Perceived health care status and health care needs of women aged 50-65 in rural Missouri: A Qualitative Assessment

An interdisciplinary team of public health researchers in women's health received funding from the Missouri Foundation for Health to perform an assessment of health status and access to health services among rural-residing women 50-65 years of age in rural Missouri. Eleven focus group with 122 women occurred with Spanish speaking Latinas (2 groups), African-Americans (3 groups) and whites (5 groups). Women were queried about the health status of women in their community and about the facilitators and barriers to health care services for women in their age group. Preliminary qualitative analysis revealed 4 major themes in the topical area of Challenges to Health. Theme 1, the interrelated challenges of minimal personal and infrastructure resources included problems with minimal incomes and lack of health insurance often in combination with transportation limitations. Theme 2, rural secrets of mental health problems, violence, and substance abuse, is linked to stigma and the fear that other people in the community would learn of women's personal issues. Theme 3, denial, concerns women avoiding going to a health care provider due to fear of learning of a life-threatening condition. Finally, theme 4, a badly stretched primary care system, refers to the absolute shortage of primary care providers and the lack of continuity of care. These findings should help to inform policy decisions and planning and contribute to the development of appropriate interventions for Midwestern rural populations thus contributing to the goal of social justice in underserved populations.