Kathryn G. Kietzman, PhD, MSW, is the director of the Health Equity Program and senior research scientist at the UCLA Center for Health Policy Research. She is also an associate researcher in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. Her research agenda 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 who rely on public programs and other informal supports to maintain their independence.

Kietzman currently leads a California Health Interview Survey study to assess population-level need for, and access to, long-term services and supports in California. 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. Kietzman also recently evaluated efforts to increase the use of clinical preventive services among the underserved 50+ population in South Los Angeles through multi-sectoral collaboration and enhanced linkages between community and clinical settings.

Prior to joining the UCLA Center for Health Policy Research, Kietzman was a Health and Aging Policy Fellow in the office of United States Senator Debbie Stabenow of Michigan. A former member of the Board of Directors for the American Society on Aging, Kietzman currently serves on the Executive Board of the Center for Health Care Rights (the Health Insurance Counseling and Advocacy Program for the City and County of Los Angeles), is a member of the Commission for the Senior Community in the City of Santa Monica, and a member of the California Master Plan for Aging Research Subcommittee.

Kietzman earned her doctorate in social welfare from the UCLA Luskin School of Public Affairs where her dissertation research was supported by the John A. Hartford Foundation and the Agency for Healthcare Research and Quality. She completed both bachelor and master degrees in social welfare at UC Berkeley.​

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How Does Age Matter? Investigating Financial Strain, Health, and Well-Being among Adults Who Need Long-Term Services and Supports
Journal Article
Journal Article

How Does Age Matter? Investigating Financial Strain, Health, and Well-Being among Adults Who Need Long-Term Services and Supports

Being or becoming disabled over the life course can have profound effects on one's financial well-being and health-related quality of life. Adults of different ages and abilities who need long-term services and supports (LTSS) may perceive and experience financial strain and its impact on their health and well-being differently. Yet research on LTSS has typically studied defined age groups separately. This study explores how age may differentiate the associations between disability status, financial strain, and the subjective health and well-being of adults with LTSS needs in California.

Using representative population-level data from the 2019–2020 California Long-Term Services and Supports survey, merged with data from the California Health Interview Survey (CHIS), descriptive and conditional process analyses were applied to answer the primary research questions.

Findings: Findings indicate that young and middle-aged adults with LTSS needs struggled more than older adults to make financial ends meet. Middle-aged and older adults reported worse self-rated health, while younger adults were more likely to experience serious psychological distress. The indirect effects of difficulty in performing instrumental activities of daily living and the experience of serious psychological distress through financial strain were significant for young and middle-aged adults but not significant for older adults.

These findings suggest the need to calibrate services to be more responsive to diverse experiences of disability, and to reset aging and disability silos to create coordinated LTSS networks for people with disabilities of all ages.
 

Covers of LTSS publications
Fact Sheet
Fact Sheet

How a Sense of Neighborhood Cohesion Affects the Health of Diverse Californians With Needs for Long-Term Services and Supports

This fact sheet reports on social characteristics of neighborhoods as perceived by Californians with needs for long-term services and supports (LTSS). Authors detail how perceptions of neighborhood safety and trust vary by race or ethnicity and income and show how a sense of neighborhood cohesion (i.e., perceptions of neighborhood safety, neighbors’ willingness to help, and trust) may be an important driver of mental health for this population. The data presented were taken from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: Most Californians with LTSS needs report high levels of neighborhood cohesion, but there are significant differences by racial/ethnic group. Significant differences in perceptions of neighborhood cohesion by income were also found. For Californians with LTSS needs, neighborhood cohesion may be an important driver of mental health. 
 

Covers of LTSS publications
Fact Sheet
Fact Sheet

Financial Worries of Diverse Californians With Needs for Long-Term Services and Supports

This fact sheet uses statewide population–level data to describe the financial worries experienced by California adults who have needs for Long-Term Services and Supports (LTSS) and to assess the extent of these worries by race or ethnicity and by employment status. Data were obtained from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: The experience of financial worries among California adults who have LTSS needs varies depending on race or ethnicity and employment status. Having financial worries among this group has implications for health outcomes. Among adults with LTSS needs, lower income is associated with poorer health outcomes.
 

Covers of LTSS publications
Policy Brief
Policy Brief

The Health of Diverse Californians With Needs for Long-Term Services and Supports

This policy brief presents data on the health and well-being of adults with a disability or with long-time chronic conditions who have needs for Long-Term Services and Supports (LTSS) and compares their health status with that of the general California population. It further examines how health outcomes vary by race and ethnicity, employment status, unmet needs for LTSS, and access to health care. The data are from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: Adults with disabilities who have needs for LTSS are three times more likely to report fair or poor health and to experience serious psychological distress than the general adult population in California. The psychological well-being of adults with needs for LTSS varies by race and ethnicity. Employment status is a potential driver of health and well-being among adults with LTSS needs. Access to both LTSS and clinical health care is a potential driver of health and well-being. 

