The action logic of the older adults about health-seeking in South Rural China

BMC Public Health · 11 authors, 4 centres

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TL;DR

This qualitative study used participatory methods to understand why older adults in rural southern China underutilize healthcare services despite improved access. The central finding is that their healthcare decisions are driven by personal health perceptions and a desire to maintain an orderly daily life, often leading to self-medication.

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The analysis revealed three themes influencing low healthcare utilization: participants defined health by their ability to perform daily chores, prioritized alleviating symptoms over curing underlying diseases through self-medication, and avoided medical interventions due to concerns about unpredictable disruptions to their established life routines and finances. The findings indicate that despite increased objective accessibility to healthcare facilities, subjective barriers related to cultural health perceptions and life priorities limit service uptake. Limitations include the geographical restriction to southern China and the exclusion of older adults with serious diseases. The implication is that rural health policy must address subjective accessibility and integrate cultural understandings of health to be effective.

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other

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public health

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ORIGINAL PAPER

PMC10714459

The action logic of the older adults about health-seeking in South Rural China

BMC Public Health

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ABSTRACT

Abstract Background The Chinese government has invested significant resources to build many rural healthcare stations. However, in the face of convenient medical paths and accessible medical resources, the utilization rate of health services for older adults in rural areas is surprisingly low. This study explored why health-seeking behavior among older adults in rural China was not active. Methods Data were collected through participatory rural appraisal (PRA) with 108 participants in 12 villages in southern China. Daily schedule and social and resource mapping were employed to outline the range of activities and the routine of the older adults, as well as in-depth interviews to understand the logic of their healthcare choices. Data collected were analyzed by content analysis. Results Three themes were generated: (1) perceptions of health status (being healthy or sick): the rural older adults used the ability to handle routine chores as a measure of health status; (2) prioritization of solving symptoms over curing diseases: the older adults preferred the informal self-medication to cope with diseases, as long as there were no symptoms and no pain; (3) ‘unpredictable’ troubles: they tended to favor the ‘optimal’ solution of keeping their lives in order rather than the best medical treatment options. Conclusion This study showed that the medical practices of the rural elderly were profoundly influenced by their perceptions of health and their life experiences. In the face of diseases, they tended to keep their lives in order, preferring self-treatment practices that address symptoms or selectively following medical advice rather than medical and science-based clinical solutions. In the future, the construction of rural health care should focus on changing the ‘inaccessibility’ of healthcare resources at the subjective level of the rural elderly and develop culturally adaptable health education. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-023-17314-y. Keywords: Health-seeking behavior, Rural China, Older people, Participatory rural appraisal, In-depth interviews

CITATION EXPORT

Jianqiang Lin, Dan Yang, Xinyu Zhao et al.. The action logic of the older adults about health-seeking in South Rural China. BMC Public Health. (2023). https://doi.org/10.1186/s12889-023-17314-y

AUTHORS

11 · 4 CENTRES

Jianqiang Lin, Dan Yang, Xinyu Zhao, Liqiong Xie, Kun Xiong, Lei Hu, Yue Xu, ShanShan Yu, Wenyong Huang, Ni Gong, Xiaoling Liang

1State Key laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
2School of Nursing, Jinan University, Guangzhou, China
3Department of Ophthalmology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
4Department of Endodontics, Stomatological Hospital of Guangzhou Medical University, Guangzhou, China