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 commissioned Listening to Black Californians, a three-phase qualitative and quantitative study to understand the health and health care experiences of Black Californians. The research is being conducted by EVITARUS, a Black-owned public opinion research firm in Los Angeles. An advisory group composed of academics, policymakers, providers, and community advocates is guiding the study.

This report describes the results of Phase I of the Listening to Black Californians study. In this phase, EVITARUS conducted individual, hour-long interviews with 100 Black Californians from June to August 2021 to understand their views on health and well-being, their perceptions of discrimination and bias in the health care system, and their views on what a quality health care system looks like. Each story provided unique insights. Still, taken as a whole, the stories revealed many similarities in how Black Californians view health and how they experience health care.

Key findings include:

  • Respondents held a holistic view of health and prioritized it in their everyday lives.
  • Experiences with racism in health care were widespread and negatively impacted participants’ health.
  • Participants envisioned high-quality health care as patient-centered and proactive.

The complete report is available under Document Downloads.

In Their Own Words: Black Californians on Racism and Health Care — Executive Summary (PDF)