Riti Shimkhada is a senior research scientist at the UCLA Center for Health Policy Research, responsible for study design and analysis planning and scientific writing for various studies in the areas of health and social disparities, immigrant and global health, and state-level health policies. She is a member of the faculty task force for the California Health Benefits Program (CHBRP) as a cost team lead analyst. CHBRP responds to requests from the California State Legislature to provide independent analysis of impacts of proposed health insurance benefit mandates and repeals. 

At the Center, Shimkhada conducts mixed-method studies, many of which have included legislative scans for health topics ranging from breast cancer to social determinants of health. She also led the analysis of social media data in a variety of settings. 

Shimkhada is involved in research in the area of disaggregated race/ethnicity data, as well as research involving policy actions, the physical and social environment, and population health outcomes. Shimkhada's peer-reviewed publications have appeared in the fields of health policy, international health, social epidemiology and environmental health. 

Shimkhada has a doctorate in epidemiology from UCLA with a special area focus on health services research.

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Breaking Barriers with Data Equity: The Essential Role of Data Disaggregation in Achieving Health Equity
Journal Article
Journal Article

Breaking Barriers with Data Equity: The Essential Role of Data Disaggregation in Achieving Health Equity

Achieving health equity necessitates high-quality data to address disparities that have remained stagnant or even worsened over time despite public health interventions. Data disaggregation, the breakdown of data into detailed subcategories, is crucial in health disparities research. It reveals and contextualizes hidden trends and patterns about marginalized populations and guides resource allocation and program development for specific needs in these populations.

Data disaggregation underpins data equity, which uses community engagement to democratize data and develop better solutions for communities. Years of research on disaggregation show that researchers must collaborate closely with communities for adequate representation. However, despite generally positive support for this approach in health disparities research, data disaggregation faces methodological and political challenges.

This review offers a framework for understanding data disaggregation in the context of data equity and highlights critical aspects of implementation, including challenges, opportunities, and recent policy and community-based efforts to address hurdles.
 

Without Data Equity, We Will Not Achieve Health Equity
Journal Article
Journal Article

Without Data Equity, We Will Not Achieve Health Equity

Data equity emphasizes the creation and distribution of inclusive, high-quality, and actionable data. It involves improving practices in data collection, processing, analysis, and sharing to ensure fair representation and utility for diverse communities. Central to data equity is the accurate and inclusive capture of community needs, which influences decisions and resource allocation.

The Office of Management and Budget's (OMB) revised Statistical Policy Directive No. 15, updated on March 28, 2024, after nearly three decades. This revision replaces the previous racial and ethnic categories with a new, single-question format that includes updated categories like Middle Eastern or North African and mandates more detailed subgroup data collection. These changes are designed to better reflect community diversity and improve the effectiveness of federal programs.

The Robert Wood Johnson Foundation funded the UCLA Data Equity Center (DEC) to support organizations in implementing these new standards by offering technical assistance and resources to turn data equity goals into concrete actions. The DEC is housed at the UCLA Center for Health Policy Research. The DEC promotes equity in data by offering resources and technical assistance that will inform, support and promote data systems becoming more representative, inclusive, and collaborative with the communities they serve. The overall strategy includes compiling curated resources that outline actionable steps organizations can take to improve data equity, developing targeted trainings for staff, and providing technical assistance to organizations as they improve their data collection, processing, reporting, and dissemination.
 

Social Media Use and Serious Psychological Distress Among Adolescents
Journal Article
Journal Article

Social Media Use and Serious Psychological Distress Among Adolescents

This research letter describes the increasing trend of almost-constant social media use among California adolescents and the association with serious psychological distress, focusing on the influence of familial and experiential factors.

Respondents were asked to report on typical daily use of social media. Family connection was measured through a series of questions, including how often the adolescent felt they were able to talk to family about their feelings, how often they felt family stood by them during difficult times, how often they felt safe and protected by the adult at home, and how often they had at least two nonparent adults taking a genuine interest in them. Adolescents responding “little to never” to any of these questions were assigned to a group characterized by little to no family connection. Adolescents responding having had at least one adverse childhood experience (ACE) were assigned “yes” to the ACEs variable. Researchers used 2019–2021 California Health Interview Survey (CHIS) data.

