Local Budgets Can Advance Meaningful Equity with Community Input 

Author Details

Monika Lee

Associate Communications Director
(858) 353-7271 

Organization: California Pan-Ethnic Health Network

The California Pan-Ethnic Health Network 
For Immediate Release 
August 16, 2022 
Contact: Monika Lee, (858) 353-7271 

Sacramento, CA – The California Pan-Ethnic Health Network, in collaboration with the California Health Care Foundation and CARESTAR Foundation, released the following report, “People Power for Public Health.” 

Two years after the racial justice protests following the murders of George Floyd, Breonna Taylor, Ahmaud Arbery, and countless more, intertwined with the devastating COVID-19 pandemic, it is clear that racism is a public health crisis. Without intentional investments, accountability, and community engagement, we will continue to see preventable death and disease.  

CPEHN surveyed nearly 1,000 people, held listening sessions in Sacramento, Fresno, Kern, Orange, and San Diego counties, and conducted 12 key informant interviews to understand respondents’ experiences with health care and emergency services and what challenges Black, Indigenous, communities of color face in accessing such services, as well as preferences for how and from whom they receive care.  

Key recommendations include: 

  1. Increase Reliable Access to High Quality Primary, Preventive, and Behavioral Health Care. Despite significant gains in health insurance coverage since the implementation of the Affordable Care Act, a substantial number of Californians of color still lack health insurance coverage. Even participants with coverage highlighted the need to improve access to quality physical and behavioral health care. 
  1. Ensure Affordable and Accessible Emergency, Prehospital, and Mental Health Crisis Response Services. Many research participants reported using emergency and urgent care providers. However, participants described many barriers that prevent them from accessing needed emergency and prehospital services, including concerns about cost and insurance coverage and fear of law enforcement involvement.  
  1. Center Community-Connected and Culturally Responsive Care Workforce. Participants overwhelmingly wanted care that was culturally and gender responsive and linguistically appropriate, and access to providers that shared similar lived experiences. However, too few said that they had access to this needed workforce. 
  1. Prioritized Investment in Social Determinants of Health. Participants desired increased investment for social determinants of health such as affordable and quality housing, transportation, safety, parks and recreation, and healthy food availability. 

Local county budgets are ripe for community advocacy and involvement to advance some of these much-needed changes to our safety net systems. County budgets fund many public service programs that impact social determinants of health as well as maintain public health departments and oversee and fund local law enforcement. Budgets, as a reflection of our values, can go further to center equity and ensure everyone has what they need to thrive where they live, work, and congregate. 

Policymakers at the state and local levels can do more to advance quality, affordable care focused on prevention and alternative destinations aside from urgent care. Policies and budgets must also expand the diversity of the health workforce to be more reflective of the people it serves and prioritize social determinants like housing and green spaces to ensure people can access good health everywhere.  

Without explicit and intentional anti-racist practices, policies and budgets will continue to harm Black, Indigenous, communities of color by upholding decades of divestment, over policing, and structural inequities from lack of affordable housing to dearth of green spaces.  

We must face the COVID-19 recovery as an opportunity for transformational change, or we risk further entrenching inequity in our state. Local governments are uniquely positioned to be a driving force for change in California due to their jurisdiction in the area of public health.