Barriers to Healthcare Seeking and Provision Among African American Adults in the Rural Mississippi Delta Region: Community and Provider Perspectives
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Barriers to health care access and utilization are likely to be perceived differently for receivers and providers of health care. This paper compares and contrasts perspectives of lay community members, volunteer community health advisors (CHA), and health care providers related to structural and interpersonal barriers to health care seeking and provision among African American adults experiencing health disparities in the rural Mississippi Delta. Sixty-four Delta residents (24 males, 40 females) participated in nine focus groups organized by role and gender. The constant comparative method was used to identify themes and subthemes from the focus group transcripts. Barriers were broadly categorized as structural and interpersonal with all groups noting structural barriers including poverty, lack of health insurance, and rurality. All groups identified common interpersonal barriers of gender socialization of African American males, and prevention being a low priority. Differences emerged in perceptions of interpersonal barriers between community members and healthcare providers. Community members and CHA fears of serious medical diagnosis, stigma, medical distrust, and racism emerged as factors inhibiting health care utilization. All groups were critical of insurance/regulatory constraints with providers viewing medical guidelines at times restricting their ability to provide quality treatment while community members and CHA viewed providers as receiving compensation for prescribing medications without regard to potential side-effects. These findings shed light on barriers perceived similarly and differently across these stakeholder groups, and offer directions for ongoing research, outreach, clinical work, and health care policy.
KeywordsAfrican American Mississippi Delta region Barriers to healthcare seeking Barriers to healthcare provision
Carol L. Connell, Sherry C. Wang, LaShaundrea Crook, and Kathy Yadrick were partially supported by a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington Engagement Award, Contract 1514-USM, during this work. Carol L. Connell, LaShaundrea Crook, and Kathy Yadrick also are partially supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 5U54GM115428. The content is solely the responsibility of the authors and does not necessarily represent the official views of PCORI®, its Board of Governors or Methodology Committee, or the National Institutes of Health.
The authors were partially funded through a Patient-Centered Outcomes Research Institute® (PCORI®) Eugene Washington Engagement Award (1514-USM) during this work. CLC, LC, and KY also are partially supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number 5U54GM115428.
Compliance with Ethical Standards
Conflict of interest
The authors declare they have no conflict of interest.
The project was reviewed and approved by the University of Southern Mississippi and Santa Clara University Institutional Review Boards.
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