Survey Reveals Rising Health Challenges for Californians

High rates of food insecurity, hate incidents and difficulties accessing health care were at the forefront of issues affecting the health of Californians in 2022, according to the annual California Health Interview Survey, or CHIS, released today by the UCLA Center for Health Policy Research.

According to 2022 data from CHIS, the nation's largest annual health survey on a single state, a growing number of low-income adults (those living below 200% of the federal poverty level) struggled to access nutritious and affordable food. In 2022, 44% of these low-income Californians were not able to afford enough food, up from 35.8% in 2020. The most significant increase in food insecurity between 2020 and 2022 occurred among low-income, working-age adults, with the figure jumping 11 percentage points among those ages 18–24, to 47.7%; 8.6 percentage points among those 25–39, to 51.4%; and 12.4 percentage points among those 40–64, to 48%.

Among racial or ethnic groups, Latino adults experienced the highest increase in food insecurity, with a 9.6 percentage point increase, to 47%. The highest overall rates of food insecurity in 2022 were seen among adults of two or more races and Black or African American adults, at 49.9% and 48.6%, respectively.

The 2022 CHIS also included new and expanded questions on experiences with hate crimes or incidents. While more than 1 in 9 adults in California, or 11.7%, said they had at some point been a victim of a hate crime or incident, the rate among Black or African American adults was 26.2% — four times as high as the figure for white adults, at 6.3%. The figure was 17.4% for adults who identify as two or more races, 15.6% for Asian adults and 13.5% for Latino adults.

"Our 2022 data reveal a complex health landscape — deepening food insecurity, hate incidents, challenges in accessing health care and an ongoing mental health crisis — that paints a stark picture of the challenges faced by California's large and diverse population," said Ninez Ponce, center director and the survey's principal investigator. "We call on community organizations and advocates, legislators and policymakers to explore the new data and address these pressing issues."

A bright spot in the data was that 94.8% of respondents had health insurance — the highest rate ever recorded by CHIS. Latino adults had the lowest rate of health coverage but the most significant increase in coverage between 2021 and 2022, from 86.0% to 89.4%.

However, difficulty accessing care was a concern among many survey respondents, with more than 1 in 5 California adults (22.4%) unable to get a doctor's appointment within two days in 2022, up from 12.3% in 2020. Similarly, one-third of adults (33.3%) who needed mental health care in 2022 said difficulty getting an appointment was the reason they hadn't received the help they needed, up from 24.4% in 2021.

CHIS has highlighted gaps and inequities in health and health care access for more than two decades. The latest survey, which included responses from 21,463 adults, 985 teens and 3,395 children, covered a wide range of health topics and topics that influence health — among them, access to and use of health care, health insurance, health conditions, health behaviors, mental health, housing, intimate partner violence, child care, caregiving, discrimination, climate change, firearm safety and gun violence, and community engagement.

Other findings from the 2022 CHIS:

A pattern of higher mental health needs

• In 2022, about 1 in 6 adults (16.4%) reported serious psychological distress in the past year, similar to the rate in 2021 (17%), with both figures being higher than in 2019 (13%) and 2020 (12.2%).
• The LGBTQ+ community had significantly higher rates of serious psychological distress, with 61.6% of transgender or gender-nonconforming adults, 46.9% of bisexual adults and 29.7% of gay, lesbian or homosexual adults experiencing distress, compared to 13.6% of straight or heterosexual adults and 15.8% of cisgender adults.
• In both 2021 and 2022, nearly 1 in 5 adults said they had experienced suicide ideation within the past 12 months (19.1% and 18.9%, respectively), up from 1 in 8 (12.2%) in 2020.
• Among adults who said they needed help for emotional/mental or alcohol/drug problems, 50.2% of those who identified as two or more races, 48.9% of Asian adults and 46.4% of Latinx adults reported seeking help but not receiving treatment.

Differences in COVID-19 vaccination status and views

• Californians with the lowest incomes (0–99% of the federal poverty level) were less likely to be vaccinated than those with the highest incomes (300% of the FPL and above), at 21.1% and 8.6%, respectively.
• Among teens who were partially vaccinated or not vaccinated for COVID-19, 21% said the reason was that their parents didn't want them to get the vaccine, and 27.6% said it was because they didn't think the vaccine was necessary.
• 41.8% of white respondents who were not fully vaccinated said they thought the vaccine was unnecessary. This percentage was about double the rates among other races and ethnicities, with 20.8% of Latino, 20.5% of Black or African American and 24.1% of Asian Californians giving this as the reason for not being fully vaccinated.
• Nearly 1 in 3 California adults (30.7%) who had had COVID-19 said they had experienced symptoms for two months or longer (long COVID). Latino adults (38.4%) had significantly higher rates of long COVID, compared with white adults (24.1%).

"While the state of California is often seen as a leader in striving toward health equity, the 2022 data highlight some of the ongoing disparities impacting Californians' overall well-being," said Todd Hughes, director of the survey. "This isn't just a collection of numbers. This is a story of Californians — their challenges, their fears and their needs. This is the key to shaping a brighter, healthier future for all."