Accessing and Utilizing Primary Care Services: The Influence of the Affordable Care Act on Latinas at a Community Health Center in San Diego Count

The implementation of the Affordable Care Act (ACA) opened the door to access for many groups that had been unable to access basic healthcare. The reality of access, however, does not immediately correlate to use among populations that have not had a history of preventive care. In this thesis, I examine how the ACA effects newly insured and insurance eligible Latinas in the San Diego border region on matters of access and utilization of health care services at a Community Health Center in San Diego County (Health Center). Findings from my research indicate that multiple intersecting factors influence access to care and utilization of primary care services. I collected data using ethnographic methods---including in-person interviews, participant observation, and surveys---and recruited community health workers employed at the Health Center as well as adult Latinas who live in the San Diego border region to participate in this research. Interviews consisted of semi-structured and open-ended questions related to primary care access and utilization and surveys collected demographic information---such as age, preferred language, birth country, income level, educational level, and health insurance status---and attitudes about health care. Analysis of this data investigates the influences of the ACA on access and utilization of primary health care services among Latinas. Findings from this research may help inform future health utilization and care practices at the Health Center and other San Diego clinics that service Latino populations.