This dissertation highlights the role of congregations in civic participation and illuminates the role of spirituality within the process of congregation based community organizing (CBCO). Empowerment (psychological, interpersonal, and behavioral), alienation, spirituality, and sense of community are found to vary by organizational affiliation (CBCO, non CBCO church, neighborhood, school, and non-affiliation). In particular, CBCO participants evidence higher levels of psychological and interpersonal empowerment and civic participation compared to those affiliated through other organizational contexts. CBCO participants are no stronger in spirituality than non CBCO church goers, but are significantly more likely to channel their spirituality into action through the civic sphere. Importantly, the directly negative effects of a heightened cognitive understanding of power on civic participation are shown to reverse (become positive) when mediating effects of spirituality and sense of community are considered.

This dissertation explores three broad questions related to data, theory, and policy on medical migration from Sub-Saharan Africa (SSA) to the United States. How many SSA-born and SSA-trained physicians are currently practicing medicine in the United States? How and why are they immigrating to the United States despite the extensive health needs in SSA? What can the United States do to mitigate the unsustainable immigration of SSA physicians? The three papers contained in this dissertation address these questions separately. The first paper uses the 2011 American Medical Association (AMA) Physician Masterfile to identify over 10,000 SSA physicians in the US physician workforce and provides a detailed descriptive analysis of their demographic characteristics and immigration patterns. The second paper examines the determinants of medical migration through in-depth interviews with migrant and non-migrant physicians from SSA. Findings from this qualitative analysis yields a complex and nuanced tapestry of factors associated with medical migration. The third paper draws insights from the two previous papers to propose a specific policy necessary in curtailing medical migration.