The Business Situation
A health insurance company operating in a city with a significant Black American population wanted to understand the community they served. Not just demographics. The real picture: the attitudes, the lived experiences, the barriers, and the context that shapes how Black Americans in their market think about health, healthcare, and the institutions meant to serve them.
The insurer knew that closing gaps in care, and in trust, required more than good intentions. It required research designed to create enough space and safety for honest answers to emerge.
The Business Question
We serve this community. But do we really understand them?
The client came in with four core questions: What are the attitudes of Black Americans in this community toward their own health and managing health conditions? What barriers to healthcare access does this community face? How do community members view the role of healthcare providers and health insurance in their lives? And, perhaps most strategically important, how is their specific organization viewed within this community?
Our Approach
Designing for Candor, Not Just Convenience
We conducted 48 in-depth interviews with Black American residents in the client’s market, a substantial qualitative sample that reflected the depth of understanding the client needed. Every methodological decision was made with the respondents in mind, not just the research objectives.
- Individual interviews over focus groups. Health is a deeply personal subject, and for many Black Americans, it carries additional layers of complexity: the weight of systemic experiences with healthcare institutions, stigma, and social dynamics that can suppress honest disclosure. One-on-one conversations allowed participants to speak candidly.
- Both Zoom and phone options. Offering phone as a full-participation option (not a fallback) ensured the sample reflected the community as it actually exists, including participants for whom broadband access, internet speed, or camera comfort might otherwise have been a barrier.
- 75-minute sessions. Building genuine rapport takes time, particularly when topics include experiences of racism, healthcare avoidance, and distrust of institutions. Extended sessions gave room for trust to develop naturally and for participants to be truly heard.
What We Found
- Black experiences are central, not peripheral. Experiences of racism in daily life, in healthcare settings, and in interactions with institutions were not background context. They were central to the health conversation. Understanding that context was essential for the client to understand anything else.
- Specific, actionable barriers identified. Cost of insurance was a meaningful obstacle the insurer could directly address. Geographic access to care pointed clearly to the value of expanding clinic presence in Black neighborhoods. A third dimension pointed toward encouraging Black community members to consider careers in the medical field, a long-term investment in representation that matters for trust and access alike.
The Outcome
Armed with these findings, the insurer could move forward with a focused strategy. The research told the client where programs needed to go, how to communicate them in ways that would be well-received, and why those choices would resonate with the people they most needed to reach.
The findings gave the client something rare: a genuine, human-level understanding of the community they were trying to serve, and a concrete picture of where they could take meaningful action.
That’s what it looks like when research illuminates the decisions in front of you.