UCLA CHPR Explores Future of Health and Wellness in California

The University of California, Los Angeles (UCLA) Center for Health Policy Research (CHPR) recently issued a research report examining the state of modern health and health care in California, the historical policy decisions and societal shifts that created the current situation, and trends influencing change in the existing health care environment. The CHPR report examines seven topic areas, including: 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.

The UCLA research team assessed actions by California to ensure that all people have reasonably equal access to covered services and to ensure population health equity into the future. Researchers studied potential future scenarios and how each may be impacted by the resilience of the population, technological advancements, civic response to proposed and real changes, sustainability of changes in the long-term, and considerations of equity.

Researchers found that two factors that affect future health is whether state leaders will define “health” in broad or narrow terms and whether health care delivery systems are interoperable. Depending on those definitions and which systems will operate well together, California has four possible health system scenarios in the future:

• Scenario 1: Patchwork of well-being – 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 – 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 or education, and there is little regional variation in health and social services systems.
• Scenario 3: Sickness systems – Health care focuses on clinical care for sick individuals and emphasizes individual responsibility for health. There is little integration of specialty or primary care, limited focus on prevention, and no larger interest in community health.
• Scenario 4: Effective sickness system – 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 rather than addressing community-level health disparities and inequities.

The research was conducted as part of the California 100 Initiative which seeks to move California toward an aspirational vision by changing policies, practices, attitudes, and mindsets to inspire a more vibrant future.

Additional information is available here.