Women living in rural areas experience many challenges in terms of looking after their own and their families’ health needs.

Policy makers are attempting to address these issues using the Internet—a tool for providing these women with useful information and the opportunity to become more involved in achieving these needs. Is it working? Dr. C. Nadine Wathen of the University of Toronto and Dr. Roma M. Harris of the University of Western Ontario argue that in spite of the potential that information and communications technology (ICT) offers, we have not really spent enough time understanding these women’s day-to-day lives.

People living in rural areas are disadvantaged not only by higher rates of disability and certain diseases, but may also be more economically disadvantaged and be geographically isolated. Transportation is often a problem, including the alternatives that urbanites take for granted. Winters can be especially difficult as roads become impassable.

Rural women, like women everywhere, need to look after themselves since they in turn need to look after their families. They are often the ones that keep communities strong. And, while those living in the country may be resilient and independent in ways that city folks with easy access to services can’t even imagine, making assumptions about how to help these rural women using technology might not be benefitting them as much as we think.

Using the results of interviews with 40 women in a rural southwestern Ontario county, Wathen and Harris pieced together a highly engaging picture of how these women cope. Their stories include some startling revelations—from concerns about confidentiality in a small community (“things get out”) to observing how a veterinarian handles things in case one needs to do the same thing for oneself. The picture that emerges is one in which women’s lives are very different indeed to those of us in large cities.

These women used family members, colleagues and friends for help as well as online information retrieved from web sites. However, not all had access to a computer—in some cases there wasn’t even a telephone in the house. For those who did download information from online sources that information was often confusing, too technical, or even frightening. People sometimes felt overwhelmed by overload on the net.

Nevertheless, going online to look things up is becoming the case. People tend to obtain health information to learn more about their condition or illness and also to prepare them for discussions with doctors, whom they anticipate will be busy and certainly not available for a long relaxing chat. But again, circumstances were different for the women in this study. While some were positive about their relationships with their doctors, some felt patronized. Others thought their doctor didn’t take much interest in them or was perhaps not up-to-date on what was going on. But finding another doctor may not be an option, so people put up with these drawbacks so as not to be labeled a “troublemaker.” Some women reported that pharmacists were much more likely to take time and answer their questions thoughtfully. What was particularly interesting in this research was the value and importance that people placed on being respected and treated courteously and with dignity. Unfortunately this was not always the case.

Wathen and Harris found that in a system where information needs were not really met by either physicians or the Internet, women used other ways to help themselves and their families. These included social and family networks along with folk remedies and complementary therapies including home remedy books. These were used particularly when the problem was not acute. The Internet was also used as a way of obtaining information on these types of complementary therapies.

So the question remains—what is the role of the Internet for these women? Clearly there is still a disconnect between how these women cope with their health care information needs and the way policy makers envision technological solutions. However, as “Web 2.0” evolves with its emphasis on information sharing and collaboration among users, perhaps more self-help and support through online communities will become available in ways that fit these women’s lives. At the same time, more and more homes are being hooked up to Internet access, with faster and better connections. The day may come when the mismatch between rural women’s’ lived realities and policy-makers assumptions might not be so far apart. We’re just not there yet.

If you have questions of comments about this or any of the articles we’ve run in this Action Health Project series, contact Guenther Krueger directly at: gkrueger@knowitallhealth.com