The findings can inform the development of policies and programs that improve the identification and assessment of need, access to appropriate care, and the allocation of resources to better address the ongoing care needs of individuals living with disabilities particularly for those who are at greatest risk of experiencing poor health and well-being. 

How Does Age Matter? Investigating Financial Strain, Health, and Well-Being among Adults Who Need Long-Term Services and Supports
Journal Article
Journal Article

How Does Age Matter? Investigating Financial Strain, Health, and Well-Being among Adults Who Need Long-Term Services and Supports

Being or becoming disabled over the life course can have profound effects on one's financial well-being and health-related quality of life. Adults of different ages and abilities who need long-term services and supports (LTSS) may perceive and experience financial strain and its impact on their health and well-being differently. Yet research on LTSS has typically studied defined age groups separately. This study explores how age may differentiate the associations between disability status, financial strain, and the subjective health and well-being of adults with LTSS needs in California.

Using representative population-level data from the 2019–2020 California Long-Term Services and Supports survey, merged with data from the California Health Interview Survey (CHIS), descriptive and conditional process analyses were applied to answer the primary research questions.

Findings: Findings indicate that young and middle-aged adults with LTSS needs struggled more than older adults to make financial ends meet. Middle-aged and older adults reported worse self-rated health, while younger adults were more likely to experience serious psychological distress. The indirect effects of difficulty in performing instrumental activities of daily living and the experience of serious psychological distress through financial strain were significant for young and middle-aged adults but not significant for older adults.

These findings suggest the need to calibrate services to be more responsive to diverse experiences of disability, and to reset aging and disability silos to create coordinated LTSS networks for people with disabilities of all ages.
 

View All Publications

Covers of LTSS publications
Fact Sheet
Fact Sheet

How a Sense of Neighborhood Cohesion Affects the Health of Diverse Californians With Needs for Long-Term Services and Supports

This fact sheet reports on social characteristics of neighborhoods as perceived by Californians with needs for long-term services and supports (LTSS). Authors detail how perceptions of neighborhood safety and trust vary by race or ethnicity and income and show how a sense of neighborhood cohesion (i.e., perceptions of neighborhood safety, neighbors’ willingness to help, and trust) may be an important driver of mental health for this population. The data presented were taken from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: Most Californians with LTSS needs report high levels of neighborhood cohesion, but there are significant differences by racial/ethnic group. Significant differences in perceptions of neighborhood cohesion by income were also found. For Californians with LTSS needs, neighborhood cohesion may be an important driver of mental health. 
 

Covers of LTSS publications
Policy Brief
Policy Brief

The Health of Diverse Californians With Needs for Long-Term Services and Supports

This policy brief presents data on the health and well-being of adults with a disability or with long-time chronic conditions who have needs for Long-Term Services and Supports (LTSS) and compares their health status with that of the general California population. It further examines how health outcomes vary by race and ethnicity, employment status, unmet needs for LTSS, and access to health care. The data are from the 2019–2020 California Long-Term Services and Supports (CA-LTSS) study, a follow-on survey of the 2019–2020 California Health Interview Survey (CHIS).

Findings: Adults with disabilities who have needs for LTSS are three times more likely to report fair or poor health and to experience serious psychological distress than the general adult population in California. The psychological well-being of adults with needs for LTSS varies by race and ethnicity. Employment status is a potential driver of health and well-being among adults with LTSS needs. Access to both LTSS and clinical health care is a potential driver of health and well-being. 

The findings can inform the development of policies and programs that improve the identification and assessment of need, access to appropriate care, and the allocation of resources to better address the ongoing care needs of individuals living with disabilities particularly for those who are at greatest risk of experiencing poor health and well-being. 

Four Health Equity Challenge winners Cameron Salehi, Nikolas Wianecki, Nadeeka Karunaratne, and Karla Murillo with their checks
Press Releases

Four UCLA students’ projects awarded $200,000 to combat health inequities

Four UCLA students’ projects awarded $200,000 to combat health inequities 

Winning projects address impacts of climate change, vision care for day laborers, and healing for victims of sexual and interpersonal violence 

Media Contact:
UCLA CHPR Communications Team


Following several months of turning their ideas to solve health inequities into full project proposals with community partners, four UCLA students will see their projects come to life as winners of the 2023 Health Equity Challenge, a competition presented by the UCLA Center for Health Policy Research, The MolinaCares Accord, and the California Health Care Foundation. 

