Date of Award

Fall 9-13-2022

Degree Type

Dissertation

Degree Name

PhD Health Sciences

Department

Health and Medical Sciences

Advisor

Genevieve Pinto Zipp, EdD

Committee Member

Deborah Deluca, JD

Committee Member

Ning Zhang MD, PhD

Keywords

Ghanaian, Immigrants, Healthcare, Access, Utilization

Abstract

ABSTRACT

EXPLORING THE GHANAIAN IMMIGRANTS’ HEALTHCARE ACCESS AND

HEALTHCARE UTILIZATION OF U.S. HEALTHCARE SYSTEM

BY

Kweku J. Agyeman

Background and Purpose of the Study: Healthcare access and utilization in the U.S. continue to pose serious challenges to immigrants. Although the U.S. spends the most on healthcare ($3.8 trillion) among developed countries, accessing and utilizing the U.S. healthcare has become an illusion to most immigrants living in the U.S. including Ghanaians. To date, little is known specifically about Ghanaian immigrants’ access and utilization of the U.S. Healthcare system. For Ghanaians and other immigrants to fully understand the complex U.S. Healthcare System, they need to acculturate and/or assimilate to the American culture. Yet, the relationship between cultural beliefs, healthcare access, healthcare utilization, and patient-centered care is not succinctly understood. Thus, this study explores the relationship between cultural beliefs, healthcare access, healthcare utilization, and patient-centered care specifically in Ghanaians living in the U.S.

Methods: A descriptive, correlational exploratory design using the Bronx Ghanaian Immigrant Muslim Community (BGIMC) survey tool was employed to engage and gather information from Ghanaians in the U.S. 133 participants were involved in the survey of which over half were male (52%) and 48% were female. Most participants had master’s and/or bachelor’s degrees. 76% of the participants were U.S. citizen and had spent over 10 years in the U.S. (74%). 88% of respondents had health insurance by way of employment. 62% of participants had not postponed a medical problem or postponed seeing a doctor because of cost. Data were compiled and analyzed using both descriptive as well as inferential statistics.

Results: The continuous variables were normally distributed when examining the skewness and kurtosis. Patient satisfaction had a high level of reliability (α = 0.82) (George & Mallery, 2003), while Healthcare access had an acceptable level of reliability (α = 0.67) (George & Mallery, 2003). There was a strong correlation between healthcare access and healthcare utilization. If participants had put off a medical problem, they were more likely to find it difficult to obtain medical services. There was negative correlation between cultural beliefs and healthcare utilization. Thus, the easier participants perceived it was to obtain medical services when needed, the less likely participants were to endorse wanting to take care of one’s own health rather than going to a doctor or not follow a doctor’s advice because it went against personal beliefs.

Conclusion: An association between healthcare access and healthcare utilization was observed such that the more individuals knew about the healthcare available to them, the more they utilized them to their advantage. Additionally, a connection between patient-centered care and health beliefs of patient. There was a connection between patient-centered care and health beliefs of patients because both involved effective interactions between patients and healthcare providers.

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