West LA Times

Adults in California who require long-term services and supports (LTSS) are significantly more likely to report their health as "fair" or "poor" and experience serious psychological distress compared to the general adult population, according to a study by the UCLA Center for Health Policy Research.

The study reveals that 46% of adults needing LTSS rate their health poorly, compared with 15% of the overall adult population. Unmet LTSS needs contribute to a higher incidence of psychological distress, affecting 27% of those with unmet needs versus 18% without such needs. These unmet needs include lack of access to necessary services or insufficient provided services.

Kathryn Kietzman, director of the Health Equity Program at UCLA CHPR and lead author of the study, stated: “What we learned demonstrates that California must improve how it provides resources for adults who need these types of assistance to live independent and healthy lives.”

The report is based on data from the 2019–2020 California Long-Term Services and Supports study, linked with the California Health Interview Survey. It highlights that approximately 4.1 million adults in California have LTSS needs due to disabilities or chronic conditions like arthritis, heart disease, diabetes, depression, or anxiety.

Key findings indicate racial disparities in psychological distress among adults needing LTSS. Asians (37%) and individuals identifying as “other” races (30%) reported higher rates of serious psychological distress compared to Latinx (22%), white (17%), and Black or African American (16%) populations.

Lei Chen, co-author and postdoctoral scholar at UC San Francisco Philip R. Lee Institute for Health Policy Studies, commented: “The differences among races and ethnicities may reflect gaps in the availability of services and programs that are culturally sensitive and available in different languages.”

Insurance status also plays a role; 38% without insurance experienced serious psychological distress versus lower percentages among those insured by Medi-Cal (30%), private insurance (23%), or Medicare-related public insurance (9%).

Kietzman emphasized the importance of understanding diverse needs within this population: “Understanding and responding to the myriad needs of a diverse population... requires careful attention to data.”

The report recommends enhancing access through public education on existing programs, improved care coordination, and better connections between LTSS recipients and behavioral health care providers. Initiatives like ARDC’s "No Wrong Door System" aim to streamline service access while CalAIM seeks to integrate various service providers more efficiently.

“As a matter of equity,” Kietzman concluded, “we should never accept disparities as the norm.”