CULTIVATING A CULTURE OF HEALTH IN THE SOUTHWEST: LINKING ACCESS AND SOCIAL DETERMINANTS TO QUALITY OF LIFE AMONGST DIVERSE COMMUNITIES

Even with advances in modern medicine and science, communities remain underprepared or unable to achieve positive health outcomes for all their residents. Such achievement requires a built and sustained culture of health that raises quality of life and improves the conditions in which people live, work, play, and learn. The Patient Protection and Affordable Care Act (ACA) has been influential on both individuals and communities, but its impact has not been comprehensively addressed regarding links to social determinants and quality of life with a special emphasis on access to care. This manuscript focuses on views expressed regarding individual, family, and organizational needs in building and sustaining a culture of health within communities of place, identity, status, and influence. Results are shared from a large-scale coordinated community health needs assessment conducted in Maricopa County, Arizona. Three hundred and sixty-seven persons (n = 367) participated in the focus groups used for the assessment. Focusing on subgroups with the County, views of the cultural, social, and economic factors impacting the health care system emerge, as do specific insights on implementation impacts of the ACA. While being able to have insurance was now a positive factor for many, cost was still a large barrier in affording insurance and obtaining health care services. Location and cultural competence of providers, health literacy, distrust, and dissatisfaction were also discussed as factors impacting quality of health care. This discussion can help with developing health care services aimed at improving quality of life.