Social Determinants of Health

Structural barriers based on race, ethnicity, income, LGBTQ status, and age among others, prevent individuals from getting the health care they need and deserve. We work toward health equity by addressing systems of oppression and barriers that lead to disparate health outcomes.

Recent Work in this Area

Health Equity Statement: Our health is affected by the conditions in which we live, learn, work and play. Known as the social determinants of health, our environments contribute to health risks and outcomes that go beyond access to high quality and affordable healthcare. Structural racism and classism, both historic and ongoing, has created the conditions for Coloradans of Color to live in the least healthy environments due to factors like persistent poverty, air pollution, lack of access to safe & affordable housing, clean water, and more. Addressing these social determinants of health is essential to creating health justice in Colorado.

Supporting a paid family and medical leave program in Colorado

We believe everyone should have access to paid family medical leave to take care of themselves or a family member—and the majority of Coloradans agree! We supported Proposition 118, a ballot measure which passed in 2020 that establishes a state run paid family and medical leave (PFML) insurance program, giving more than 2.6 million Coloradans access to up to 20 weeks of PMFL. Low income families and people of color are the least likely to have access to these benefits through their employer; and often are the most vulnerable to financial and health crises when they are forced to choose between their income or job and taking care of themselves and their families. Individuals and families with access to PFML—and progressive wage replacement to ensure they can afford time off—are better able to heal after injury and illness. This program prioritizes equity and promotes positive health outcomes for consumers.

Supporting perinatal health legislative and regulatory initiatives that advance dignity and equity for birthing persons, particularly Black and Indigenous Coloradans

The perinatal period (i.e. pregnancy and one year postpartum) is a critical juncture for the individual and population level health of our communities. Colorado, and the U.S. more broadly, is coming up unacceptably short when it comes to equitable access to care and health outcomes for birthing people of color and their children. In order to address the systemic failings driving increased mortality rates for Black and Indigenous birthing people and their infants in Colorado, we supported our members and community partners in creating the Maternal Mortality Review Commission (HB19-1122) and passing the Birth Equity Bill package (SB21-193 and SB21-194). We continue to participate in coalition work to ensure the successful implementation of these bills and advance additional community-driven solutions to improve perinatal health equity.

Advocating for fairer medical debt collection practices

  • People of Color in Colorado, especially Black, Native American, and Chicanx/Latinx Coloradans, are more likely to earn lower incomes, be impoverished, and be uninsured or underinsured. We believe that robust consumer protections are a powerful tool to help balance the scales and make health care fairer for all Coloradans, especially Coloradans of Color, who have been intentionally shut out of financial stability and equity for decades, if not centuries. 
  • CCHI has taken action to address medical debt collection practices by helping to pass HB21-1198, which requires health care facilities to screen all uninsured patients for eligibility for public health insurance programs and discounted care, prevents health care facilities from charging monthly bills that are more than 4% of a patient’s monthly household income, and requires that a medical bill be considered paid in full after 36 months of consistent payments. HB21-1198 also requires that health care facilities provide accessible information to all patients and the public about patients’ rights and how to get discounted care at their facility.
  • Recent legislation CCHI has supported to tackle debt collection practices in general includes SB20-211, which created emergency protections designed to prevent creditors from garnishing a person’s wages or seizing their property and assets during the COVID-19 disaster emergency, and also protected up to $4,000 held in any account from any seizure. These protections were extended until June 1, 2021 with SB21-002.

Supporting housing policies that secure healthy living environments and funding for legal support to Coloradans facing eviction

  • Housing Justice is Health Justice. We believe that access to safe, stable, and affordable housing is essential to a healthy life. We also know that Coloradans of Color, especially Black, Native American, and Chicanx/Latinx Coloradans, are less likely to own a home and more likely to be renters, and that Coloradans of Color are more likely to be at risk of eviction due to their rent burden and the structural, intentionally-imposed inequality that Coloradans of Color face.
  • In 2020, CCHI supported HB20-1332, which makes discrimination based on source of income an illegal housing practice. With HB20-1332, landlords are prohibited from refusing to rent or lease, refusing to provide a showing, and refusing to make an offer to rent or lease to someone on the basis of their source of income. Landlords are also prohibited from changing the terms and conditions of a rental agreement based on a person’s source of income.
  • In 2021, CCHI supported SB21-173, which creates sweeping protections for renters by capping the maximum amount for late fees at $50 or 5% of the past due rent amount, prohibiting evictions for not paying late fees, and prohibiting late fees from being charged more than once for the same missed payment, including many other protections. SB21-173 also establishes court procedures and rights that protect tenants, and help level the playing field if a landlord takes them to court.

Immigrant Rights

Healthcare is a human right. We are committed to expanding healthcare access to all Coloradans, regardless of immigration status. Recent legislation to improve healthcare accessibility included the passage of SB21-199 and SB21-018 which removed administrative barriers for undocumented Coloradans to ensure access to existing public benefits and free ID cards. Access to care was expanded through SB21-009, which established a program to provide contraceptives to undocumented folks and increases contraceptive accessibility for Medicaid beneficiaries. SB21-087 outlines long overdue agricultural worker protections by setting standards for health, safety, and collective bargaining rights. We will continue to support policies that create more robust social safety nets for all Coloradans.

Oral Health Equity

Oral health is a fundamental component of overall well-being, with increasing evidence of how oral health links to overall physical and mental health. While Colorado has seen the percentage of Coloradans with dental insurance increase, there are consistent access and affordability challenges, particularly for BIPOC communities. CCHI is working with partners at the community level to create an oral health equity policy agenda that is directly informed by the communities facing the biggest barriers. We are also working to survey Coloradans about their oral health experiences to direct this work.

Our Work

Protecting Consumers

Coloradans should not face financial hardship because they need access to health care or because they have received health care services. CCHI works to protect consumers from health care industry practices that jeopardize the health and financial security of Colorado families.

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Access & Affordability

All Coloradans should have access to the health care they need, when they need it, and be able to afford it. While the Affordable Care Act has helped many Coloradans obtain health insurance, we know there are many that still struggle to access and afford the care they need because they cannot find a doctor or because the out-of-pocket costs are too high.

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Reimagining Health Care

Structural barriers based on race, ethnicity, income, LGBTQ status, and age among others, prevent individuals from getting the health care they need and deserve. We work toward health equity by addressing systems of oppression and barriers that lead to disparate health outcomes.

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Prescription Drug Affordability

Every year health care costs continue to rise, becoming an even bigger percentage of our economy and an increasingly unsustainable portion of family budgets. We are working to control costs and hold the health care industry accountable to patients.

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At the Capitol

Every year, CCHI fights for policies and bills that improve health care for Coloradans during the legislative session and year round within Colorado’s agencies that oversee health care. CCHI ensures consumers interests are advanced and protected in private insurance, Medicaid, hospitals and physicians’ offices, and access to prescription drugs. We empower Coloradans to use their own health care experiences to make positive change.

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Colorado Consumer Health Initiative
303 E 17th Ave, Suite 400
Denver, CO 80203



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