Centering Community Voices to Address Healthcare Inequities in Underserved Utah Populations

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.