Centering Community Voices to Address Healthcare Inequities in Underserved Utah Populations

Karishma Shah, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USAFollow
Jazmine Abril, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA
May Shaaban, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
Silvia Soule, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
Sonia Sehgal, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
Rawad Farhat, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA
Jeannette Villalta, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA
Oreta Tupola, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA
Valentine Mukundente, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA
Cathy Wolfsfeld, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA
Ivana Holiday, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA, AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA; AND Urban Indian Center of Salt Lake, Salt Lake City, UT, USA
Walter Watchman, Urban Indian Center of Salt Lake, Salt Lake City, UT, USA
Carrie Olvera, Utah Center for Rural Health, Southern Utah University, Cedar City, UT, USA
Lauren Gleave, Utah Center for Rural Health, Southern Utah University, Cedar City, UT, USA
Kamaile Tripp, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA AND AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA
Alexander Sperber, University of Utah Health, University of Utah, Salt Lake City, UT, USA
Rita Osborn, AHEC Scholars Program, Utah Area Health Education Centers, Salt Lake City, UT, USA AND Utah Center for Rural Health, Southern Utah University, Cedar City, UT, USA

ORCID

Karishma Shah: https://orcid.org/0000-0001-5229-3843

Jazmine Abril: https://orcid.org/0000-0002-2025-4978

May Shaaban: https://orcid.org/0000-0002-7998-8896

Silvia Soule: https://orcid.org/0000-0001-8942-7016

Sonia Sehgal: https://orcid.org/0000-0002-1517-878X

Rawad Farhat: https://orcid.org/0009-0009-0524-8308

Abstract

Persistent disparities in health outcomes across the United States are often driven by systemic inequities and social determinants of health. In Utah, these inequities are particularly pronounced among racially, ethnically, and geographically underserved populations. Community healthcare workers (CHWs) who share lived experiences with these communities are uniquely positioned to bridge the gap between patients and a fragmented healthcare system. This study aimed to explore how underserved communities in Utah perceive and interact with the healthcare system, centering their lived experiences to inform more equitable care models. We conducted eight focus groups with 73 participants from six medically underserved communities: African American, African Refugee, Native American, Pacific Islander, Hispanic-Latino, and Rural Utah. Each group was co-facilitated by trained CHWs from respective communities. Using a phenomenological approach and inductive analysis, we identified key themes based on shared narratives of health, healthcare access, and cultural context. Eight major themes emerged: barriers to accessing care, personal or systemic trauma, humanistic healthcare, building relationships, cultural competency, dimensions of health, navigating the healthcare system, and advocacy. While some themes were common across groups, community-specific priorities also emerged, highlighting the need for culturally grounded approaches. CHWs were consistently described as trusted advocates, helping participants navigate care and elevate their concerns in ways traditional systems often fail to accommodate. Findings underscore the urgent need to reform healthcare systems around the lived experiences of marginalized communities. Embedding CHWs in care delivery, emphasizing cultural humility, and promoting trauma-informed, relationship-centered models can help address persistent health inequities.

Recommended Citation

Shah K, Abril J, Shaaban M, Soule S, Sehgal S, Farhat R, Villalta J, Tupola O, Mukundente V, Wolfsfeld C, Holiday I, Watchman W, Olvera C, Gleave L, Tripp K, Sperber A, Osborn R. Centering Community Voices to Address Healthcare Inequities in Underserved Utah Populations. Patient Experience Journal. ; 13(2):65-77. doi: 10.35680/2372-0247.2132.