The four 2023 Health Equity Challenge grand prize winners and their community partners are: 

Karla Murillo
Murillo’s project will increase access to ophthalmic care in under-resourced communities of color through the development of a mobile health screening protocol for vision-threatening conditions and eye safety training to prevent occupational eye injuries for jornaleros (day laborers) who often encounter hazardous working conditions. The UCLA Mobile Eye Clinic and her community partner, the Institute of Popular Education of Southern California, will work together to implement the project. 

Cameron Salehi
Salehi’s project will address climate-related health risks among American Indian and Alaska Native communities in Southern California through a continuing education and deployment training program for community health workers (CHW). His community partner, United American Indian Involvement, Inc., will implement the project.

Nikolas Wianecki
Wianecki’s project aims to alleviate the impact of extreme heat events on older adults through a comprehensive heat preparedness and response training for informal — or family — caregivers. His community partner, The Los Angeles Caregiver Resource Center, will implement the project. 

Nadeeka Karunaratne
Karunaratne’s project will provide trauma-informed yoga services, mental health services, and educational workshops to promote healing and wellness for South Asian survivors of interpersonal violence, including sexual, physical, and emotional violence. Her community partner, the South Asian Network (SAN), will implement the project.

The community partners will receive $50,000 each.

“We are inspired by these student leaders and their passion and commitment to health equity,” said Kathryn Kietzman, PhD, Director of the Health Equity Program at the UCLA Center for Health Policy Research. “Our 14 Health Equity Challenge finalists developed outstanding proposals to make an impact on some of the greatest challenges of our time — from the health effects of climate change to water quality to poverty. If we listen to and support these students and their ideas, our future will be in good hands.”

“We won’t get to health equity if health care does what it’s always done,” Kara Carter, Senior Vice President of Strategy and Programs with the California Health Care Foundation said. “These winners are modeling exactly the kind of inventive, people-centered problem solving that’s needed throughout our health systems.”

For Murillo, whose mother has been a farmworker in the Central Valley of California for more than 18 years, the Health Equity Challenge intervention was personal. “Helping my mother navigate the downstream consequences of her occupational exposures were the first lived experiences I had with the world of public health,” said Murillo, a first-generation medical student at the UCLA Program in Medical Education – Leadership and Advocacy (PRIME-LA). “My mother, like many other Mexican immigrants, has endured unsafe, labor-intensive occupations to provide for my siblings and me.” 

Fourteen UCLA graduate students were named finalists in the Health Equity Challenge in January 2023, with the final awards presented on June 1, 2023. The remaining 10 finalists and their proposals were:

Purnima S. Bharath: An education-based social supports public health intervention aimed at helping overweight/obese neurotypical children and children with autism in Riverside County, California.

Katie Fruin: A hydroponic farm that will provide nutritious food for the community, job training opportunities for formerly incarcerated individuals, and a hands-on classroom to engage youth and adults in learning about farming and nutrition. 

Chenglin Hong: A model that encompasses prevention, early detection, intervention, and post-intervention support for lesbian, gay, bisexual, transgender, and queer (LGBTQ+) people who experience or are at risk of intimate partner violence (IPV).

Mariam Khan: A peer-led employment support program to improve employment outcomes among individuals who have been systems-involved and formerly incarcerated in South Los Angeles.

Mohammad Khorgamphar: A water quality improvement program that would provide educational, water testing, and water filtration resources to people from disadvantaged socioeconomic and minority communities. 

Cassandra Lautredou: A program that uses systematic reinforcements (such as money or vouchers) with the administration of HIV pre-exposure prophylaxis (PrEP) to reduce the risk of HIV infection in people experiencing homelessness.

Patrick Liu: An app that provides low-income families with digestible information and digital applications for anti-poverty programs at the federal, state, and local levels.

McKayla Poppens: The implementation of sunscreen dispensers, shade structures, and educational programs to improve knowledge about skin cancer and provide access to sun-protection measures in low-resourced areas, including public housing communities. 

Virginia Reyes: A hybrid health education and peer support program to address low rates of exclusive long-term breastfeeding practices among low-income Latina women in Los Angeles County.

Cecile Yama: Implementation of “Let’s Get Set,” a mobile tax filing and financial health app that is designed to help low-income parents with young children maximize their receipt of tax credits, with the goal of yielding thousands of unclaimed dollars in financial relief for families.

“MolinaCares congratulates the winners of this year’s UCLA Health Equity Challenge! We are thrilled to have partnered with the California Health Care Foundation and UCLA in selecting this talented set of future health care leaders as they design and implement innovative solutions to reducing health disparities in communities throughout the Greater Los Angeles area,” said Abbie Totten, Plan President of Molina Healthcare of California.

