Rural African American Women and Breast Cancer: Social Determinants of Health Shape Ability to Conceptualize Health in the Arkansas Delta

We know that certain components including demographics, cultural background, lifestyle choices and lack of access to health care contribute strongly to health disparities in rural regions of the United States. This paper explores perceptions of health, the environment, and the relationships between them that impact health disparities in the Arkansas Delta. The social-ecological model provides a conceptual approach to relate social determinants to health disparities. Few US rural health community-based studies have utilized this approach, or engaged ecological theory to explore rural contexts. This exploratory study blended a community-based, qualitative approach with social-ecological theory, to identify potential social determinants of health that impact rural Arkansans. Methods: Qualitative data were gathered with (n=79) women, ranging in age from 18 to 84, who were residents of 3 rural Arkansas Delta communities. Respondents poignantly described issues that affect health disparities in their communities. Conclusions: The study identified potential social determinants of health at multiple ecological levels among rural African American women. It was the social determinants of health and the legacy of segregation, that impacted their ability to conceptualize health in the resource resisted environment.