Healthcare Access

Prior to the emergence of COVID-19 and the destruction it has visited on communities of color, immigrants, and others, Los Angeles County faced a long-standing set of structural disadvantages in access to quality, affordable healthcare. Those disadvantages resulted in worse outcomes, poorer care, fewer doctors per population, and a set of communities sufficiently under-cared for, and manifesting considerable nonCOVID-19 morbidities. The impact of the pandemic would inevitably be catastrophic and far worse for these communities than in others. The low income and working class communities of Los Angeles were, and are, disadvantaged by a series of structural disadvantages in the healthcare system which limit their access to care, its quality, and its effectiveness.

Higher infection rates are yielding higher death rates. Moreover, residents of color are experiencing higher mortality among the infected—that is, conditioned on viral exposure, residents of color in Los Angeles are more likely to succumb to the disease than white residents exposed to COVID-19.

Report Authors

Impacts of COVID-19 on Healthcare Access in Los Angeles County

Under-resourced populations in Los Angeles County, even prior to the current crisis, have faced persistent and on-going denial of care. Beyond the shortage of co-ethnic providers, the structural disadvantage in funding criteria, and the challenge of uninsured residents, the health care infrastructure in Los Angeles has not been up to the task of providing the necessary services. The shortage of physicians directly affects Los Angeles — to have the necessary medical work force, Los Angeles needs 500 additional primary care physicians and 700 specialists in a variety of areas. The existing roster of primary care physicians, allied health professionals, and Federally Qualified Health Clinics simply cannot meet the needs of a large, diverse, and underinsured population.

The result is the utter absence of preventative care and wellness support and the inevitable reliance on the emergency room as the site of overdue primary care. 82 COVID-19 and the Health Effects in Los Angeles County In the earliest stages of the epidemic in the United States, African American infection and mortality rates were shocking and the focus of considerable attention. By June 2020, it was clear deaths among African Americans were substantially and disproportionately higher (Ford, Reber, and Reeves 2020). More recently, data from the Centers for Disease Control and Prevention reported rates of infection among Latinos above 30 percent of all cases in the United States, while representing 18 percent of the national population. The Centers for Disease Control and Prevention also stated that African Americans, comprised just under 20 percent of infections while only making up 13 percent of the national population (Centers for Disease Control and Prevention 2020).

While we have largely been spared a crushing wave of pandemic-related evictions so far, its specter looms on the horizon. Though there is still time to increase tenant protections, landlords have already begun to file UD complaints for non-payment of rent. In the vast majority of cases, for every tenant who reaches out for assistance, there are many more who opt not to contest the UD complaint to avoid navigating a complex, costly process. Further, the lack of clarity as to what, exactly, relief entails muddies the water for tenants. For example, in the current framework, a Los Angeles County resident could legally have until fall of 2021 to pay back any missed rent, but could be legally evicted starting in September of 2020 for failing to pay at least 25 percent of their current rent. As already dire economic situations worsen across the region and prospects for our local, regional, and national economic recovery remain unclear, we stand poised to face an unprecedented eviction crisis with significant human cost.

Our goal is that all residents of California, regardless of citizenship or immigration status, must enjoy health care access at a rate they can afford from gestational periods to end of life care.

7.1 percent of enrollments in medical school last year were African American and only 6.2 percent were Latino (Association of American Medical Colleges 2019).

7.1% 7.1%

7 percent of African Americans, 8 percent of Asian Americans, 11 percent of Native Americans, and 16 percent of Latinos lack health insurance coverage.

7% 7%

More recently, data from the Centers for Disease Control and Prevention reported rates of infection among Latinos above 30 percent of all cases in the United States, while representing 18 percent of the national population. The Centers for Disease Control and Prevention also stated that African Americans, comprised just under 20 percent of infections while only making up 13 percent of the national population (Centers for Disease Control and Prevention 2020).

30% 30%

8 Healthcare Access Policy Recommendations

The report puts forward 8 recommendations for policy and practical action.

Increase Medi-Cal payments to the same level as Medicare

Pay more for outpatient care, disease management, and population health (and not just to Federally Qualified Health Centers)

Integrate funding and delivery of medical and behavioral health care

Reduce barriers and increase payments for telehealth services.

Provide more equitable funding for medical training

Covered California Expansion to include undocumented adults

Creating Universal healthcare access: Statewide Single Payer

Creating Universal healthcare access: Medi-Cal Expansion

Our Streets Our Stories

I’d like to see more measures taken by local government to support the health of the population and repercussions for those not following rules because I’d like to get back to work.

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To learn more download the full No Going Back LA report (PDF)

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