Pandemic-related disparities persist, UCLA California Health Interview Survey finds

Pandemic-related disparities persist, UCLA California Health Interview Survey finds

New California Health Interview Survey data highlight urgent need for mental health services, challenges in accessing medical care 

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UCLA CHPR Communications Team

The number of 18-to-24-year-olds in California who reported having thought about committing suicide at some point in their lives increased to 30.5% in 2021 from 23.9% in 2020 — the year COVID-19 emerged in the U.S. — according to new data published by the UCLA Center for Health Policy Research. 

Those figures represent a dramatic increase from just five years ago. The Center’s 2016 survey found that 14.1% of California’s young adults said they had experienced thoughts of suicide at some point in their lives. 

The 2021 data is from the latest California Health Interview Survey (CHIS), the nation’s largest state health survey. The survey highlights the consequences of the pandemic in terms of people’s mental health and their ability to afford or access needed health care. 

In the study, 36.7% of respondents age 13 to 17 said they needed help for emotional or mental health problems, but 26.2% of them did not receive any counseling in the past year. 

“There is an urgent need for resources that will aid Californians through a crisis that’s dramatically affecting people’s mental health,” said Ninez A. Ponce, PhD, MPP, UCLA CHPR director and CHIS principal investigator. “Our findings show that more people are experiencing serious psychological distress, more people are in need of professional help and more people are reporting moderate or severe impairment in their work, social lives, relationships and daily activities. Our hope is that these data will be used by policymakers and the public to help improve the Californians’ health.”

The survey covers more than 100 other topics on Californians’ physical and mental health, including new-for-2021 questions on traumatic childhood experiences, encounters with police, climate change and gun violence.

Among the other findings:  

Adverse Childhood Experiences 

• ​67.3% California adults reported having at least one adverse childhood experience — defined as traumatic events involving serious physical injury or psychological, emotional or sexual abuse before the age of 18 — and 1 in 5 (21.2%) report having experienced four or more adverse childhood experiences.
• Nearly 1 in 3 Californians (32.3%) who had four or more adverse childhood experiences had serious psychological distress during the past year, compared to 7.8% of those who have not had adverse childhood experiences. 
• Adults with four or more adverse childhood experiences were more than three times as likely to have needed professional help in the past 12 months for emotional or mental health problems or use of alcohol or drugs than those who have not had adverse childhood experiences (42.1% vs 12.7%), and were twice as likely to report overall poor or fair health (23.5% vs 12.2%).
• Black or African American adults and American Indian and Alaska Native adults were the most likely to have adverse childhood experiences, with 77.1% of Black or African American adults and 90.1% American Indian and Alaska Native adults saying they had one or more adverse childhood experiences compared to 67.2% of all Californians. 

Unfair Treatment due to Race/Ethnicity

• 26.9% of California adults who were treated unfairly because of their race/ethnicity thought about committing suicide. 
• 34.2% California adults who were treated unfairly because of their race/ethnicity has serious psychological distress, double the number of all California adults (17%). 

Police Encounters

• ​36.4% of Black or African American adults have been stopped by police at least once in the last three years, compared to 21.5% of all Californians adults.
• 25.4% of people who have been stopped by the police at least once in the last three years have experienced serious psychological distress in the past year, significantly higher than the 18.6% of all Californians who experienced serious psychological distress. 
• 24.9% of people who have ever had a member of their household get arrested have experienced serious psychological distress during the past year. 

Access to Care

• 27.1% of Californians who had delayed or did not get needed medical care cited COVID-19 as the main reason why, and 27.5% cited cost, lack of insurance, or other insurance-related reasons. Adults ages 65 and over were significantly more likely than adults ages 18-64 to cite COVID-19 as the reason why, 40.4% vs. 25.3%, respectively. 
• 33.4% of people who had trouble paying for necessities due to COVID-19 delayed or did not seek medical care.
• 25.3% of people who ever had or thought they had COVID-19 delayed or did not seek medical care.

Food Insecurity 

• 39% of California adults earning under 200% of the federal poverty level said they were not able to afford enough food in 2021. The rate was highest among Black or African American adults (46.3%), adults with two or more races (42.5%), and Latino adults (41.4%).
• Nearly half, or 41.7% of, California immigrant adults were not able to afford enough food in comparison to 36.9% of U.S. born citizens. 

Climate Change 

• ​44.8% of adults experienced an extreme-weather related event, including extreme heat waves, flooding, wildfires, smoke from wildfires, and public safety power shutoffs to prevent a wildfire, in the past two years. Across the state, 16.6% of those living in the Northern/Sierra region (which consists of 25 counties) had their physical health affected, compared to adults in the Greater Bay area: 11.7%, Sacramento area: 11.1%, Central Coast: 9.3%, San Joaquin Valley: 9.0%, Los Angeles: 4.6%, and other Southern California: 4.5%.
• 23.9% of adults living in the Northern/Sierra region (which consists of 25 counties)​ reported that these extreme-weather related events impacted their mental health, compared to adults in the Greater Bay Area: 17.1%, Central Coast: 15.7%, Sacramento area: 11.9%, San Joaquin Valley: 7.8%, Los Angeles: 5.7%, and other Southern California: 5.5%.

Housing Instability 

• ​4.7% of California adults reported feeling fairly or very unstable and insecure in their current housing situation. Younger adults ages 18—24 were twice as likely as adults ages 65 and older to report feeling unstable: 6.2% vs. 3.1%.
• California adults with poor overall health were five times more likely to feel fairly or very unstable and insecure in their current housing situation than those with excellent health: 13.3% vs. 2.7%. Those with poor overall health were three times more likely to worry “very often” about struggling with their mortgage: 12.6% vs. 3.8%. 

The 2021 survey includes responses from 24,453 adults, 1,169 teens and 4,067 children. Children’s survey response were obtained through their parents. 

“As the largest and most diverse state, California is often looked at as a model that strives toward health equity,” said Todd Hughes, director of the California Health Interview Survey. “However, the data show there is still a need to address some of the inequities in California that have been magnified since the start of the pandemic.”

Ponce and Hughes will discuss more findings from the annual CHIS data release today at noon. 

The new survey results are available to the public for free through the center’s AskCHIS online health query site at ask.chis.ucla.edu. ​