Doctoral Dissertation Research: Socio-Spatial Factors Influencing Prenatal Care Availability, Access, and Use

该项目通过调查影响怀孕期间移民妇女健康的不断变化的社会空间关系（如政治、经济、社会文化和地理），探讨与移民保健有关的问题。本研究以佛罗里达州Immokalee的海地移民农场工人为例，调查了移民妇女产前护理的可得性、提供、利用和可及性，不仅是为了了解这些妇女在怀孕期间试图保持健康时面临的具体问题，而且是更广泛的政治、经济和社会过程，这些过程导致了美国各地移民妇女的健康差异。该研究有望填补学术和临床空白，以了解影响移民健康的社会空间因素，移民医疗保健的政治，农村和少数民族健康差距，以及《平价医疗法案》对医疗保健系统的新影响。它还探讨了定性地理信息系统通过制作显示性别、政治、经济和卫生保健之间复杂关系的动态地图，为卫生研究人员和规划人员提供的方法可能性。利用关键医学地理框架，研究人员从医疗保健、交叉性、移民和关键地理信息系统的跨学科文献中提取。该项目有四个相互关联的目标：首先，利用档案研究和地图绘制，探索移民健康的政治变化（以及“应得性”的概念）如何影响美国的医疗保健景观。其次，它使用来自医疗保健提供者的访谈数据来解释移民医疗保健政策的变化如何影响对移民妇女的护理提供。第三，使用女权主义定性GIS和多会话深度访谈，该项目调查移民妇女的医疗保健系统的经验，以及这些经验如何影响他们在哪里和如何利用医疗保健服务。最后，它确定了移民妇女在获得保健方面面临的社会空间障碍，以努力改善社区的保健可及性。

This project explores issues related to immigrant health care through an investigation of the changing socio-spatial relationships (e.g. political, economic, socio-cultural, and geographic) that shape immigrant women's health during pregnancy. Using the case of Haitian migrant farm workers in Immokalee, FL, this research investigates the availability, provision, utilization, and accessibility of prenatal care to immigrant women in order to understand not only the specific issues that these women face in trying to maintain their health during pregnancy, but also the broader political, economic, and social processes that contribute to immigrant women's health disparities across the United States. The research is expected to fill scholarly and clinical gaps in understanding the socio-spatial factors influencing immigrant health, the politics of immigrant health care, rural and minority health disparities, and the emerging impacts of the Affordable Care Act on the health care system more broadly. It also explores the methodological possibilities offered by qualitative GIS to health researchers and planners by producing dynamic maps that show the complex relationship between gender, politics, economics, and health care. Using a critical medical geography framework, the researchers draw from interdisciplinary literatures on healthcare, intersectionality, immigration, and critical GIS. The project has four interrelated aims: First, using archival research and mapping, it explores how the changing politics of immigrant health (and the notion of "deservingness") affect the health care landscape in the United States. Second, it uses interview data from health care providers to explain how the changing politics of immigrant health care affects the provision of care for immigrant women. Third, using feminist qualitative GIS and multi-session in-depth interviewing, the project investigates immigrant women's experiences of the health care system, as well as how these experiences influence where and how they utilize health care services. Finally, it identifies the socio-spatial barriers that immigrant women face in accessing care in an effort to improve health care accessibility in the community.