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      Chapter Seven Health & Education 88 Healthcare: Quality & Outcomes 90 Good health depends greatly on access to and quality of healthcare, on health behaviors, socioeconomic conditions, and physical environment, which vary widely across California and create persistent disparities between places and racial/ethnic groups. Healthcare: Cost & Access 92 Healthcare costs have been rising rapidly, burdening families, employers, and governments. Yet California ranks towards the bottom in per capita health spending, as well as in state Medicaid support, employer-based coverage, and percentage of uninsured. Pre-K Education 94 Despite its leadership in introducing a variety of early childhood education and support programs, California provides preschool access to only half of its three and four year olds, and quality access to even fewer. K–12 Education 96 California’s once-heralded K–12 public education system today ranks near the bottom in student achievement, graduation rates, student–teacher ratio, and per-pupil funding. Greatly increased investment and commitment are needed to put public schooling back on a sound footing. Higher Education 98 California’s public universities, vital engines of economic and civic life, are in danger of failing to provide affordable access to quality higher education. Can California rediscover its former commitment to public higher education? Chapter Eight Inequality & Social Divides 100 Income, Wealth, & Poverty 102 Income and wealth inequality have grown significantly in the last 30 years, fueled by stagnant wages, rising assets values and corporate pay, as well as federal tax relief for the rich. Poverty is rampant in California despite its wealth and prosperity. Hunger & Homelessness 104 Millions of Californians go hungry every day and tens of thousands are homeless. This is one of the worst records in the nation. Government food assistance programs that help mitigate hunger need to be strengthened. Homeless people have little institutional support and often face hostility. Race & Ethnicity 106 California enjoys a rich mix of people of different races and national origins, just one of four states where minorities are the majority. Yet the participation of people of color in politics and business is much less than that of Whites, and almost all suffer disproportionately from low incomes, poor health, and less education. Gender & Sexual Orientation 108 California’s record of gender equity is good in education, moderate in wages and political representation, and poor in business. The state has been a pioneer in the struggle for gay rights, but has suffered setbacks on the question of equal rights to marriage. Youth & Old Age 110 California’s young and old suffer disproportionately from deprivation, and many are ineligible for government benefits because of inadequate measures of cost of living and need. Chapter Nine Challenges Ahead: A Glimpse into the Future 112 California’s glory resides in its prosperity but, in the face of multiple challenges, it needs to forge a new identity. Chapter Ten Data Challenges 116 Data must be selected and interpreted with caution because of the challenges presented by inconsistency, omissions, imperfections, and underlying assumptions. Definition of Key Terms 118 Sources 120 Index 129

      

      

      

      

      

      

      

      

      California is just a sliver of the globe, a slice off the west coast of North America, one state among many United States; but it is more, much more. California is a world apart, a region unto itself, a state within a state, a place with its own character. New York, Washington DC, and Texas all feel very far away in outlook and obsessions. If, as a famous coffee company’s slogan has it, “geography is a flavor”, then California is one of the most distinctive and full-bodied. To draw up an atlas of California requires considerable imagination. It is a hard state to get one’s head—and compass—around. This is about more

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