Date of Conferral

11-7-2024

Degree

Ph.D.

School

Public Policy and Administration

Advisor

Anne Hacker

Abstract

Despite advancements in integrated care, persistent health care disparities and systemic barriers continue to contribute to poor health outcomes among African Americans. The purpose of this qualitative study was to explore the implementation of culturally integrated behavioral health care within the context of African American experiences, focusing on health care access and quality through a public policy lens. The study was informed by Ostrom's institutional analysis and development framework, health equity framework developed by the nonprofit organization Education Training & Research, and Hankivisky's intersectionality-based policy analysis. To gather data, semistructured interviews were conducted with 20 African American adults who receive primary care at a federally qualified health center for co-occuring disorders, to assess their perspectives on culturally integrated care. Data was analyzed using thematic coding and interpretative phenomenological analysis, which allowed for the identification of key themes related to systemic biases, cultural insensitivity, and inequities in health care delivery. Findings reveal that these factors such as systemic biases, cultural insensitivity, and inequities, significantly affect patient outcomes. The study highlights the urgent need for targeted interventions, including policy reforms and enhanced cultural competence, to address these disparities and promote equitable health care. Implications for positive social change include the potential for policy makers to provide enhancements that could improved health equity and more effective health care delivery systems that address the unique needs of marginalized communities.

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