Date of Award

4-2025

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Health Outcomes and Policy Research

Track

Health Policy

Research Advisor

Shelley White-Means, PhD

Committee

Sara Day, PhD; J. Carolyn Graff, PhD; Kathy Lovett, MEd; Keesha Roach, PhD

Keywords

African Americans; hidden disabilities; students

Abstract

Introduction. Learning disabilities result from genetic and neurobiological factors that alter brain function, such that cognitive processes related to learning are affected. Hidden disabilities can be defined as a non-apparent chronic condition that interferes with a person’s activities of daily living. While learning disabilities may be hidden, there are non-learning disabilities, such as dyslexia, autism, depression, fibromyalgia, and attention deficit hyperactivity disorder. While all races/ethnic groups have persons within their population who are disabled, African Americans are at a double disadvantage due to race and disability status. Therefore, the intersectionality of race and disability status among African American students in the health sciences may pose unique barriers to these students, both of which have a history of inherent inequalities that have plagued both disabled persons and African Americans for many years. While there is minimal literature that addresses the effect of hidden disabilities on students in the health sciences, there is a plethora of research on school-age and high-school students. Students with hidden disabilities (SHD) may be impacted by their disabilities when aiming to complete rigorous programs in graduate programs at health science centers. The Student Academic Support Services and Inclusion (SASSI) at The University of Tennessee Health Science Center (UTHSC) reported that African American students disclose their disabilities to institutional officials at lower rates than students of other races. This literature introduces the question of whether inadequate knowledge of and lack of use of institutional accommodations for African American students with hidden disabilities negatively impact matriculation in their respective graduate programs.

Purpose. The purpose of this study was to assess how African American students with hidden disabilities perceived their disabilities, disclosed the disabilities, and how their hidden disabilities impacted their matriculation through their programs and the use of institutional resources.

Methods. This study employed purposive sampling to select students for semi-structured interviews. Participants were selected from colleges at UTHSC. Semi-structured interviews were conducted via Zoom. 20 interviews were recorded, transcribed, and coded according to descriptive phenomenological analysis.

Results. The data from this study resulted in 47 clusters, each exhibiting various components to student’s experiences, grouped into 3 overall themes and 10 subthemes. The first was student’s perception of having a disability was lacked positivity, with 19 clusters supporting this overall theme, and 3 sub-themes under this overall theme. The second was experiences with disclosing disability status with 13 clusters supporting this overall theme, and 3 sub-themes under this overall theme. Finally, the last overall theme was access to and use of institutional resources, with 15 clusters supporting this overall theme, and 2 sub-themes under this overall theme as well.

Conclusion. The academic success of African American students with hidden disabilities is a multi-faceted phenomenon that da working tandem between the student, professors, and institutional officials. For African American students who have hidden disabilities, it is important that these students received equitable and fair treatment during the graduate careers to promote their success. The implementation of the student recommendations is a start for evolving the current processes and procedures to reduce barriers to obtaining and accessing institutional resources and accommodations for African American students. The results of this study showed that African American students with hidden disabilities had a unique experience in the health sciences. The intersectionality of race and disability status should be realized as a true phenomenon and considered by professors and institutional officials who have a direct impact on these student’s success and progression. The results from this study are a strong foundation to future studies that can lead to potential policy reformation and implementation to better support and alleviate present barriers that African American students face.

Declaration of Authorship

Declaration of Authorship is included in the supplemental files.

ORCID

https://0009-0009-3336-8585

DOI

10.21007/etd.cghs.2025.0687

Additional Files
2025-004-Houston-DOA.pdf (187 kB)
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