Date of Conferral





Public Policy and Administration


Anne Fetter


African American women (AAW) suffer from disproportionately high death rates due to coronary heart disease (CHD) compared to Caucasian women. Although there have been a number of studies targeting African American adults with CHD in clinical interventions, very few studies have addressed the social determinants of health and the influence of AAW's perceptions of health factors on health outcomes. The purpose of this phenomenological study was to fill the gap in the existing knowledge base by examining the lived experiences of 10 AAW diagnosed with CHD with a focus on the perceptions of environmental, socioeconomic, and cultural factors related to their disease. The framework for this study was Stokol's socioecological theory. Data were collected through individual semi structured interviews that were audio recorded, transcribed, inductively coded, and organized into themes. Results confirmed an expected connection between CHD and key external factors such as smoking, poor nutrition, and low exercise. The findings also indicated that financial considerations were a factor, including the affordability of healthy foods, although the historical cultural connections to cooking and eating were a greater impediment. The financial burden of medical treatment was less troublesome for the participants of this study, as all had access to private or public insurance plans. Other significant barriers included the inability to schedule appointments with physicians due to work and home commitments. The findings from this study contribute to social change by providing insight into the need for public policy that encourages a more culturally-competent health care system to better educate people about CHD, amend AAW's perceptions on CHD, and aid in the possible reduction of CHD.