“Unworthy of Care and Treatment”: Cultural Devaluation and Structural Constraints to Healthcare-Seeking for Older People in Rural China

International Journal of Environmental Research and Public Health

Jing-Bao Nie¹  Ruth Fitzgerald²  Xiang Zou³ 

[1] Bioethics Centre, University of Otago, Dunedin 9016, New Zealand;Department of Anthropology and Archaeology, University of Otago, Dunedin 9016, New Zealand;Department of Medical Humanities, Southeast University, Nanjing 211189, China;

关键词: health-seeking;    older people;    structural constraints;    cultural devaluation;    rural china;   

DOI  :  10.3390/ijerph17062132

来源: DOAJ

【 摘 要 】

This paper examines the experiences of seeking healthcare for rural Chinese older people, a population who experiences the multiple threats of socio-economic deprivation, marginalization, and lack of access to medical care, yet have been relatively overlooked within the existing scholarly literature. Based on ethnographical data collected from six-month fieldwork conducted in a rural primary hospital in Southern China, this paper identifies a widespread discouraging, dispiriting attitude regarding healthcare-seeking for rural older members despite the ongoing efforts of institutional reforms with a particular focus on addressing access to health services amongst rural populations. Such an attitude was expressed by older people’s families as well as the public in their narratives by devaluing older members’ health care demands as “unworthy of care and treatment” (“buzhide zhi” in Chinese). It was also internalized by older people, based on which they deployed a family-oriented health-seeking model and strategically downgraded their expectation on receiving medical care. Moreover, underpinning this discouragement and devaluation, as well as making them culturally legitimate, is the social expectation of rural older people to be enduring and restrained with health-seeking. Simultaneously, this paper highlights the sourc2e of institutional and structural impediments, as they intersect with unfavorable socio-cultural values that normalize discouragement and devaluation.

【 授权许可】

Unknown