Influencing Self-Reported Health Among Rural Low-Income Women Through Health Care and Social Service Utilization: A Structural Equation Model

Abstract

Using structural equation modeling, this study examined the mesosystemic processes among rural low-income women, and how these processes subsequently influenced self-reported health. Acknowledging the behavioral processes inherent in utilization of health care and formal social support services, this study moved beyond a behavioral focus by shifting attention to the affective and cognitive processes within the mesosystem. Findings from this study demonstrate that behavioral processes alone did not have a direct significant effect on self-reported health problems over time. However, by shifting attention to the affective and cognitive processes, a missing link between service utilization and future reported health emerged.

KEYWORDS:

• rural
• low-income women
• health care access
• formal social support
• health disparities
• intersetting knowledge
• multisetting participation

Notes

¹Participating were California, Colorado, Indiana, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Nebraska, New Hampshire, New York, Oregon, and Wyoming.

*p significant at .05 level (2-tailed). **p significant at .01 level.