Date of Award
4-7-2026
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Educational Policy and Leadership
First Advisor
Jody Jessup-Anger
Second Advisor
Eric Dimmitt
Third Advisor
Janice Jones
Fourth Advisor
Jeffrey LaBelle
Abstract
This study examines the impact of federal funding on healthcare access at Milwaukee County’s Federally Qualified Health Centers (FQHCs) from 2009 to 2023. Guided by Levesque’s conceptual framework, which defines healthcare access across five dimensions: approachability, acceptability, availability and accommodation, affordability, and appropriateness, this study uses each dimension to analyze complex factors influencing access among diverse patient groups. The literature review identifies persistent disparities in access across demographic groups, including age cohorts, racial and ethnic minorities, veterans, and low-income populations, despite Affordable Care Act (ACA) provisions intended to expand coverage and improve services for underserved communities. The research questions explored whether federal funding improved healthcare access across Levesque’s five dimensions, with particular attention to populations facing the most significant barriers to care. A quantitative, correlational research design was employed using patient-level data from the Health Resources and Services Administration (HRSA) Uniform Data System (UDS) and federal funding records. Group analyses were conducted by age, gender, race/ethnicity, social vulnerability, income level, insurance type, and chronic conditions. Twenty-nine correlation tests and regression models were run in SPSS to identify significant relationships. Findings revealed statistically significant relationships for several patient groups, but no significant results for children, black/African American and non-Hispanic Latino patients, individuals experiencing homelessness, veterans, asthma patients, or individuals with incomes above 200% of the Federal Poverty Level (FPL). These results suggest uneven effects of federal funding on healthcare access and underscore the need for more targeted, equity-focused policy interventions.