Findings: Almost-constant social media use for the youngest teens (aged 12-14 years) increased significantly between 2019 and 2021, whereas this increase was not noted for older teens (aged 15-17 years). Among male adolescents, almost-constant social media use increased significantly between 2019 and 2021 for both age groups. By 2021, there were no longer significant differences in almost-constant social media use according to age group.

The rates of almost-constant social media use were the highest for teens living in poverty, those who have experienced ACEs, those who reported little to no family connection, and those who reported serious psychological distress.

The researchers examine the association between social media use and psychological distress controlling for ACEs and the adolescent-reported level of family connection, both of which are significantly associated with psychological distress. Even when controlling for these and other demographic variables, almost-constant social media use remained significantly associated with psychological distress. 

This research is consistent with prior research that finds increasing trends in use of social media among the youngest teens and potential adverse mental health impacts from high or almost-constant social media use.
 

Snapshots of policy brief with image of hospital emergency room and infographic with map of Los Angeles County planning areas
Policy Brief
Policy Brief

Geographic Disparities in Preventable Hospitalizations and Emergency Department Visits in Los Angeles County

Summary: This policy brief examines geographic disparities in rates of potentially preventable hospitalizations and emergency department (ED) visits among adults ages 18 and older by Service Planning Areas (SPA) in Los Angeles County from 2016 to 2021. Authors look at three combinations of conditions that are typically preventable, given appropriate disease management: all conditions, chronic conditions, and diabetes-related conditions.

Findings: South Los Angeles (SPA 6) and the Antelope Valley (SPA 1) have the highest rates of potentially preventable hospitalizations and emergency department visits among Los Angeles’ 8 SPAs. South Los Angeles has a rate of preventable hospitalizations for all conditions that is 1.7 times that of West Los Angeles (SPA 5), which has the lowest rate. Also, SPA 6 has the highest proportion covered by Medi-Cal (35.2%), followed by SPA 1 (27.9%), while SPA 5 has the lowest percentage insured with Medi-Cal (10.7%). Authors recommend that state and local policymakers and payers should consider improving access to primary and specialty care and increasing payments for Medi-Cal providers to help prevent costly ED visits and hospitalizations.

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Breaking Barriers with Data Equity: The Essential Role of Data Disaggregation in Achieving Health Equity
Journal Article
Journal Article

Breaking Barriers with Data Equity: The Essential Role of Data Disaggregation in Achieving Health Equity

Achieving health equity necessitates high-quality data to address disparities that have remained stagnant or even worsened over time despite public health interventions. Data disaggregation, the breakdown of data into detailed subcategories, is crucial in health disparities research. It reveals and contextualizes hidden trends and patterns about marginalized populations and guides resource allocation and program development for specific needs in these populations.

Data disaggregation underpins data equity, which uses community engagement to democratize data and develop better solutions for communities. Years of research on disaggregation show that researchers must collaborate closely with communities for adequate representation. However, despite generally positive support for this approach in health disparities research, data disaggregation faces methodological and political challenges.

This review offers a framework for understanding data disaggregation in the context of data equity and highlights critical aspects of implementation, including challenges, opportunities, and recent policy and community-based efforts to address hurdles.
 

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Social Media Use and Serious Psychological Distress Among Adolescents
Journal Article
Journal Article

Social Media Use and Serious Psychological Distress Among Adolescents

This research letter describes the increasing trend of almost-constant social media use among California adolescents and the association with serious psychological distress, focusing on the influence of familial and experiential factors.

