California is home to a diverse population varying by income, age, region, and racial and ethnic background. Annually since 2019, the California Health Care Foundation has conducted a survey of residents’ views on a variety of health care topics, some of which are tracked over time to detect meaningful differences in public opinion.

The California Health Care Foundation and NORC at the University of Chicago, a nonpartisan research organization, conducted a statewide survey of California’s residents in late 2021 to understand their views on health care policy, as well as their experiences with COVID-19 and the health care system overall. Results from this survey are reported and, where applicable, compared to the prior annual survey published last January to understand emerging trends.

Key findings from this year’s survey include:

Health care costs. Half of Californians (49%) skipped or postponed some type of health care in the last 12 months due to cost. Among those who postponed care, 47% report that their condition worsened as a result, an increase from last year’s survey (41%).

Problems paying medical bills. One in four Californians (25%) say they or someone in their family had problems paying at least one medical bill in the past 12 months, an increase from 20% in last year’s survey. Forty-three percent of Californians with lower incomes report having issues paying for medical bills, an increase from 32% last year.

Homelessness. One in five Californians (19%) say they or someone close to them has experienced a period of homelessness in the past five years. The same proportion (19%) are “very” or “somewhat” worried about experiencing homelessness themselves. Californians also see a connection between affordable housing and health status, with 80% of Californians saying lack of affordable housing impacts the physical or mental health of people with low incomes “a lot” or “some.”

Telehealth. More Californians are receiving care via telehealth than last year. More than half (55%) report receiving care by phone in the last 12 months, an increase from 45% in last year’s poll, and more than 4 in 10 (44%) by video, an increase from 35%. Californians are satisfied with the quality of health care they receive via telehealth, with more than 8 in 10 (83%) “very satisfied” or “satisfied” with their care by video, and a similar proportion (79%) “very satisfied” or “satisfied” with care by phone.

Equity. Nearly 6 in 10 Californians (59%) believe that the health care system treats people unfairly based on their race or ethnic background — one quarter (26%) “regularly” and a third (33%) “occasionally.” Eighty-three percent of Black Californians expressed this belief, a significantly higher percentage than any other race or ethnic group. In addition, Black and Latinx Californians were more likely than White or Asian Californians to report negative experiences by a doctor or other health care provider.

The full report, available for download below, shows data broken down by race and ethnicity, income, political party, and region. Also available are the detailed topline results, charts, and a press release about the poll. A post on The CHCF Blog, “For One in Five Californians, Homelessness Is Personal, CHCF Survey Finds,” underscores the importance of the state’s  CalAIM initiative.