Cultural Barriers/Facilitators to Access and Utilization of Health Care among African Immigrants

Background: African immigrants are a rapidly growing segment of the U.S. population with diverse lifestyles and health needs, yet little is known about how and when they access/utilize health care or what barriers exist.  This study was conducted to gain insight into the cultural beliefs, practices and traditions of African immigrants on barriers/facilitators to access of health care.

Methods: Four focus group interviews were conducted with 30 African immigrants (18 Nigerians, 5 Ghanaians and 7 Cameroonians) in Pittsburgh, PA., all interviews were digitally recorded and transcribed, and emerging analyses (comprised of categories, patterns and themes) was used.

Results: Four themes emerged from the interviews: (1) challenges exist in navigating and using the health care system, (2) secrecy and stigma exists around chronic diseases such as diabetes, mental illness, and HIV/AIDS, (3) self-treatments/ home remedies is customary and (4) use of religion /spirituality to heal most illnesses is common.  A few quotes from participants: “Most people don't go to the hospital till they're really sick” and “If someone is sick, they believe someone is causing it” and “If I can get over the counter medication that I can take to treat myself, I will do it first before I go to the doctor”. Most participants are male, 50 and older and lived >10yrs. in the US.

Conclusion: We conclude that cultural, traditional and religious beliefs can positively and/or negatively influence African immigrants’ access to and utilization of health care.  More research is needed to identify specific components to be incorporated into interventions.