Medicaid consumers’ views on health and control of health
Allyson G Hall, Gail Young, Keva Thompson, Kimberly Elliott, Lilliana Bell, Rada K Dagher
Objective: Medicaid enrollees in the United States are among the poorest and sickest of the population. Meeting their health needs can be difficult, in part due to their vulnerability. Little is known about how Medicaid beneficiaries view their health, the healthcare delivery system, or their own ability to participate in activities or actions that would help them control or improve their health. This qualitative study used a combination of individual telephone interviews and in-person focus groups to explore Medicaid beneficiaries’ views of their health. Method: Instrument development was informed by theories of health and health behavior. Community liaisons and Medicaid eligibility files were used to identify participants. Thirtytwo individual telephone interviews and seven focus groups were conducted, tape-recorded, transcribed, and coded. Themes and conclusions were generated by consensus among the study team by an iterative process. Results: Beneficiaries described health as a life experience, as a function or action, and with respect to the healthcare system. The ability to control health was associated with the availability of resources, the influence of family and friends, and the role of God and prayer. Conclusions: Beneficiaries have many conceptualizations of health. Some individuals do believe that there are some actions they can take to control their health. However, this belief in one’s ability to control health is not universal and is subject to a consumer’s life experiences.