Millions of Californians struggle with costs of housing, health care, latest California Health Interview Survey shows

Increasing numbers of Californians worry about paying their housing costs and consequently have run up credit card debt, taken on additional work to make ends meet and stopped saving for retirement, according to 2024 data released today by UCLA's California Health Interview Survey , or CHIS.

In 2024, 19.9% of adults in the state - approximately 5.9 million people - said they worried very often or somewhat often about struggling to pay their mortgage or rent. In 2021, that percentage was 15.1%, in 2022 it was 18.2% and in 2023 it was 18.8%.

To be able to pay their housing costs during the past three years, 15.6% of adults took on an additional job or more work at their current job, 14.2% stopped saving for retirement, 15.9% accumulated credit card debt, 12.2% cut back on healthy foods, and 5.8% cut back on health care, the CHIS data show.

Among single parents with children, 36.2% said they worried very often or somewhat often about paying their mortgage or rent in 2024 - nearly triple the 12.8% among married parents with children.

These data on housing security represent one of hundreds of topics available in the latest edition of the annual survey produced by the UCLA Center for Health Policy Research . For 24 years, CHIS has collected data and revealed patterns and trends about Californians' health, access to health care, the social drivers of health and health needs, among hundreds of other topics, that have informed legislation, policy, resource distribution, advocacy and research.

"The California Health Interview Survey provides clear, quantifiable data showing that millions of Californians have been struggling to get by," said Ninez Ponce, principal investigator of CHIS and the center's director. "This continues our history of CHIS providing freely accessible data about the vast, interconnected array of factors and conditions affecting the health of California's large and diverse population."

Administered since 2001, the California Health Interview Survey is the largest population-representative state health survey in the United States. To provide a more precise picture of how different population groups are faring in terms of their overall health and well-being, the survey's data is disaggregated by a wide range of demographic characteristics. The 2024 CHIS data includes responses from 24,810 adults, 1,021 adolescents and 3,733 children.

CHIS provides insights into the effects of wildfires

Nearly 3 million California adults, 10%, said they or a household member personally experienced a wildfire in the past two years, and 10.9 million, 37%, said they or a household member experienced smoke from wildfires during that time.

While the data about wildfires and smoke do not include the experiences of Los Angeles County residents affected by the January 2025 fires in Altadena and Pacific Palisades, the findings are still crucially important for protecting people's health, said Todd Hughes, director of the survey.

"The CHIS findings can help policymakers, clinicians, researchers and advocates form a clearer understanding of how wildfires and wildfire smoke affect the physical and mental health of people in California," he said.

Among adults who experienced wildfires in the past two years, 9.7% said their physical health was harmed as a result, as did 25.5% of those who experienced wildfire smoke.

Adults with asthma who had experienced wildfire smoke in the past two years were more likely to have had an asthma episode or attack over the past 12 months - 31.2%, compared with 26.1% of those with asthma who had not experienced smoke.

Survey respondents were also asked how wildfires affected their mental health. Among adults, 17.2% who experienced wildfires in the past two years and 14.7% of those who experienced wildfire smoke during that period said their mental health was harmed.

Exposure to wildfires and wildfire smoke in the past two years was also associated with higher rates of visiting a professional for mental health and drug- and alcohol-related issues in the past year: 21.7% of those exposed to fires and 35.4% of those experiencing smoke did so, versus 17.1% of California adults overall.

Other findings of note:

• Hate acts in California
  In partnership with the California Civil Rights Department, CHIS measured Californians' experiences with hate. In 2024, 3.1 million Californians who were 12 years old or older directly experienced a hate act, an increase of approximately half a million people over 2023. A fact sheet released today provides more detailed data, including the most common types of hate acts, where they happened and reasons why victims believed they were targeted, as well as differences in experiences between adults and adolescents, and people's experiences witnessing hate acts.
• Telehealth
  The percentage of adults using telehealth services (video or telephone conversations) decreased slightly, from 40.4% in 2023 to 37.9% in 2024. But among Californians using telehealth, there was an increase in preference for it, from 57.9% in 2023 to 61.2% in 2024.
• Food security
  Data about food security show that many Californias are struggling to afford the basics. Among adults earning less than 200% of the federal poverty level ($62,400 for a family of four or $30,120 for a single adult in 2024), 47.2% said in 2024 they could not afford enough food in the past 12 months, up from 35.8% in 2020. For single-parent households with children that earned less than 200% of the FPL, 61.3% could not afford enough food.
• Medical debt
  10.5% of adults had problems paying for their own or a household member's medical bills in the past 12 months, and 38.4% of those with medical debt said that they were unable to pay for basic necessities as a result.
• Delaying medical care
  15.4% of Californians had to delay or forgo needed medical care in 2024, and half of them never got the care they needed. Of those who chose to delay or forgo medical care, the main reason cited by 24.8% of them was cost, a lack of insurance or other insurance-related issues. For adults with disabilities, the survey revealed a stark disparity: 30.7% of disabled adults delayed or did not receive care in the past 12 months, compared with 15.5% of those who were not disabled.

"To make California a place where everyone receives a fair opportunity to prosper, we must have data," said Ponce, who holds the Fred W. and Pamela K. Wasserman Chair in Health Policy and Management at the UCLA Fielding School of Public Health.

"Every year, CHIS works for the benefit of 40 million Californians and serves as a national model for how data can help tell the story of a population's health," Hughes said.