Doctoral Dissertation Research: Impacts of Healthcare Reform on Healthcare Service Delivery for Vulnerable Populations

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This award is funded in whole or in part under the American Rescue Plan Act of 2021 (Public Law 117-2). Public health systems are always embedded in a particular social context. Studies have demonstrated that how citizens interact with and respond to public health campaigns often depends on the quality of citizens’ relationship to the state. However, the question of how marginalized communities interact with the public health systems remains understudied. The research supported by this award uses observations, interviews, and media analysis to investigate how vulnerable populations receive public healthcare services in the context of an ambitious healthcare reform. In addition to providing funding for the training of a graduate student in anthropology in the methods of empirical, scientific data collection and analysis, the project will enhance scientific understandings of how public health strategies translate and are adjusted and modified in different local contexts. The research will take place over 12 months in a context where a previously discontinued public healthcare service has been resumed. Firstly, the research asks about the cultural ideas that inform public health workers’ delivery of HIV services to vulnerable groups. Secondly, the research explores how interactions with a reformed public health system impact the vulnerable community’s feeling of belonging. The researcher will work across two different settings: a local public health center and among the larger vulnerable community that it services. Data will be collected through detailed observation, and interviews with health workers and vulnerable members of the local population. This research contributes to theories of state care and state-citizens relations. In the fields of political anthropology and medical anthropology, the project advances theoretical understanding of the formation of political subjectivity among marginalized populations and how everyday bureaucratic interactions shape citizens’ ideas of the state. Finally, findings from this research will produce multi-perspective data that will aid policymakers, educators, and public health workers to develop better policies and programs that anticipate the effects of local cultural factors on the delivery of healthcare services.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.