Access to healthcare for black women in Alberta: an interpersonal-level analysis of barriers and facilitators

Alberta is home to one of Canada's fastest growing populations of Black people, driven by an influx of African immigrants to major metropolitan areas such as Edmonton and Calgary. As the Black population in Alberta continues to grow, it is crucial to the well-being of these communities that we understand their health service needs. Black women are a vulnerable group within the Black population due to inequities in social determinants of health such as access to healthcare. In Canada, little is known about the healthcare access experiences of Black women despite reported disparities in their health outcomes. As such, we undertook a qualitative study to examine access to health services for Black women in Alberta. Semi-structured interviews were completed with 30 Black women from Edmonton and Calgary. We applied intersectionality as an analytical framework to guide our understanding of how interconnected social processes shape Black women's experiences of accessing healthcare. Following our thematic analysis, we identified two major barriers to healthcare access: patient-provider discordance and negative healthcare encounters. We identified two key facilitators: positive patient-provider dynamics and individual and social network strengths. Our findings suggest that Black women have distinct experiences of accessing the healthcare system which are best understood as a confluence of their race, gender, and other aspects of their personhood.