Title page for ETD etd-488111769631981

Type of Document Dissertation
Author Lee, Renee Gravios
URN etd-488111769631981
Title Uneasy Tensions in Health Care Delivery in a Rural Appalachian Coal Mining Community: Envisioning Alternative Solutions
Degree PhD
Department Marketing
Advisory Committee
Advisor Name Title
Bailey, Carol A.
Hill, Ronald Paul
Keith, Janet E.
Littlefield, James E.
Ozanne, Julie L. Committee Chair
  • womens health care
  • appalachia
  • empowerment
  • field research
  • feminist
Date of Defense 2000-01-01
Availability unrestricted
Research consistently supports that some

segments of society are at considerably higher

risk for illness and death than the national

average. While the existence and extent of

poor health outcomes for these "vulnerable

populations" are well documented, less

research attempts to explain why such

inequities persist and how they might be

resolved. Thus, many vulnerable individuals fail

to get adequate health care.

How can health care delivery be improved to

better serve those consumers most at risk of

poor health? Addressing this issue requires an

in-depth understanding of the unique health

and social needs of vulnerable consumers and

how these needs are being met (or not met) by

the health care industry. Based on field

research using a variety of methods, this study

examined health care delivery to one at-risk

population, women in a rural Appalachian coal

mining community, with the ultimate goal of

envisioning service design and distribution

strategies that might better serve

disadvantaged populations.

Consistent with the change-oriented goal of

this research, a feminist approach guided this

study. Women's everyday experiences in

managing their health needs were explored

through an analysis of their health care stories.

Health care providers were also interviewed in

order to explore both sides of the service

encounter dyad. The voices of the women and

the providers reveal uneasy tensions in health

care delivery and illuminate why the current

system does not meet the actual health care

needs of the women or their community. A

variety of solutions are offered to improve

health care delivery.

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