Article Figures & Data
Figures
- Figure 1.
Deriving cross-cutting themes.
Tables
Health Care Cost Tell us about your experience accessing health care in Ketchikan.
How has the cost of health care affected how you seek care?
Have you experienced any challenges with medical bills? And if yes, please tell us more about what was difficult?Accessing care (Transportation, Language, etc.) Have you faced any challenges that have impaired your ability to seek medical care? (for example, transportation, interpretation services, etc.)
Can you tell us about the experiences you’ve had communicating your health concerns? What has gone well and what has been difficult?
Have you had experience needing to use interpreter services at your health care provider’s office? If yes, what was the experience?Trust & perceived fear What factors affect your ability to trust a health care provider?
Do you have any fear about various medical conditions or learning new information about your health? If yes, tell us more about those fears?Culture, religion, and spirituality What do you think are the defining factors of the Filipino community?
What strengths of the Filipino community contribute to your overall health?
Does religion or spirituality play a role in your overall health?
Have you experienced racism and bias when receiving health care? If yes, can you share more about that experience(s)?
How do you think consuming typical Filipino food has contributed to your overall health?Gender Men 8 Women 12 Place of birth Philippines 17 United States 3 Age 18 to 20 years 0 21 to 34 years 2 35 to 49 years 9 50 to 64 years 1 65+ years 8 Languages spoken English only 3 Tagalog only 0 English and Tagalog 9 English and other dialect1 1 English, Tagalog, and other dialect 7 Household size2 1 to 2 7 3 3 4 3 5 or more 7 Highest level of education High school graduate/GED 7 Associate degree 2 Bachelor’s degree 7 Technical school 3 Decline to answer 1 Employment pattern Full-time 10 Retired 6 Student 1 Other3 3 Annual household income Less than $20,000 5 $20,000-$29,999 1 $30,000-$49,999 1 $50,000-$74,999 3 $75,000-$99,999 3 $100,000 or more 1 Decline to answer 6 Financial hardships in the last 12 months4 Never 17 Occasionally 2 Monthly 1 Housing stability in the last 30 days5 Yes 19 No 1 Primary method of health care payment Cash/Out-of-pocket 2 Health Insurance 11 Medicare/Medicaid 6 Other 1 Health care obtained in the Philippines6 Medical 9 Dental 9 Prescriptions 8 Decline to answer 5 ↵1 Dialects include: Kapampangan, Visaya, Ilocano, Hiligaynon, Ilonggo, Waray.
↵2 Household size includes participant.
↵3 Includes part-time work or working for cash without records.
↵4 How many times did you run out of money for necessities like housing or food?
↵5 Have you had a stable place to live (i.e., you were not moving from place to place)?
↵6 Participants chose combinations of each option, therefore not summative.
Culture and language: as a feature of access “I do believe [Filipinos] are very hard working and dedicated to their families, and stubborn, especially, [when it comes to] taking of themselves. [Filipinos] would take of other family members before themselves. [They] are friendly, warm, caring, and it comes from everywhere depending on the family dynamics. They would rather take care of everyone, make sure everyone [else is] healthy and fed, before themselves.” (#18, 5.24)
“I work two jobs and so I have problems with that, but now with the medicine that they [prescribed] makes me feel good.” (#19, 6.27)
“[It’s] a cultural thing. I feel we're hard workers and we try and strive to put money aside so we could have food on the table, shelter over our head and things like that. So, I can see why health can be put on the back burner.” (#16, 5.24)
“We care for each other. We give advice to others. We help, we share what we have. That's good. They bring food. We bring food. That's why we are happy.” (#6, 4.26)
“As I got older, the fear [that] a lot of Filipino families have is this fear of going to hospitals, whether it's just the fear [overall] or the fear of the language barrier, the fear of the medical bill or what. Especially [for families] coming over from the Philippines, there's not enough education[al] information [about when] teenagers or girls should be going in for their annual appointments or things such as birth control. Those are just things I feel like in most households are topics that are avoided. These girls either learn about it on their own or they just, they just don't learn about it at all. [In] my experience growing up, that's something that was missing. [Things like] birth control and annual appointments weren’t spoken about in my household. I just figured [that stuff] out on my own. Even my mom was shocked when I did start taking birth control [after high school even