2022

UCLA report: Reimagining the future of health and wellness in California


A report by a UCLA team led by Dr. Ninez Ponce helps to point the way toward greater access and equity as part of statewide initiative.

Toddler with various health-related background images

Will all Californians have a chance to enjoy good health in the coming 100 years? What steps can policymakers and healthcare leaders take to make that happen?

These questions are tackled in a time-jumping research report released today by the UCLA Fielding School of Public Health's UCLA Center for Health Policy Research and supported by a grant from California 100, a new statewide initiative focused on inspiring a vision and strategy for California’s next 100 years that is innovative, sustainable and equitable.

“What health and wellness looks like for our great-grandchildren depends on what steps the state’s leaders take now and in the near future,” said Dr. Ninez PonceUCLA Fielding School professor of health policy and management, director of the center, and lead author of the report.

The UCLA team examined the state of modern health and healthcare in California, the historical policy decisions and societal shifts that created the current situation, and trends influencing change in the existing environment. Working with community-based experts and stakeholders, the team focused on seven topic areas: (1) health systems and public programs, (2) insurance coverage and markets, (3) environmental influences, (4) chronic conditions and mental health, (5) child and adolescent health, (6) aging residents and (7) racial justice and immigrant populations.

Two factors that affect future health are whether leaders in the state will define “health” in broad or narrow terms and whether health systems are interoperable, meaning they can exchange and make use of information together, according to the report. Depending on those definitions, the authors say, California has four possible health system scenarios in the future:

  • Scenario 1: Patchwork of well-being

(broad definition of health | lower interoperability)
More than just clinical care limited to an individual, this localized health system recognizes factors that lead to health disparities and supports connections between housing, education, employment and health at the community level.

  • Scenario 2: Uniform health and wellness

(broad definition of health | higher interoperability)
In this system, health and wellness include an understanding of the social determinants of health and are scaled for the whole state population. Health is highly integrated with social needs such as housing and education, and there is little regional variation in health and social services systems.

  • Scenario 3: Sickness systems

(narrow definition of health | lower interoperability)
Health care focuses on clinical care for sick individuals and emphasizes individual responsibility for health. There is little integration with specialty or primary care, limited focus on prevention and no larger interest in community health.

  • Scenario 4: Effective sickness systems

(narrow definition of health | higher interoperability)
Health care focuses on individualized care. A one-stop shop for all health care needs, this approach emphasizes clinical care solutions and individual responsibility to improve health outcomes but does not address community-level health disparities and inequities.

“We began this process with a question: What progress has California made to ensure that all people have reasonably equal access to covered services, and how can the state ensure health equity in the future?” Ponce said. "No single policy will improve health for all; rather it is a broad collection of influences that will ultimately determine outcomes.”

Ponce will share details and discuss potential developments from the report in a panel discussion on Monday, April 25.

The research on health and wellness is part of the broader California 100 initiative, developed at the University of California and Stanford University, which seeks long-term innovative and equitable strategies for the state in a number of areas, from health and education to transportation, immigration and the economy. The initiative awarded grants to 18 centers and institutes in California to examine future scenarios that have the potential to shape the state over the next century. The first California 100 reports were released March 29, and remaining reports will be released over the coming months.

“After months of diligent research by our partners across the state, we are excited to share their findings with the public to kickstart a conversation about the policy options we can take to create an inclusive, equitable and sustainable California,” said Dr. Karthick Ramakrishnan, executive director of California 100. “Our research partners engaged a diverse group of stakeholders in their work, and it will take all of them and all of us to take this work and make it actionable today — to influence tomorrow.”

The California 100 research will later be tested through deliberative polling exercises and engagement sessions directly with Californians in the summer of 2022 and into 2023 to inform a vision and policy strategy for the state’s future.

by Venetia Lai


The UCLA Fielding School of Public Health, founded in 1961, is dedicated to enhancing the public's health by conducting innovative research, training future leaders and health professionals from diverse backgrounds, translating research into policy and practice, and serving our local communities and the communities of the nation and the world. The school has 761 students from 26 nations engaged in carrying out the vision of building healthy futures in greater Los Angeles, California, the nation and the world.

Faculty Referenced by this Article

Dr. Ninez Ponce
Ninez Ponce
Health Policy and Management
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David Hayes-Bautista
Health Policy and Management
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Dr. William McCarthy
William J. McCarthy
Health Policy and Management
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Warren Scott Comulada
Warren Scott Comulada
Health Policy and Management
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Dr. Joann Elmore
Joann G. Elmore
Health Policy and Management
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Alan Tomines
Health Policy and Management
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Barbara Berman
Health Policy and Management
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Robert Brook
Health Policy and Management
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Dr. Anthony Schiff
Anthony Hunter Schiff
Health Policy and Management
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Michael Ong
Michael Ong
Health Policy and Management
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Dr. Alice Kuo
Alice Kuo
Health Policy and Management
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Dr. Kenneth Wells
Kenneth Wells
Health Policy and Management
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Sangeeta Ahluwalia
Sangeeta Ahluwalia
Health Policy and Management
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Dr. Jonathan Fielding
Jonathan Fielding
Health Policy and Management
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Pamela Davidson
Health Policy and Management
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Ron Andersen

Dr. Ron Andersen is the Wasserman Professor Emeritus in the UCLA Departments of Health Policy and Management.

