This thesis examines how a Patient-Centered Medical Home addresses, implements, and provides medical and social resources and services within the Florida U.S. safety-net system, and how patients and providers perceive health care interactions. The safety-net clinics fill the care gap for millions of uninsured low-income U.S. residents, including those who are unemployed or undocumented. I have conducted ethnographic research at a safety-net clinic in Central Florida which included five months of primary data collection via participant observation, informal conversations, and 22 semi-structured interviews of healthcare providers, volunteers, and patients. My secondary data analysis focused on health policies and guidelines. Based on the study data, I argue that safety-net clinics are vital in addressing health care gaps for the uninsured, and are in the position to provide comprehensive services by integrating social care (e.g., transportation, housing, food) together with medical services.
The generative labor approaches evident at my research site are valuable in mitigating structural vulnerabilities and remaining barriers in the delivery of social care, however the safety-net clinics must navigate state and government policies that are complicated and challenging. The interview narratives also show that care is conceptualized beyond medical and social needs, with the goal of restoring dignity in care, fostering relationships, and offering Christ-centered, non-judgmental care. This study is significant to anthropology because it demonstrates successful implementation of integrative, comprehensive medical and social care in addressing social determinants of health within the Florida safety-net system. It also advances our understanding of the way that care is conceptualized at a faith-based safety-net clinic. As patient-centered care is becoming the gold standard in recent decades, this study also contributes an ethnographic analysis of how a safety net clinic achieves the goal of providing this form of care.
Outline of Studies:
Major: Anthropology
Educational Career:
B.A., 2016, University of Central Florida
Committee in Charge:
Dr. Joanna Mishtal
Dr. Shana Harris
Dr. Lindsay A. Taliaferro
Approved for distribution by Dr. Joanna Mishtal, Committee Chair, on April 19, 2023.
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