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

Author

Listed:
  • Xiang Zou

    (Department of Medical Humanities, Southeast University, Nanjing 211189, China)

  • Ruth Fitzgerald

    (Department of Anthropology and Archaeology, University of Otago, Dunedin 9016, New Zealand)

  • Jing-Bao Nie

    (Bioethics Centre, University of Otago, Dunedin 9016, New Zealand)

Abstract

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.

Suggested Citation

  • Xiang Zou & Ruth Fitzgerald & Jing-Bao Nie, 2020. "“Unworthy of Care and Treatment”: Cultural Devaluation and Structural Constraints to Healthcare-Seeking for Older People in Rural China," IJERPH, MDPI, vol. 17(6), pages 1-13, March.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:6:p:2132-:d:335926
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    References listed on IDEAS

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    1. Adam Wagstaff & Winnie Yip & Magnus Lindelow & William C. Hsiao, 2009. "China's health system and its reform: a review of recent studies," Health Economics, John Wiley & Sons, Ltd., vol. 18(S2), pages 7-23, July.
    2. Zhou, Xu Dong & Li, Lu & Hesketh, Therese, 2014. "Health system reform in rural China: Voices of healthworkers and service-users," Social Science & Medicine, Elsevier, vol. 117(C), pages 134-141.
    3. Ye Li & Qunhong Wu & Chaojie Liu & Zheng Kang & Xin Xie & Hui Yin & Mingli Jiao & Guoxiang Liu & Yanhua Hao & Ning Ning, 2014. "Catastrophic Health Expenditure and Rural Household Impoverishment in China: What Role Does the New Cooperative Health Insurance Scheme Play?," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-9, April.
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    Cited by:

    1. Muzhe Pan & Yaofu Huang & Yawen Qin & Xun Li & Wei Lang, 2022. "Problems and Strategies of Allocating Public Service Resources in Rural Areas in the Context of County Urbanization," IJERPH, MDPI, vol. 19(21), pages 1-20, November.
    2. Lu Chen & Miaoting Cheng, 2022. "Exploring Chinese Elderly’s Trust in the Healthcare System: Empirical Evidence from a Population-Based Survey in China," IJERPH, MDPI, vol. 19(24), pages 1-16, December.
    3. Ryuichi Ohta & Mikiya Sato & Jun Kitayuguchi & Tetsuhiro Maeno & Chiaki Sano, 2021. "The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study," IJERPH, MDPI, vol. 18(16), pages 1-10, August.

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