2015

Nearly 60 million residents of the United States are enrolled in that country’s Medicaid program. The Medicaid program, jointly funded and administered by the federal and state governments, provides health insurance and financial access to qualified low-income individuals and families. Medicaid enrollees are among the poorest and sickest of the population, and without this program many would not have access to needed health care services. Meeting the health needs of this population can be difficult, in part due to their vulnerability. Yet, relatively little is known about how Medicaid beneficiaries view their health, the healthcare delivery system, or their own abilities to participate in activities or actions that would help them control or improve their health.

“Health” has been described and defined in a number of ways. Specifically, health has been described in terms of a physical or biological manifestation; the extent to which an individual is able to maintain functioning within their social context; or the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity,” as articulated by the World Health Organization (WHO). These definitions of health are varied. However, no research has assessed whether consumers, and in particular Medicaid beneficiaries, share these same definitions.

Theories of individual health behaviors classify and explain factors which will influence individual health actions. According to the Health Belief Model and the Theory of Planned Behavior, factors that can influence an individual’s decision to act or engage in their health or health care include an individual’s sense of whether the benefits outweigh barriers, a belief in their own competency or ability to take action, and access to necessary resources. Individuals with this belief in their ability to act are likely to have a high degree of perceived and actual behavioral control.

Focus groups and in-depth interviews with Medicaid beneficiaries were conducted in order to gain an understanding of their definitions of health and their ability to control their health. Such an understanding is key to the successful development and implementation of health promotion and healthcare access strategies for this vulnerable group of individuals.