California Health Interview Survey reveals alarming rates of food insecurity, hate incidents, mental health concerns, and challenges in accessing needed care

High rates of food insecurity, hate incidents, and difficulties accessing health care were all at the forefront of issues that plagued Californians in 2022, according to the annual California Health Interview Survey (CHIS) data released today by FSPH's UCLA Center for Health Policy Research (CHPR).

According to the 2022 data, a growing number of low-income Californian adults (earning less than 200% of the federal poverty level) struggled to access nutritious and affordable food: 44% were not able to afford enough food in 2022, up from 35.8% in 2020. 

The most significant increase between 2020 and 2022 occurred among working-age adults, jumping 11 percentage points among adults ages 18–24 to 47.7%; 8.6 percentage points among adults ages 25–39 to 51.4%; and 12.4 percentage points among adults ages 40–64 to 48%. Among racial or ethnic groups, Latinx adults experienced the highest increase in food insecurity, with a 9.6 percentage point increase to 47%. However, adults who identify with two or more races and Black or African American adults had among the highest overall rates of food insecurity in 2022: 49.9% and 48.6%, respectively.

“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 Dr. Ninez Ponce, director of the center, principal investigator of the California Health Interview Survey, and professor and chair of the Department of Health Policy and Management at the UCLA Fielding School of Public Health. “We call on community organizations and advocates, legislators, and policymakers to explore the new data and address these pressing issues.”

The 2022 survey also added new and expanded questions on Californians’ experiences with hate crimes or incidents. While more than 1 in 9 (11.7%) California adults said they have ever been a victim of a hate crime or incident, the rate among Black or African American adults was 1 in 4 (26.2%) — four times as high as the 6.3% for white adults. The figure was 17.4% for adults who identify with two or more races, 15.6% for Asian adults, and 13.5% for Latinx adults.

A bright spot in the data was that the proportion of California’s adults, teens, and children who had health insurance in 2022 reached 94.8% — the highest rate recorded by CHIS. Latinx adults are experiencing the lowest rate in health coverage but are also seeing the most significant increase in coverage: From 86% to 89.4%.

However, difficulty accessing care was a concern among many, with more than 1 in 5 (22.4%) California adults indicating they were never able to get a doctor’s appointment within two days when they tried, up from 12.3% in 2020. Similarly, one-third (33.3%) of adults who needed mental health care said difficulty getting an appointment was the reason they didn’t get the emotional help they needed in 2022, up from 24.4% in 2021.

The nation’s largest state health survey, CHIS has highlighted gaps and inequities in health and health care access for more than two decades. The 2022 survey, which includes responses from 21,463 adults, 985 teens and 3,395 children, covers a wide range of health topics and topics that influence health — 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, community engagement, and much more. 

Other 2022 findings about the health of Californians also include: 

A continued pattern of higher mental health needs 

• About 1 in 6 (16.4%) adults reported in 2022 that they likely had serious psychological distress in the past year, similar rates to 2021 (17%), and 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.
• Nearly 1 in 5 adults in 2022 said they ever experienced suicide ideation within the past 12 months (18.9%) and 2021 (19.1%), up from 12.2% in 2020.

COVID-19 vaccination status and views

• Among teens who were partially vaccinated or not vaccinated for COVID-19, 21% said the reason for not being fully vaccinated is because their parents didn’t want them to get the vaccine and 27.6% said it’s because they think the COVID-19 vaccine is unnecessary. 
• Nearly 1 in 3 (30.7%) California adults who have had COVID-19 experienced symptoms for two months or longer (long COVID). Latinx adults (38.4%) had significantly higher rates of long COVID compared to white adults (24.1%). 

“While the state of California is often seen as a leader in striving toward health equity, the 2022 data highlights some of the ongoing disparities that are impacting Californians’ overall well-being,” said Todd Hughes, CHIS director. “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.”

The 2022 data have been made available to the public via our free online health query tool, AskCHIS.

Hughes and Ponce will discuss findings from the 2022 survey at the CHIS data release from noon to 1 p.m. PT today on Zoom.

By Tiffany Lopes for FSPH's UCLA Center for Health Policy Research