Space, place, and the politics of access: Service provider perspectives on health system responses to sexual- and gender-based violence in rural communities.
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| Titel: | Space, place, and the politics of access: Service provider perspectives on health system responses to sexual- and gender-based violence in rural communities. |
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| Autoren: | Sheppard-Perkins MD; Faculty of Health Sciences, Carleton University, 1125 Colonel By Dr., Ottawa, ON, K1S 5B6, Canada. Electronic address: maddysheppardperkins@cmail.carleton.ca., Darroch FE; Faculty of Health Sciences, Carleton University, 1125 Colonel By Dr., Ottawa, ON, K1S 5B6, Canada. |
| Quelle: | Health & place [Health Place] 2025 Nov; Vol. 96, pp. 103572. Date of Electronic Publication: 2025 Nov 06. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Elsevier Country of Publication: England NLM ID: 9510067 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-2054 (Electronic) Linking ISSN: 13538292 NLM ISO Abbreviation: Health Place Subsets: MEDLINE |
| Imprint Name(s): | Publication: Exford, England : Elsevier Original Publication: [Kidlington, Oxford, U.K.] : Pergamon, c1995- |
| MeSH-Schlagworte: | Health Services Accessibility* , Rural Population* , Gender-Based Violence* , Sex Offenses* , Politics* , Rural Health Services* , Health Personnel*/psychology, Humans ; Qualitative Research ; Ontario ; Male ; Female ; Interviews as Topic ; Adult ; Middle Aged |
| Abstract: | Background: Sexual- and gender-based violence (SGBV) remains a pervasive public health concern in Canada, with rural communities facing disproportionate rates of severe violence alongside significant barriers to care. While previous research has documented rural service scarcity, less attention has been paid to the socio-spatial dynamics that shape how health and support services are experienced, accessed, and provided. Methods: This qualitative study draws on semi-structured interviews with 18 SGBV service providers working in rural Ontario. Guided by an intersectional geography framework, we examine how providers interpret and navigate the spatial, structural, and sociocultural conditions influencing care, particularly for groups experiencing intersecting forms of marginalization. Reflexive thematic analysis was used to identify key themes across institutional healthcare settings and community-based supports. Findings: Two overarching themes emerged: (1) SGBV care pathways in a rural context: Fragmentation, stigma, and scope of support, which highlights how institutionally-constrained systems (i.e., emergency and primary care) often operate on crisis-driven thresholds that may not be suited to meet survivors where they are; and (2) Reimagining rural SGBV response through multi-service hubs, which explores integrated, place-based care models as promising but underfunded alternatives. Across interviews, participants emphasized that access is shaped not only by geographic distance and logistical specificities, but by safety, stigma, trust, and relational continuity. Conclusion: This study illustrates how spatial and institutional inequities intersect to limit meaningful access to SGBV-related healthcare in rural contexts. Findings support the development of community-embedded models that respond to the place-based realities of survivors and providers alike, such as rural care hubs. (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Contributed Indexing: | Keywords: Intersectional geography; Multi-service hubs; Rural health; Sexual and gender-based violence; Space and place |
| Entry Date(s): | Date Created: 20251107 Date Completed: 20251129 Latest Revision: 20251129 |
| Update Code: | 20251130 |
| DOI: | 10.1016/j.healthplace.2025.103572 |
| PMID: | 41202716 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Background: Sexual- and gender-based violence (SGBV) remains a pervasive public health concern in Canada, with rural communities facing disproportionate rates of severe violence alongside significant barriers to care. While previous research has documented rural service scarcity, less attention has been paid to the socio-spatial dynamics that shape how health and support services are experienced, accessed, and provided.<br />Methods: This qualitative study draws on semi-structured interviews with 18 SGBV service providers working in rural Ontario. Guided by an intersectional geography framework, we examine how providers interpret and navigate the spatial, structural, and sociocultural conditions influencing care, particularly for groups experiencing intersecting forms of marginalization. Reflexive thematic analysis was used to identify key themes across institutional healthcare settings and community-based supports.<br />Findings: Two overarching themes emerged: (1) SGBV care pathways in a rural context: Fragmentation, stigma, and scope of support, which highlights how institutionally-constrained systems (i.e., emergency and primary care) often operate on crisis-driven thresholds that may not be suited to meet survivors where they are; and (2) Reimagining rural SGBV response through multi-service hubs, which explores integrated, place-based care models as promising but underfunded alternatives. Across interviews, participants emphasized that access is shaped not only by geographic distance and logistical specificities, but by safety, stigma, trust, and relational continuity.<br />Conclusion: This study illustrates how spatial and institutional inequities intersect to limit meaningful access to SGBV-related healthcare in rural contexts. Findings support the development of community-embedded models that respond to the place-based realities of survivors and providers alike, such as rural care hubs.<br /> (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
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| ISSN: | 1873-2054 |
| DOI: | 10.1016/j.healthplace.2025.103572 |