Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chair; Mary Jo Clark, PhD, RN; Sandra Bibb, DNSc, RN


African Americans, health care utilization, non-economic barriers, nursing


Many efforts have been made to maximize the utilization of health cue system. As a result the utilization of health care system by African Americans has increased, improving the health status (Blendon, Aiken, Freeman, & Corey, 1989). While some improvements have been made, recent reports show disparities between African Americans and Caucasians in the utilization of health care systems and in their health status. Barriers have been identified among those in the lower social economic status (SES). These barriers impede health care utilization and negatively affect health status. However, studies show that among some African Americans when health care is affordable and available, the utilization of health care systems is not maximized. This suggests there are noneconomic barriers impeding access to and the utilization of health care systems for some African Americans. This phenomenological study was based on Van Manen's hermeneutic phenomenological approach (Van Manen, 1990). Data were collected from participants on their experiences gaining access to and utilizing health care systems. As data were analyzed, six themes emerged. These themes were: delay before seeking health care services, fear, distrust, quality of care, racism and long waiting time. Six of the original participants formed a focus group and through a dialectic process, gave meaning to the identified themes. Most of these themes continue to affect how African Americans gain access to and utilize health care systems.

Document Type

Dissertation: Open Access



Included in

Nursing Commons