This policy brief profiles California's informal caregivers—adults who provide care to a family member or friend coping with an illness or disability. Although caregivers appear to be as healthy as noncaregivers of the same age, they report higher levels of psychological distress and engagement in poor health-related behaviors, such as smoking. Middle-aged caregivers may be at greatest risk for poor health outcomes such as high blood pressure, diabetes and heart disease. Few caregivers are paid for their work or use state services that might help alleviate both financial and psychological burdens. Caregivers should foresee difficult times ahead, given recent state budget cuts to programs that support caregivers, and older and disabled adults.

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This new policy brief from the UCLA Center for Health Policy Research presents diabetes prevalence rates among adults by California Assembly and Senate districts. These data are relevant to policymakers and advocates concerned with the impact of chronic conditions on the health of Californians. Estimating the prevalence of diabetes at the local level is increasingly important as rates continue to climb and the state's population continues to age and become more ethnically diverse. Diabetes prevalence rates were estimated using a small-area methodology with data from the 2001 California Health Interview Survey (CHIS 2001), 2000-2002 Current Population Surveys (CPS) and 2000 Census.

This policy brief highlights the geographic variations in hypertension rates among California adults for counties, county-groups, Los Angeles Service Planning Areas, as well as for state legislative and Congressional districts. The first-of-its-kind sub-county data in this publication are useful for policy makers, advocates and medical providers in understanding the burden of the condition in local communities across California. Hypertension rates were estimated by applying a small-area methodology to multiple data sources, including the 2001 California Health Interview Survey (CHIS 2001), 2000-2002 Current Population Surveys, and the 2000 Census.

This policy brief highlights the geographic variations in uninsured children's Medi-Cal/Healthy Family eligibility rates by state Assembly, Senate and Congressional districts, as well as by counties and the Los Angeles Service Planning Areas (SPAs). Funded by The California Endowment, the brief is particularly relevant at this time when the lack of health insurance among children is becoming a focus of state and national policymakers as well as advocacy groups, including the recently approved expansion of the Healthy Families program by the Department of Health and Human Services. Uninsured-eligibility rates were estimated by applying a small-area methodology to multiple data sources, including the 2001 California Health Interview Survey (CHIS 2001), 2000-2002 Current Population Surveys, and the 2000 Census. Among the key findings are: The areas in the state that had notably high numbers of uninsured-and-eligible children were located primarily in the greater Southern California and Central Valley regions of the state. Almost one out of every three California child who was uninsured-and-eligible for Medi-Cal or Healthy Families in 2002 lived in a geographic area with uninsured-eligibility rates at or below the statewide average. Key Policy Recommendation Public and private efforts currently underway to improve the outreach and enrollment of eligible children can be complemented by statewide initiatives such as fully implementing "express lane eligibility" that automatically enrolls children who qualify for free and subsidized school lunches.

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This policy brief highlights regional variations of rates among California children ages 0-5 and ages 6-17 from limited income families (below 300% FPL) who were uninsured and not eligible for Medi-Cal or Healthy families in 2001. This Web-only publication is relevant to policy makers and children health advocates who work on health access and children’s issues at the local level. These data are particularly pertinent as public-private partnerships have emerged across California to provide health care coverage for this vulnerable population. Rates of uninsured-and-not eligible children were estimated using the 2001 California Health Interview Survey (CHIS 2001).

This policy brief highlights the geographic variations in obesity and overweight rates among California adults for counties, county-groups, Los Angeles Service Planning Areas, as well as for state legislative and Congressional districts. The first of-its-kind sub-county data are useful for policy makers, advocates, and health professionals in understanding the severity of unhealthy weight among adults throughout California and within local communities. Obesity rates were estimated by applying a small-area methodology to multiple data sources, including the 2003 California Health Interview Survey (CHIS 2003), 2000-2002 Current Population Surveys, and the 2000 Census.

This policy brief highlights the differences in uninurance rates among the new California Assembly and Senate districts resulting from redistricting based on the 2000 Census. Funded by The California Endowment, this report is particularly relevant at this time when the lack of health insurance has moved higher on political agendas at the state and national levels. Uninsured rates at the district levels are estimates created by a small-area-methodology with data from 2001 California Health Interview Survey (CHIS 2001), the March 2000-2002 Current Population Surveys, and the 2000 Census. This first-of-its-kind information contributes valuable and timely data needed by California’s community and health advocacy groups as well as legislators to support their respective policy development roles and to inform and focus their efforts on high-priority health and medical care issues, locally and statewide. In addition to the data presented in this policy brief, several supplemental California Assembly and Senate exhibits (tables and maps) are available on this Web site: maps by district of uninsured rates for children (ages 0-17) and for adults (ages 18-64); demographic tables of district population distributions by race/ethnicity and income-to-poverty ratios; and confidence intervals (or precision estimates) for the published uninsured rates. Among the key findings are: Rates of uninsurance are particularly acute in legislative districts located in the Central Valley and in Southern California. There are substantial geographic disparities in health insurance coverage for children and adults among the newly redrawn California Assembly and Senate districts. Legislative district uninsured rates range from a low of 7% for children ages 0-17 in Assembly District 15 to a high of 50% for adults ages 18-64 in Assembly District 46. Even the districts with the lowest rates of uninsurance have a considerable number of uninsured residents. For example, Assembly District 15 has 38,000 uninsured persons under age 65, and the Senate District with the lowest rate of uninsurance (SD 7) is home to 78,000 persons under age 65 who have no insurance. Key Policy Recommendation More extensive outreach efforts must be implemented to ensure that all children and adults who are eligible for public programs get enrolled into them. The findings in this brief identify the locations in the state where outreach and enrollment efforts can be most effective.

This policy brief reports basic estimates of health insurance coverage and uninsurance in 1999 and estimates of uninsured children and adults who are eligible for coverage through public programs in California. We focus especially on uninsured adults because of the current policy efforts to expand coverage for this large group.