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Public Policy and Administration


Elizabeth Hagens


Despite the passage of the Patient Protection and Affordable Care Act (PPACA) in 2010, the Centers for Disease Control and Prevention identified persistent disparities in health care resources as the primary causes of mortality among minority populations. An underexplored resource for affected African American populations is the church, which is not a recognized stakeholder in the implementation of current health care policy. The purpose of this phenomenological case study was to gather perspectives from African American parishioners who lacked sufficient health care insurance on the roles the church could play. Qualitative data management software was used to organize the data (transcripts of interviews) for coding. The purposeful sample of 12 church attendees came from urban, suburban, and rural African American churches. The Andersen behavioral model and Hochbaum's health belief model were used as the conceptual framework for thematic analysis of health care disparities. Kingdon's multiple-stream framework provided theoretical grounds for policy development and revision. Key findings revealed several interrelated health care disparity themes: the significance of insurance coverages, premium costs, financial barriers, family and personal issues, empowerment strategies, religious beliefs, and roles the church could play in promoting quality community health. The study has implications for positive social change: The results include guidance for the development of a bipartisan health care policy that includes the church as a stakeholder. A- partnership between the church and the legislators of health care reform could be a catalyst for improved metrics, trust, accountability, transparency, and opportunities to create tailored health care interventions and thus help alleviate societal health crises.

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