Respondents were asked to report on typical daily use of social media. Family connection was measured through a series of questions, including how often the adolescent felt they were able to talk to family about their feelings, how often they felt family stood by them during difficult times, how often they felt safe and protected by the adult at home, and how often they had at least two nonparent adults taking a genuine interest in them. Adolescents responding “little to never” to any of these questions were assigned to a group characterized by little to no family connection. Adolescents responding having had at least one adverse childhood experience (ACE) were assigned “yes” to the ACEs variable. Researchers used 2019–2021 California Health Interview Survey (CHIS) data.

Findings: Almost-constant social media use for the youngest teens (aged 12-14 years) increased significantly between 2019 and 2021, whereas this increase was not noted for older teens (aged 15-17 years). Among male adolescents, almost-constant social media use increased significantly between 2019 and 2021 for both age groups. By 2021, there were no longer significant differences in almost-constant social media use according to age group.

The rates of almost-constant social media use were the highest for teens living in poverty, those who have experienced ACEs, those who reported little to no family connection, and those who reported serious psychological distress.

The researchers examine the association between social media use and psychological distress controlling for ACEs and the adolescent-reported level of family connection, both of which are significantly associated with psychological distress. Even when controlling for these and other demographic variables, almost-constant social media use remained significantly associated with psychological distress. 

This research is consistent with prior research that finds increasing trends in use of social media among the youngest teens and potential adverse mental health impacts from high or almost-constant social media use.
 

Without Data Equity, We Will Not Achieve Health Equity
Journal Article
Journal Article

Without Data Equity, We Will Not Achieve Health Equity

Data equity emphasizes the creation and distribution of inclusive, high-quality, and actionable data. It involves improving practices in data collection, processing, analysis, and sharing to ensure fair representation and utility for diverse communities. Central to data equity is the accurate and inclusive capture of community needs, which influences decisions and resource allocation.

The Office of Management and Budget's (OMB) revised Statistical Policy Directive No. 15, updated on March 28, 2024, after nearly three decades. This revision replaces the previous racial and ethnic categories with a new, single-question format that includes updated categories like Middle Eastern or North African and mandates more detailed subgroup data collection. These changes are designed to better reflect community diversity and improve the effectiveness of federal programs.

The Robert Wood Johnson Foundation funded the UCLA Data Equity Center (DEC) to support organizations in implementing these new standards by offering technical assistance and resources to turn data equity goals into concrete actions. The DEC is housed at the UCLA Center for Health Policy Research. The DEC promotes equity in data by offering resources and technical assistance that will inform, support and promote data systems becoming more representative, inclusive, and collaborative with the communities they serve. The overall strategy includes compiling curated resources that outline actionable steps organizations can take to improve data equity, developing targeted trainings for staff, and providing technical assistance to organizations as they improve their data collection, processing, reporting, and dissemination.
 

Center in the News

Historically allied CA healthcare groups split over proposition 35

Riti Shimkhada, a senior research scientist at UCLA’s Center for Health Policy research was quoted in an article explaining California ballot Proposition 35, which is related to funding for Medi-Cal. News https://peninsulapress.com/2024/10/28/historically-allied-ca-healthcare-groups-split-over-proposition-35/

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Center in the News

Experts discuss details, implications of 2 health care propositions on the ballot

Two people from the UCLA Center for Health Policy Research – Naomi Zewde and Riti Shimkhada – were quoted in a Daily Bruin article about health care-related propositions on the ballot in California. News https://dailybruin.com/2024/10/24/experts-discuss-details-implications-of-2-health-care-propositions-on-the-ballot
Center in the News

In the San Gabriel Valley, language barriers to healthcare still steep for many Asian Americans

Data disaggregation is important to truly understand the needs of the many communities under the umbrella term: AAPI, said Riti Shimkhada, a senior research scientist at the UCLA Center for Health Policy Research. “You can take that information and start to drive community action or interventions to address those very specific needs,” she said.

News https://www.sgvtribune.com/2022/09/24/in-the-san-gabriel-valley-language-barriers-to-healthcare-still-steep-for-many-asian-americans/
Online

Overcoming Invisibility: Better Health Data for American Indians and Alaska Natives

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