Developing Resilience: How Women Maintain Their Health in Northern Geographically Isolated Settings

Abstract

The purpose of this study was to explore how women maintain their health in northern geographically isolated settings, using a feminist grounded theory method. Twenty-five women of diverse backgrounds in northern British Columbia, Canada, engaged in qualitative interviews over a 2-year period to express perspectives about how the north affects their health and how they maintain their health in northern settings. Findings reveal that the women experienced vulnerability to physical health and safety risks, psychosocial health risks, and risks of inadequate health care. The women responded to these vulnerabilities by developing resilience through the strategies of becoming hardy, making the best of the north, and supplementing the north. These strategies, which reflect both individual and collective actions, were determined by the needs and interests of the women and their social and personal resources. The findings have implications for women's health research and health practices and policies in geographically isolated settings.

Place, space, and health inequalities

“…These studies have found geographically defined populations which face long-term socioeconomic deprivation, yet appear to have significantly better health outcomes than their economic or environmental peers. Mixed methods research, for example, suggests that strong local social cohesion, demographic stability, local housing policies, and physical environments were all implicated in their apparent resilience (Leipert and Reutter 2005;Mitchell et al 2009).…”

Northern health care: a woman's experience

“…These studies repeatedly conclude "that poor health is commonly linked with lower social class position, low income, less education, and other indices of disadvantage" (Coburn & Eakin, 1993, p. 89). Indeed, social, environmental, and economic factors, as well as gender, are recognized determinants of health that may have a significant impact on the health of women (Leipert, 2002). In more recent years, cultural and gender determinants of health have been identified as important factors that also affect health (Health Canada, 1996).…”

“…Rather, she was referred to several specialists and was not able to obtain a definitive diagnosis for several years. Citing both gender and geography, Leipert (2002) notes that these two elements play a key role in the treatment afforded. women by the health care system.…”

“…Similar to the difficulties entrenched in finding a succinct definition of rural, is the task of defining 'north' (Bone, 1992;Coates & Morrison, 1992;Leipert, 2002;Zapf, 1993Zapf, , 1996. In the absence of such a definition, it is perhaps easiest to describe some of the characteristics that encapsulate 'north'.…”

“…As such, those things that encompass 'male' are more highly valued than things defined as 'female'. Indeed, Leipert (2002) states that "women's quality care is compromised when their perspectives about health are dismissed, and the knowledge they have about their illness is belittled or ignored" (p. 119). This theme of women's voice being dismissed is evident in other research.…”