COVID-19 and California’s Commitment to Health Equity

California continues its focus on health equity and strives to provide the highest possible standard of health for all Californians. The California Department of Public Health (CDPH) uses health equity data to improve the state’s response and to track trends over time. Collecting and reporting health equity data helps to identify those at greatest risk and to provide special attention to those communities least served by our public health and healthcare systems. 

Health equity is a priority for advancing public health in California and is elevated as a focus in the 2024 State of Public Health Report (PDF). The report finds that there have been major improvements in health and well-being over the past 20 years; however, there are significant opportunities to reduce health inequities and address emerging public health concerns. The importance of addressing equity has been further elevated in the wake of the COVID-19 pandemic. 

California put health equity at the center of its COVID-19 response and recovery efforts. CDPH developed and incorporated a health equity metric to improve overall vaccination rates and address differences in outcomes across communities and populations. California’s COVID-19 response worked to mitigate the impacts of the pandemic and continues to prioritize equity and community partnership. 

The pandemic exposed harsh racial, ethnic, and socio-geographic disparities driven by inequities in factors associated with the risk of COVID-19 infection and severe illness, including income, access to health insurance, occupation, and housing security. The Demographic Report on Health and Mental Health Equity (PDF) discusses some of the destructive health equity fault lines of the pandemic and aims to help mobilize the understanding of and sustain the commitment to improvements in health equity in California. 

COV​​ID-19 Health Equity Data  

CDPH has tracked the following COVID-19 outcomes to inform health equity: hospital admission rates, case data, and death data by race and ethnicity. Comparisons of health equity data from 2023 and health equity data from the entire COVID-19 response helps with understanding trends over time. Data available to monitor COVID-19 has changed over the course of the COVID-19 response.

Data trends reflect a shift in impact of COVID-19 from widespread cases, hospitalizations, and the leading cause of death, to a less severe endemic status due to public health interventions for prevention, testing, and treatment. Throughout the pandemic, COVID-19 disproportionately impacted Native Hawaiian/Pacific Islander, African American, American Indian/Alaska Native, and Latino populations. Severe COVID-19 also disproportionately affected communities with higher rates of chronic illness and those with less access to health information and high quality, culturally humble health care. Additionally, since the rollout of the COVID-19 vaccines it has been a challenge to achieve vaccine equity in these traditionally underserved communities. ​

In 2023, COVID-19 death rates declined for all populations compared to previous years. However, hospitalizations and/or deaths were still higher among Native Hawaiian/Pacific Islander, Latino, African American, and American Indian/Alaska Native populations compared to all Californians. 

COVID-19 Hospitalization Data  

• During the first year of the pandemic, COVID-19 hospitalization rates were disproportionately higher for Native Hawaiian/Pacific Islanders, Latinos, and African Americans. 

• Throughout the pandemic, hospitalizations remained higher among Native Hawaiian/Pacific Islanders and African American populations. By 2023, COVID-19 hospitalization rates declined for all populations compared to previous years. ​​

COVID-19 Hospitalization Rate, b​y Race, California (2020–2023)

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​COVID-19 Hospitalization Rate, by Race, California (2023)

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*This rate of hospitalization is higher than the average in California.

Data notes: COVID-19 Hospitalizations 

• Hospitalization data is sourced via All Facilities Letter 21-25 which mandates the reporting of line-level hospital discharge data for all persons hospitalized who tested positive for COVID-19. This mandate began July 2021; therefore, hospitalization data is incomplete for 2020 and part of 2021. (Some hospitals opted to provide historical data prior to July 2021).
• Hospitalization counts include all patients with laboratory-confirmed COVID-19 during their hospital stay. This does not necessarily mean patients were hospitalized because of COVID-19 symptoms or complications. 
• Reporting of race and ethnicity is incomplete and missing for 34% of hospitalizations. 
  

COVID-19 Death Data  

• ​​Throughout the pandemic, COVID-19 deaths disproportionately impacted Native Hawaiian/Pacific Islanders, Africa​n American, American Indian/Alaska Native, and Latino populations. ​
  

• ​In 2023, COVID-19 death rates declined for all populations compared to previous years. However, deaths remained highest among Native Hawaiian/Pacific Islanders, and American Indian/Alaska Native populations. ​
  

​​COVID-19 Death Rate (2020-2023) ​​

COVID-19 Death​ Rate (2023)

COVID-19 Death Rate, by Race, California

*This death rate is higher than the average in California.

Data notes: COVID-19 Death Data 

• As of January 1, 2023, data was sourced from the California Department of Public Health, California Comprehensive Death File (Dynamic), 2023–Present. Prior to January 1, 2023, death data was sourced from the COVID-19 case registry. The change in data source occurred in July 2023 and was applied retroactively to all 2023 data to provide a consistent source of death data for the year of 2023. 
• Beginning in 2023, laboratory confirmation was not required for COVID-19 deaths. Deaths due to COVID-19 represent deaths occurring in California among residents who had COVID-19 noted anywhere on the death certificate. 
• The population denominators in these tables come from the California Department of Finance’s population projections for 2020. 
  
  

COVID-19 Vaccine Equity

Throughout the pandemic, COVID-19 disproportionately impacted Native Hawaiian/Pacific Islander, African American, American Indian/Alaska Native, and Latino populations. CDPH tracks California’s progress in vaccinating groups and communities with the most urgent need. Data shows that COVID-19 vaccine coverage was lowest among Latino, African American, and American Indian and Alaska Native communities. CDPH continues to work to increase access and resources in order to promote vaccine equity in historically underserved communities. 

California put health equity at the center of its COVID-19 vaccination allocation and distribution efforts. CDPH incorporated the Healthy Places Index into a vaccine equity metric to improve overall vaccination rates and address disparities in outcomes across communities and populations. California’s commitment to equitable vaccine administration meant that additional vaccines and resources were provided to the hardest hit communities and technical support was offered to safety net providers throughout the state. 

The Healthy Places Index (HPI 3.0) was developed by the Public Health Alliance of Southern California and uses a range of data sources and indicators to calculate a measure of community conditions ranging from the most to the least healthy based on economic, housing, and environmental measures.

Find current vaccine​ data:  

• Sign up to get a COVID-19 vaccine: My Turn  ​
• COVID-19 Vaccine Health Equity Data: COVID Health Equity Vaccine Data
• CDPH COVID-19 vaccine data: COVID Vaccine Data
• CDC Vaccine information​
• CA Open Data
  
• Healthy Places Index