We explore the effects and interplay of physical and social environments on the inaccessibility of gynecological health care for women with spinal cord injury. We also explore women’s responses to the inaccessibility of this care, in hopes of trying to understand better how women navigate their gynecological health and health care when faced with physical and social environmental constraints.
The data for this phenomenological study were gathered using in-depth, qualitative interviews with 20 women living with spinal cord injuries in or around Detroit, Michigan. Each interviewee was questioned about overall health and physical functioning, accessibility of doctor offices, interactions with health care providers, gynecological health-seeking behaviors, and complementary and alternative medicine use. In this paper we report on data on women’s difficulties in securing gynecological health care experiences and related attitudes and practices.
Findings echo past literature about the inaccessibility of doctor’s offices, including the lack of suitable exam tables and medical equipment. Office staff varied in their willingness to help transfer women from wheelchairs to exam tables as well, often creating what we term an inaccessible social environment. Individual women in our sample found different strategies for navigating the environmental contexts of a doctor’s office and the encounters that they had with providers within medical settings. These strategies had varying impacts on individuals’ abilities to secure gynecological health care.
Our findings point to the possibility of an interplay between and intersection of physical and social environments within medical settings that needs to be explored further and, potentially, the primary importance of the social environment over the physical environment in determining whether an individual’s disability makes health care inaccessible.
Dillaway, H. and Lysack, C. (2014), "Encounters with Inaccessibility: The Contexts Women with Spinal Cord Injury Face when Seeking Gynecological Health Care", Environmental Contexts and Disability (Research in Social Science and Disability, Vol. 8), Emerald Group Publishing Limited, Bingley, pp. 231-257. https://doi.org/10.1108/S1479-354720140000008013
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