Interventions to Address Reproductive Health Disparities among African-American Women in a Small Urban Community: the Communicative Construction of a “Field of Health Action”

Abstract

Guided by communication infrastructure theory (CIT) and based on analyses of multiple sources of data gathered as part of a four-year intervention to address reproductive health-care disparities among African-American women in a small, disadvantaged urban community in the northeastern USA, this mixed-methods study advances understanding of challenges that such health interventions face in smaller urban settings. Findings suggest that factors in residents’ material environment and their social construction of that environment interact to produce a “field of health action,” within which health-care seeking behavior is enabled and constrained. Four factors emerged as salient: actual availability of and perceptions of access to health-care resources, transportation options, communication resources (including interpersonal, media, and organizational) that aid health-care seeking, and privacy concerns around reproductive health-care seeking. The findings are discussed with regard to their implications for future research and health communication interventions that promote reproductive health-care seeking in small urban communities.

Keywords:

• Reproductive Health Disparities
• Women's Health
• Health-care Access
• Urban Communities
• Communication Infrastructure Theory

Notes

[1] The construct of a “field of health action” shares with the Kovandžić et al.'s (2012) concept of “space of access” the notion that individuals’ socially constructed understandings of a community's resource base (e.g., as rich or poor) are also critical determinants of access and service utilization. The field of health action uses CIT to elaborate more fully relationships between the social and the material, and the processes through which they are linked.

[2] There are 60.6 primary care FTEs (full-time equivalent) per 100,000 population in the county in which Riverton is located versus 97.2 in a nearby county that is the home of the state capital (Armstrong et al., 2013).

[3] A six-month subscription to the local newspaper costs US$91 (for home delivery from Tuesday to Saturday).

Additional information

Funding

This research was supported by the National Institute on Minority Health and Health Disparities, National Institutes of Health (P20MD003373).