Spatial barriers as moral failings: What rural distance can teach us about women's health and medical mistrust author names and affiliations. (July 2020)

• Record Type: Journal Article
• Authors: Statz, Michele; Evers, Kaylie
• Is Part Of: Health & place. Volume 64(2020:Jul.)
• Publication Date: 2020-07
• Subjects: Rural women's health -- Medical mistrust -- Rural distance -- Rural health care deserts; Health -- Social aspects -- Periodicals; Health services accessibility -- Periodicals; Public health -- Periodicals; Political planning -- Periodicals; Social medicine -- Periodicals; Epidemiology -- Periodicals; Health Policy -- Periodicals; Health Services Accessibility -- Periodicals; Public Health -- Periodicals; Public Policy -- Periodicals; Sociology, Medical -- Periodicals; Épidémiologie -- Périodiques; Politique sanitaire -- Périodiques; Santé, Services de -- Accessibilité -- Périodiques; Health services accessibility; Health -- Social aspects; Political planning; Public health; Social medicine; Periodicals; 613
• DOI: 10.1016/j.healthplace.2020.102396
• Languages: English
• ISSNs: 1353-8292

Abstract

Abstract: 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. Highlights: As a conceptual tool, "rural distance" reveals overlooked experiences of healthcare environments. Barriers to rural healthcare are viewed as moral failings, not spatial or structural challenges. Policy efforts to address rural health care deserts must consider the role of medical mistrust. Policies must address barriers to rural women's ability and willingness to access health care.