To learn more about the 14 projects, visit the UCLA 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​.

Health Equity Challenge
Press Releases

UCLA announces finalists in health equity competition for graduate students

The UCLA Center for Health Policy Research, MolinaCares, and California Health Care Foundation have announced 14 finalists in the 2023 Health Equity Challenge. The competition is an opportunity for UCLA graduate students to identify a health equity issue across Los Angeles, San Bernardino, and Riverside counties, create a proposal to address it, and work with a community-based organization to implement their project. Up to four finalists’ community-based organizations will be awarded up to $50,000 each to fund the project.

“In order to achieve health equity, the community needs more people who are committed to making a positive impact,” Kathryn Kietzman, PhD, director of the Health Equity Program at the UCLA Center for Health Policy Research, and lead of the Health Equity Challenge, said. “Each of our finalists has this vision. All 14 graduate students have innovative ideas to bridge gaps that often go unaddressed by our health care system.”

2023 marks the second year of the Health Equity Challenge. Last year’s winners were Angelica Johnsen and Alma Lopez, whose respective projects were a de-escalation toolkit for medical providers working with patients experiencing a mental health crisis, and an intervention program to improve the quality of maternal mental health care for mothers of color in South Los Angeles. Each of their community partners were awarded $50,000 to fund and implement their proposals.

The 2023 Health Equity Challenge finalists’ projects will tackle health inequities among communities facing significant barriers to care such as immigrants who are undocumented, low-income communities, people experiencing homelessness, and Indigenous communities. Proposed solutions include trauma-informed yoga services for victims of domestic and sexual violence, extreme heat trainings and toolkits for caregivers of older adults and people with chronic conditions, and expanding access to sun protective measures for people experiencing homelessness.

“I believe that in order to achieve health equity, we must reshape our systems to actively invest in — and not just intervene on — the health and financial well-being of our communities,” said Patrick Liu, Health Equity Challenge finalist and MD and PhD dual candidate at the David Geffen School of Medicine at UCLA. “My hope is that through the Health Equity Challenge, we can begin to build stronger bridges to evidence-based approaches that directly address poverty as a cause of health inequity for families in Los Angeles.”

“The proposals from finalists are all creative and practical solutions to serious inequities in health care and public health,” said Kara Carter, senior vice president of strategy and programs for the California Health Care Foundation. “Beyond the projects themselves, it is incredibly exciting to imagine what these students will accomplish over the course of their careers.”

Each student finalist will be awarded $2,500 and will be paired with a mentor to develop a project proposal over 15 weeks. Each student’s goal is to identify a community partner that will implement their proposal idea to address a specific health equity issue. At the end of the project, an independent review committee will review the proposals: Up to four student winners will be selected and their community partners will receive $50,000 each to implement the project. The winning students will receive an additional $2,500 to continue to document the progress and impact of their project’s implementation.

The 14 graduate student finalists are:

Kaitlyn Fruin
Medical Resident, UCLA Geffen School of Medicine

Project: A multilingual financial health toolkit in the form of a cookbook that combines recipes with a basic financial health curriculum for immigrant families who are undocumented.

Chenglin Hong
PhD in Social Welfare, UCLA Luskin School of Public Affairs

Project: Technology-based interventions to facilitate Intimate Partner Violence (IPV) prevention, predict IPV victimization using social media data, and inform IPV help-seeking strategies that are specifically tailored for gay, bisexual, and other men who have sex with men.

Nadeeka Karunaratne
PhD in Higher Education and Organizational Change, UCLA School of Education & Information Studies

Project: Integrates trauma-informed yoga services into domestic and sexual violence agencies in Los Angeles County, providing Asian and Pacific Islander survivors access to healing modalities that support their trauma recovery and overall health and wellness.

Mariam Khan
Doctor of Medicine and Master of Public Health, David Geffen School of Medicine at UCLA and UCLA Fielding School of Public Health

Project: A pilot program that offers financial services and education, including tailored employment, credit, debt, and budget counseling, for low-income communities in South Los Angeles, in a trusted community-based setting.

Mohammad Khorgamphar
Master of Public Health in Environmental Health Sciences and Policy UCLA Fielding School of Public Health

Project: A water quality improvement program to prevent and reduce the rate of related disease among people from lower socioeconomic statuses who are more at risk.

