Individual perceptions of healthcare inequalities among older people

The article discusses strategies for perception of inequalities in the healthcare among older residents of large cities and rural areas. The study is based on a multi-level approach to investigation of inequalities, with an emphasis on analyzing the features of everyday perception of inequalities in medical care among urban and rural older people. The research methodology includes conducting semi-structured interviews with older people living in St. Petersburg and rural areas of the Republic of Karelia. Based on the thematic analysis, individual strategies for dealing with the existing inequalities were identified, as well as differences in the ways they are accepted and not accepted within each strategy. The results of the study demonstrate that the greatest differences between urban and rural older people are related to the availability and quality of medical care. It is these aspects that form the main inequalities and cause differences in the lives of older people in urban and rural environments. The highlighted strategies show that rural residents are most characterized by acceptance or a neutral attitude towards the emerging inequalities. At the same time, urban residents are more likely to express disagreement with the quality of medical care, and also seek alternative ways to solve the emerging problems, including those related to their legal regulation. The conducted research shows that when developing measures to improve the healthcare system and minimize medical inequalities, it is important to take into account the individual characteristics and personal attitude of older citizens to the medical care. Of particular importance is the need to develop various criteria for assessing and eliminating inequalities applicable in both urban and rural areas.

older people, healthcare, health, inequalities, rural-urban differences