Understanding Access to Health Care Services Through the Stories of Women Living on a Low Income: A Qualitative Secondary Data Analysis

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Sparringa, Michaela

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thesis

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eng

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Women , Health Care Access , Low Income , Socioeconomic Status , Social Determinants of Health , Narrative Inquiry , Health Inequity , Canada , Dialogic/Performative Analysis , Qualitative Secondary Data Analysis , Qualitative

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In 2021, more than 2.4 million women and girls in Canada were living on a low income, which is a main social determinant of health (SDH). These women are at an increased risk for health issues, including anxiety, depression, and negative health behaviours such as smoking, physical inactivity, and unhealthy eating. Despite their risk of adverse health, women living on a low income continue to face challenges with accessing health care services. Although researchers have explored access among several subgroups of women who live on a low income, few have used a narrative approach as their methodology, and none have used dialogic/performative analysis. Furthermore, no qualitative secondary data analysis (QSDA) has been done among this population in the Canadian context. The purpose of this QSDA was to critically examine the stories about access to health care services for women living on a low income in Kingston, Ontario and to explore how the SDH (e.g., housing, food, income, transportation) affect their experiences, as reflected through a theatrical metaphor. Using interview and focus group transcripts from the primary study, five narrative threads were illuminated in the stories of five participants: sacrifice and survival; feeling powerless; loss of hope; abandonment and trust; and resilience. In this study, the complexity of health care for women was demonstrated; this involves their values about health, the barriers encountered when accessing services, and the deterrents of future system use. Increased financial support for women to promote their own health at home and in the community was highlighted as an ongoing need. Within health care settings, women indicated more compassion is needed from health care workers to encourage trust and partnership. Despite the hardships they experienced, the women continued to show strength and motivation. In this study, by further examining participant transcripts, a deeper understanding of women’s access to health care in Canada while living on a low income was developed.

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