Cassandra Lautredou
Master of Health Policy and Management, UCLA Fielding School of Public Health, and second-year fellow in a combined Infectious Diseases and Preventive Medicine program at the Geffen School of Medicine at UCLA

Project: Combines a behavioral approach that uses systemic reinforcement (either money or vouchers) with the administration of oral PrEP to decrease the risk of HIV acquisition in people experiencing homelessness and at risk of HIV infection.

Patrick Liu
Doctor of Medicine and PhD, David Geffen School of Medicine at UCLA and UCLA Medical and Imaging Informatics (MII)

Project: Transforms safety net health care clinics into anti-poverty gateways through the development of a web app that provides low-income families with easy-to-understand information and digital applications for anti-poverty programs at the federal, state, and local levels.

Purnima Mudnal-Bharath
PhD in Health Policy and Management, UCLA Fielding School of Public Health

Project: A social support public health intervention for overweight/obese children and children with special health care needs in Riverside County, California.

Karla Murillo
Doctor of Medicine Program in Medical Education – Leadership and Advocacy (PRIME-LA), David Geffen School of Medicine at UCLA

Project: A comprehensive mobile health screening protocol for chronic eye diseases designed for use in low-resource settings, titled Integrated Screening Eye Exams – Los Angeles (iSEE-LA).

McKayla Poppens
Doctor of Medicine, Charles R. Drew and UCLA Medical Education Program

Project: Expands access to sun protective measures for people experiencing homelessness and reduces skin cancer by providing sunscreen dispensers in community parks and nearby highly-trafficked areas.

Cameron Salehi
Executive Master of Public Health, UCLA Fielding School of Public Health

Project: A continuing education program to provide Community Health Workers (CHWs) with the knowledge and skills necessary to build capacity for risk mitigation and resilience against the health effects of climate change in indigenous communities.

Virginia Reyes
Master of Public Health, UCLA Fielding School of Public Health

Project: A hybrid health education and peer support program to address low rates of exclusive long-term breastfeeding practices among low-income Latina women in Los Angeles County.

Nikolas Wianecki
Master of Public Health in Community Health Sciences, UCLA Fielding School of Public Health

Project: Extreme heat survival trainings and toolkits for caregivers of older adults and people with chronic conditions to prepare them to respond to increasingly devastating natural disasters and protect vulnerable communities.

Cecile Yama
Master of Science in Health Policy and Management, UCLA Fielding School of Public Health

Project: Implementation of a novel tax filing app, Let’s Get Set, to increase receipt of direct cash payments via tax credits for low-income families in community and health care settings.

The MolinaCares Accord is a commitment to building stronger communities through improving people’s health and lives,” said Carolyn Ingram, executive director of The Molina Healthcare Charitable Foundation. “The MolinaCares partnership with UCLA and CHCF supports the next generation of changemakers in designing innovative solutions to reduce health and wellness disparities in our more vulnerable communities throughout the Los Angeles area and Inland Empire. Congratulations to our winners!”

Learn more about the Health Equity Challenge finalists.

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Video

Improving California’s Behavioral Health Workforce for Older Adults

One in five Californians will be an older adult by 2030, yet gaps and deficits in the state’s geriatric mental health care workforce still exist.

In our January seminar, Faculty Associate Janet Frank and Research Scientist Kathryn Kietzman share recommendations from their new study on how state policymakers, educational institutions, and county mental health/behavioral health departments and their contracted providers can help improve this workforce and ensure that mental health care training that addresses the unique needs of older adults is a priority instead of an afterthought.

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Center in the News

Caring for Aging Adults

UCLA Center for Health Policy Research showed that more than two-thirds (67.5%) of caregivers in California are middle aged, with nearly 40% between the ages of 45 and 64. News https://blackvoicenews.com/2024/12/03/caregivers-aging-black-voicenews/

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Center in the News

California Adults in Long-Term Care Struggle with Resource Access

Whether because of age or disability, California adults who require assistance with day-to-day activities reported their health as worse overall and experience higher rates of serious psychological distress, according to a new study by the UCLA Center for Health Policy Research. Also picked up by MSN, Sierra Sun Times, Medical Xpress, and Health Medicine Network. News https://www.miragenews.com/california-adults-in-long-term-care-struggle-1282410/
Center in the News

How do you help homebound, hungry seniors? These services deliver free meals

UCLA Center for Health Policy Research's Kathryn Kietzman and Imelda Padilla-Frausto are cited in this article about hunger among older adults. News https://www.latimes.com/california/story/2024-03-21/home-delivered-meals-can-help-food-insecure-seniors
In-Person

2024 E.R. Brown Symposium

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Online

Addressing Social and Economic Drivers of Health among Californians Who Need Long-Term Services and Supports

Online

Health Equity Challenge Information Session: October 23, 2023