Can Rural Health Insurance Improve Equity in Health Care Utilization?

• In Event: 157 - Regular Session. Rural Contexts as Spaces of Inequality, Power, and Identity

Abstract

As older adult population has rapidly increased in China, the attending increase in chronic disease poses serious concerns regarding disparities in medical care utilization for elders in rural areas. Drawing on 48 semistructured interviews with elders with chronic conditions and their caregivers in China, this paper analyzes two opposite patterns of health-seeking behavior in urban and rural areas. Presenting the findings as a relational model, we argue that the interplay between structures of medical care and cultural discourses about health and (un)worthiness generate different habitus as sets of practices and beliefs that facilitate or hinder elders’ and their caregivers’ decisions to engage with medical care. By demonstrating the Chinese state’s social health insurance reform’s failure to improve health-seeking behavior in rural areas, our findings suggest that efforts to understand health care delivery need to address local cultural discourse and hierarchies structuring urban/rural space.

Author

• Yan Long, Stanford University