuse (35%), parental divorce or separation (34%), witnessing intimate partner violence (33%), mental illness in the household (31%), sexual abuse (26%), and incarceration of someone in the household (18%).
Fact Sheet

Fact Sheet

Hypertension, Heart Disease, and Diabetes Among American Indian and Alaska Native Adults in California

American Indian and Alaska Native (AIAN) populations face disproportionately high rates of cardiovascular disease nationally, and among California tribal communities, diabetes, high blood pressure, and heart disease have been identified as major health priorities.

This fact sheet uses combined 2020–2024 California Health Interview Survey (CHIS) data to examine hypertension, heart disease, diabetes, diabetes medication use, hypertension medication use, and uncontrolled hypertension among American Indian and Alaska Native (AIAN) adults in California.

Findings: 

  • 1 in 4 AIAN adults reported living with hypertension (25%), and an additional 9% reported having borderline or pre-hypertension. This amounts to more than 1 in 3 living with elevated blood pressure (34%).
  • Approximately 6% of AIAN adults reported living with heart disease (e.g., coronary artery disease).
  • About 1 in 9 AIAN adults reported living with diabetes (12%).
  • Overall, nearly 1 in 3 AIAN adults reported living with heart disease, hypertension, and/or diabetes (32%), and approximately 10% of AIAN adults reported living with at least two of these conditions. 
Fact Sheet

Fact Sheet

Access to Healthcare Among American Indian and Alaska Native Adults in California

American Indian and Alaska Native (AIAN) populations face longstanding barriers to healthcare. 

Using data from the 2020–2024 California Health Interview Survey (CHIS), this fact sheet examines healthcare access among AIAN adults in California across six indicators: health insurance coverage, usual source of care, preventive care visits, emergency department visits, delays in accessing needed medical care, and delays in filling prescribed medication. American Indian and Alaska Native adults in California fared worse on all of them compared with all adults in the state.

Access to timely and appropriate healthcare is a fundamental determinant of health and a crucial component of preventing and managing disease. These results suggest a need to make culturally responsive and geographically accessible primary care more available, especially for rural communities.

Findings:

  • Nearly 1 in 7 AIAN adults (14%) did not have health insurance for all or part of the past year compared with 10% of all California adults. 
  • About 1 in 5 AIAN adults (21%) delayed needed medical care in the past year compared with 18% of all California adults. 
  • More than 1 in 3 AIAN adults (35%) had no preventive care visits in the past year, which was higher than the state average.
  • Nearly 1 in 4 AIAN adults (22%) had no place they usually go for medical care, compared to fewer than 1 in 5 of all adults (19%).
     

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Fact Sheet

Fact Sheet

Suicidal Thoughts and Attempts Among American Indian and Alaska Native Adults in California

Using combined data from the 2020–2024 California Health Interview Survey (CHIS), authors of this fact sheet examined the prevalence of suicidal thoughts and attempts among American Indian and Alaska Native (AIAN) adults in California and found that those rates were higher when compared with all California adults.

This study helps fill a crucial gap in representative data on suicidal thoughts and behaviors among AIAN adults in California.

Findings:

  • About 1 in 11 AIAN adults (9%) in California had attempted suicide in their lifetime, nearly double the percentage for all adults (5%).
  • About 1 in 4 AIAN adults (24%) in California had ever seriously thought about suicide, significantly higher than California adults overall (18%).
  • Among AIAN adults in California who reported having had suicidal thoughts, more than 1 in 3 had ever attempted suicide (37%), a rate significantly higher than that for all adults in the state who reported ever having had suicidal thoughts (30%).
     
Fact Sheet

Fact Sheet

Adverse Childhood Experiences Among American Indian and Alaska Native Adults in California

American Indian and Alaska Native (AIAN) adults in California reported significantly more adverse childhood experiences (ACEs) than adults overall in the state, based on combined data from the 2021–2024 California Health Interview Survey (CHIS).

Experiencing a higher number of ACEs is associated with progressively worse outcomes, with the highest risk found among individuals exposed to four or more ACEs.

Findings:

  • 4 in 5 AIAN adults (80%) in the state reported experiencing at least one adverse childhood experience, significantly more than the 67% of all California adults who reported the same. 
  • More than 1 in 3 AIAN adults (36%) experienced at least four ACEs, and more than 1 in 5 experienced at least five ACEs (22%), roughly double the rates seen for all adults in California (20% and 11%, respectively).
  • More than half of AIAN adults in California (53%) reported experiencing emotional abuse, significantly more than all California adults (39%).
  • All types of ACEs were relatively common: substance use in the household (43%), physical abuse (35%), parental divorce or separation (34%), witnessing intimate partner violence (33%), mental illness in the household (31%), sexual abuse (26%), and incarceration of someone in the household (18%).

Center in the News

Equality California confronts persistent hate, expands its outreach as need for support grows in state

This story cites 2024 data from the California Health Interview Survey showing that 3.1 million Californians ages 12 and over experienced hate acts in the previous year, with 31% reporting unmet support needs. News https://sdvoice.info/equality-california-confronts-persistent-hate-expands-its-outreach-as-need-for-support-grows-in-state/

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Center in the News

With California anti-hate program set to end, report warns Black Californians remain most targeted group

This story cites California Health Interview Survey data that showed nearly 3.1 million Californians experienced a hate act in the year prior to being surveyed. News https://www.theobserver.media/california/with-california-anti-hate-program-set-to-end-report-warns-black-californians-remain-most-targeted-group-a38b7cc0

Center in the News

Millions of Californians witness or experience hate crimes, report finds

This story features data from the California Health Interview Survey (CHIS) on the prevalence of hate acts in the state. According to the report, an estimated 8 percent of Californians over the age of 12 — roughly 2.6 million people — experienced at least one act of hate within a one-year period between 2022 and 2023. News https://davisvanguard.org/2026/03/california-hate-crimes-report/

Online

Disparities in Chronic Health Conditions and Substance Use among American Indian and Alaska Native Adults in California

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Online

When Hate Hits Home: Understanding Californians’ Experiences with Acts of Hate

Online

California Health Interview Survey (CHIS) Annual Data Release