though I was older].” Especially when our culture, [even though] many of us grew up in the United States, we see our families, or our parents and the older generation really find it very taboo to talk about sex education or birth control or even understanding the menstrual cycle.” (#16, 5.24)Relational, Community-Based Care Experience “I just like the way my [doctor] comes off, he comes off pretty friendly and makes you feel comfortable just by engaging in regular conversations sometimes. It’s not all about what’s ailing me. [The visit] is a little more personal, [with time to be] able to talk and just make me feel comfortable. [Even when I was given the option to transfer to a Filipino Tagalog speaking physician], I declined because I was more comfortable just staying with him and [we have a] good relationship.” (#10, 5.18)
“But overall [the healthcare providers I’ve seen have] been very helpful. They've been very accommodating and it’s usually not just business with them. [They always ask] ‘Hey, how's it going?’ Small talk is not necessary, but it definitely helps you get to know what's actually going on versus what you think's going on.” (#15, 5.24)
“There are just some [physicians] whose answers are more real, [and who give more] real world answers than the medical aspect of it. They try to make things very relatable and understand[able].” (#16, 5.24)
“My provider is very thorough, and she doesn't seem like she's rushing through questions that I have. She understands my preferences when it comes to medication or care. And she takes her time.” (#18, 6.27)
“I [saw one] physician throughout all my adult life, then I realized, you can change physician if you don’t see eye to eye with how [they] explain certain things. My physician didn’t get what I was trying to address, so I changed over to a new physician and I felt he understood what I was trying to [convey]; I think it was just a communication factor. He was my age and understood what I was going through. So, it was easier for me to just to open up.” (#2, 4.20)
“With my new physician now, I feel that he gets it. When I see him, it feels like he understands. There's a relationship that is just more comfortable for me to tell him what I exactly want or need.” (#2, 4.20)
“I changed my doctor because she didn’t understand me, or I didn’t understand her because her suggestion was to come back again if the [issue] ever becomes big again.” (#8, 5.05)
“A lot of it has to do with how they speak to you and how address your concerns. Because going to the doctor can be scary and a lot of it is kind of overwhelming because it's your body and it's your health. It can be very complicated if the doctor or even the front desk people that you're trying to work with are not being very endearing when you’re scared and it’s your health and you just want to make sure that you're okay. A lot of people don't like to go to the doctor anyways and like me, I don't really particularly like going to the doctor. So, without that extra sense of security and extra sense of calmness, I think it's really hard to want to go to the doctor.” (#11, 5.18)Structure of current healthcare system as a barrier to accessing care “[My friend] went [to the ER] and the next thing he has like a $1500 bill (laughing). Right now [he still has a] $100 balance… That’s how [the] hospital works. You know, when you see a doctor, even if you don’t do anything [you get charged] a lot.” (#3, 4.25)
“I have a huge bill, so yeah, that’s my biggest challenge….” (#8, 5.05)
“My insurance takes care of a lot of it, but it also gets pretty expensive every month.” (#10, 5.18)
“When I do my mammogram [and other women’s care], I have to pay extra aside from my insurance… Sometimes [I ask] for [financial assistance through the hospital] or I can … just pay it monthly.” (#8, 5.05)
“Everything was clear… when I went to check out up front, [the girls] up front also gave me the information of who to call regarding [the cost] out of pocket [for treatment] … so it’s like, I got the full 360 of what needs to be done after my business, everything was taken care of. I left knowing what I need to do and how to do it.” (#9, 5.17)
“I have never used the interpretation services at the doctor’s office, and I didn’t know they had this available.” (#12, 5.19)
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Keywords
- Access to Health Care
- Clinical Medicine
- Community Medicine
- Community-Based Research
- Cultural Competency
- Diversity
- Doctor-Patient Relations
- Education of Patients
- Family Medicine
- Health Communication
- Health Disparities
- Health Equity
- Health Literacy
- Immigrants
- Language Barriers
- Minority Health
- Patient Navigators
- Patient-Centered Care
- Population Health
- Primary Health Care
- Qualitative Research
- Quality of Care
- Rural Health