NORC at the University of Chicago conducted the Listening to Californians with Low Incomes project for the California Health Care Foundation. This mixed-methods project measured low-income Californians’ health care wants, needs, and values through a series of community-based focus groups. Subsequently, NORC conducted a survey to learn about Californians’ health care, mental health, access to care and experiences with care before and during the COVID-19 pandemic, experiences with racial discrimination, and the impact of the pandemic on employment. 

Analysis of survey results focused on identifying significant differences between Californians with lower and higher incomes and between racial and ethnic subgroups. The project’s final phase consisted of qualitative in-depth interviews with survey respondents with low incomes and health care experts.  

The survey of 2,249 adults, ages 18 to 64, found that the COVID-19 pandemic both exposed and exacerbated inequities in health, mental health, and health care access for Californians with low incomes—particularly Californians of color. In addition, the pandemic heightened and increased economic and employment inequalities, placing additional stress on people most likely to experience inequities. 

The project defined low-income individuals as those living at less than double the federal poverty line. All study activities were conducted in English, Mandarin, Spanish, and Vietnamese.