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The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.

This chapter will review the evaluations of the newly developed elderly care system in Japan, Long Term Care Insurance, and its social implications with the focus on demographic change.

By reviewing literature, this chapter will examine how demographic and social change over the years has impacted the features of caregivers. Then, how this policy change has demedicalized the aging process will be described. Finally, this chapter will evaluate whether this insurance has shifted the responsibility for elderly care from the family to society as the governmental slogan advertised.

The new insurance has offered more options in different services and established a new norm of self-reliance and determination for one’s own aging however it is doubtful if this new insurance has shifted the responsibility from family to society.

Applying the implications of policy reforms for elderly care in Japan to the United States, one can assume the traditional U.S. norms and values can facilitate effective utilization of the elderly care system. However, since each nation faces different problems with its specific condition, continuous studies and observations on the relationship between elderly care, immigration issues, and demographic changes will be necessary in order to offer more specific suggestions for each aging nation.

As Japan’s new insurance scheme for the elderly has been studied by many aging nations, recommendations for more comprehensive plans are suggested including building a community-based support system into the Long Term Care Insurance scheme to prevent social isolation and respond to emergency situations for the elderly.

Scholars have explained how people in Japan feel ashamed when elderly members of the family are cared for by formal services such as day care or government/commercial-based nursing homes due to the cultural norms of the consciousness of social appearance. However, this consciousness of social appearance plays a minimum role when it comes to elderly Japanese immigrant women's preference to utilize formal care services in the United States. They see receiving family based care as a burden on their middle-aged children (or grandchildren) and they prefer purchasing formal long-term care services when they can no longer feel confident about maintaining their independent lives. Elderly Japanese immigrant women hold rather positive views on formal care in the United States, including nursing homes. This chapter suggests that elderly Japanese immigrant women may not consider it shameful to utilize formal care as many previous scholars have suggested.

This study aims to better understand the key factors that affect the quality of care that patients with Hepatitis C are likely to receive in rural communities and to consider how to build a more effective health support system for the rural residents.

This qualitative study with a grounded theory approach allowed us to draw a conceptual map of the occurrence while informants had the opportunity to contemplate and share their thoughts on the issues, which led into new understandings of the subject matter.

The local leaders held a romanticized view toward rural life while the disadvantaged reported a sense of powerlessness to bring about the needed changes to help them battle Hepatitis C.

Although describing a single social setting provides in-depth description, generalizability to other settings is always a limitation. If one wishes to start a support group, he/she may have to start asking the clergy of different churches to be the cofounders of the support group organization.

Churches may have the most potential to bring about the needed changes in rural settings by fostering a supportive heath care environment in their communities.

This chapter provides both an introduction to the volume and a brief review of literature on technology, communications, and health disparities.

Literature review.

The chapter argues for the importance of greater examination of technology, communications, and their linkages to health disparities and other related factors.

Reviews the topic of technology, communication, and health disparities and previews this book.

This chapter will initially review some health care system issues with a focus on the US health care system. It will then review some of the sociological literature about race/ethnicity, immigration, socioeconomic status (SES) and gender and how these factors link to health and health care. In addition, the chapter will serve as an introduction to the volume and will briefly review the contents of the other sections and chapters in this volume.