Policy attention to growing rural “health care deserts” tends to identify rural distance as a primary spatial barrier to accessing care. This paper brings together geography, health policy, and ethnographic methods to instead theorize distance as an expansive and illuminating concept that highlights place-based expertise. It specifically engages rural women's interpretations of rural distance as a multifaceted dimension of accessing health care, which includes but is not limited to women's health services and maternity care. Presenting qualitative research with 51 women in a rural region of the U.S., thematic findings reveal an interpretation of barriers to rural health care as moral failings rather than as purely spatial or operational challenges, along with wide communication of negative health care experiences owing to spatially-disparate but trusted social networks. Amid or owing to the rural crisis context, medical mistrust here emerges as a meaningful but largely unrecognized barrier to rural women's ability—and willingness—to obtain health care. This underscores how a novel interpretation of distance may inform policy efforts to address rural medical deserts.
Bibliographical noteFunding Information:
The authors are grateful to our research participants for so generously sharing their time and expertise with us. Special thanks as well to Jon Bredeson for helpful research assistance. This work was supported by the National Science Foundation, United States (SBE?1729117).
This work was supported by the National Science Foundation, United States (SBE-- 1729117 ).
© 2020 Elsevier Ltd
- Medical mistrust
- Rural distance
- Rural health care deserts
- Rural women's health
PubMed: MeSH publication types
- Journal Article
- Research Support, U.S. Gov't, Non-P.H.S.