Date of Conferral

9-25-2026

Date of Award

September 2026

Degree

Ph.D.

School

Health Sciences

Advisor

Christopher Miller

Abstract

Access to public oral healthcare in Alabama’s Black Belt Region has been a persistent systemic challenge for working poor adults ages 19–64. This population continues to face barriers to oral healthcare because of socioeconomic disparities, geographic isolation, lack of insurance, provider shortages, limited infrastructure, and the need to travel long distances for quality or specialized services. This study investigated whether public health programs have improved access to oral healthcare for working poor adults in rural communities, from the perspective of oral healthcare providers. The Social Ecological Model served as the theoretical framework. Data were collected through semi-structured interviews with 13 oral healthcare providers using one primary research question and five sub-questions and were analyzed using Braun and Clarke’s six-phase reflexive thematic analysis approach. Findings revealed three themes and eight subthemes related to barriers to access, public health program limitations, and providers’ perspectives and mitigation strategies. Findings also showed that although public health programs exist, they have not improved accessibility or availability of oral healthcare for adults. Providers reported that low reimbursement rates contribute to workforce shortages, public health programs offer limited services, and insufficient funding restricts the delivery of quality care. Recommendations include expanding Medicaid, increasing the number of federally qualified health centers in the region, integrating oral health literacy into public health departments, offering incentives to attract new graduates, and expediting Medicaid reimbursements to improve equitable access to oral health care.

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