In Their Own Words: Black Californians on Racism and Health Care

California, home to the most culturally diverse population in the country and the fifth largest Black population of any state, has a major opportunity to be a leader in health equity. But glaring racial and ethnic inequities pervade its health care system, from insufficient access to worse health outcomes to excess mortality. Black residents have the shortest life expectancy (75 years) at birth of any racial/ethnic group, six years shorter than the state average. Black Californians have the highest death rates from breast, cervical, colorectal, lung, and prostate cancers. Black birthing people experience the highest rates of prenatal and postpartum depression, preterm births, low birthweight births, and pregnancy-related mortality. And Black infants have the highest mortality rates.As part of its commitment to ending health inequities, CHCF is funding Listening to Black Californians, a three-phase qualitative and quantitative study to understand the health and health care experiences of Black Californians. This project will also explore the impact of racism on Black Californians' experiences in the health care system, as well as the detrimental effects of racism on their health.EVITARUS, a Black-owned public opinion research firm in Los Angeles, is conducting the research. An advisory group composed of academics, policymakers, providers, and community advocates is guiding the study. Listening to Black Californians will identify policy actions and practice changes at the clinical, administrative, and training levels that policymakers and health system leaders can take to eliminate discrimination in health care and to improve the health outcomes of Black Californians.This report describes the results of Phase I of the Listening to Black Californians study, which was conducted during the summer of 2021. The 100 people interviewed for this phase explained how they think about health and described their individual experiences with California's health care system. While each interview provided unique insights, taken together, the conversations revealed many similarities in how Black Californians view health and how they experience health care. Interviewees shared their perceptions about health, their experiences with racism and health care, and their perspectives on what constitutes quality health care. The study results are summarized on the following page