To Seek or Not to Seek: Examining Health-Seeking Behaviors among Ethiopian Immigrants in the United States

Abstract

Existing literature suggests that immigrants underutilize U.S. health care. Care utilization is associated with poor health for both patients and those around them. Current health care research lacks data specific to Ethiopian immigrants and the influences of their health-seeking behaviors. Such research is necessary, as the Trump Administration has made recent efforts in reforming health care and immigration policies. Therefore, the goal of this thesis is to investigate the reasons why Ethiopian immigrants choose and choose not to seek American health care. Past studies have identified (1) language differences with providers and (2) perceived discrimination from providers as barriers and (1) existing insurance coverage and (2) positive word-of-mouth testimonials from social networks as facilitators to health care use for immigrants. These identified factors served as the hypotheses for this thesis. Moreover, focus group methodology was applied to explore these hypotheses. Five focus groups were conducted with a total of 26 Ethiopian patients (n = 26) of Learn and Live Wholestic Health Services, a public clinic located in Northern Virginia, from July 2017 to August 2017. The focus group discussions highlighted both hypothesized and emerging themes. Language was not a barrier to health care for participants, but there was variation on characterizing social discrimination as a barrier. Public insurance was a facilitator and private insurance was a barrier to utilization. Positive testimonials were strongly regarded as facilitators. In terms of emerging themes, one’s attachment to Ethiopian traditionalism arose as a barrier, while professionalism of U.S. health care was branded a facilitator. This thesis concludes by providing the following policy implications: implementation of health advertisements in Ethiopian immigrant communities, development of tools to solicit Ethiopian ideas, improvement of language services in health facilities, and further health research on Ethiopians immigrants.