Health Policy and Management
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Nadereh Pourat
Nadereh Pourat
Health Policy and Management
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James Macinko
James Macinko

Professor of Community Health Sciences & Health Policy and Management, and Associate Dean for Research

Community Health Sciences Health Policy and Management
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Dr. Jennifer Wortham
Jennifer Wortham
Health Policy and Management
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Jean Balgrosky
Health Policy and Management
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Moira Inkelas
Moira Inkelas
Health Policy and Management
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Dr. Lillian Gelberg
Lillian Gelberg
Health Policy and Management
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Dr. Frederick Zimmerman
Frederick Zimmerman
Health Policy and Management
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Paul Chung
Paul Chung
Health Policy and Management
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Thomas Priselac
Health Policy and Management
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Jody Heymann
Jody Heymann
Epidemiology Health Policy and Management
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Brennan Spiegel
Health Policy and Management
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Dr. Xi Zhu
Xi Zhu
Health Policy and Management
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Burt Cowgill
Burt Cowgill
Health Policy and Management
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Dr. Aria Fallah
Aria Fallah
Health Policy and Management
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Dr. Arturo Vargas Bustamante
Arturo Vargas Bustamante
Health Policy and Management
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Gerald Kominski
Gerald Kominski
Health Policy and Management
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Robert Kaplan
Robert Kaplan
Health Policy and Management
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Jeanne Miranda
Jeanne Miranda
Health Policy and Management
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Rosenstock
Linda Rosenstock
Environmental Health Sciences Health Policy and Management
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Leah Vriesman
Leah Vriesman
Health Policy and Management
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Arlene Fink
Health Policy and Management
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Dr. Yvonne Flores
Yvonne Flores
Health Policy and Management
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Neal Halfon
Health Policy and Management
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Steven Teutsch
Health Policy and Management
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Roshan Bastani Headshot
Roshan Bastani
Health Policy and Management
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Dr. Samuel Sessions
Samuel Sessions
Health Policy and Management
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Aronberg, Sandra
Sandra Aronberg
Health Policy and Management
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Ron D. Hays
Ron D. Hays

@UCLA since 1997

Health Policy and Management
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Avram Kaplan
Avram Kaplan
Health Policy and Management
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Corrina Moucheraud
Corrina Moucheraud
Health Policy and Management
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Dr. Thomas Rice
Thomas Rice
Health Policy and Management
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Emmeline Chuang
Health Policy and Management
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Olivia Jung
Olivia Jung
Health Policy and Management
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Ty Robbins
Health Policy and Management
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Dr. Stephanie Taylor
Stephanie L. Taylor

Nationally recognized health services researcher and sociomedical scientist with 25+ years' experience in effectiveness and implementation research.

Health Policy and Management
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Laura Erskine
Laura Erskine
Health Policy and Management
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Jack Needleman
Jack Needleman
Health Policy and Management
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Susan Ettner
Health Policy and Management
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Thomas D. Gordon
Health Policy and Management
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Dr. Paul Fu, Jr.
Paul Fu, Jr.
Health Policy and Management
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Michelle Keller
Michelle S. Keller

Dr. Michelle S. Keller is a health services researcher whose research focuses on the use and prescribing of high-risk medications.

Health Policy and Management
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Galper, Michael
Michael Galper
Health Policy and Management
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Julie A. Elginer

EMPH Academic Program Director with expertise in healthcare marketing, finance, and reproductive health policy, teaching in the EMPH, MPH, MHA program

Health Policy and Management
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Mangione, C
Carol Mangione
Health Policy and Management
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Vickie Mays
Vickie Mays
Health Policy and Management
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Lori Pelliccioni
Health Policy and Management
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Dr. Kristen Choi
Kristen Choi
Health Policy and Management
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Dr. Dylan Roby
Dylan Roby
Health Policy and Management
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Dr. Daniel Eisenberg
Daniel Eisenberg
Health Policy and Management
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Freund, Deborah
Deborah Anne Freund
Health Policy and Management
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Dr. Risha Gidwani
Risha Gidwani
Health Policy and Management
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Diana Hilberman
Diana Hilberman
Health Policy and Management
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Mark Litwin
Health Policy and Management
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Yusuke Tsugawa
Yusuke Tsugawa
Health Policy and Management
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Patricia Ganz
Patricia Ganz
Health Policy and Management
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Annette Maxwell
Health Policy and Management
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Dr. Elizabeth (Becky) Yano
Elizabeth (Becky) Yano
Health Policy and Management
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Dr. Beth Glenn
Beth Glenn
Health Policy and Management
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Comanor, Bill
William Comanor
Health Policy and Management
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Dr. Felicia Hodge
Felicia Hodge
Health Policy and Management
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Jose J. Escarce
Health Policy and Management
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Kadiyala, Srikanth
Srikanth Kadiyala
Health Policy and Management
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Dr. Naomi Zewde
Naomi Zewde
Health Policy and Management
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Emily Abel
Emily Abel
Health Policy and Management
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Clifford Ko
Clifford Ko
Health Policy and Management
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Dr. John Lu
Z. John Lu
Health Policy and Management
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Isomi Miake-Lye
Isomi Miake-Lye
Health Policy and Management
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