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Healthcare in Rural Areas : Domestication of the Care System and Individual Trajectories Embedded in Kinship Relations (Lorraine, France)

Virginie Vinel, Déborah Kessler-Bilthauer

Research Framework : Throughout all stages of life and across all phases of managing health problems, the family is at the heart of structuring and organizing care pathways.

Objectives : Based on a qualitative research carried out in Lorraine (France), this article intends to examine the influence and actions of family members in the construction of therapeutic trajectories.

Methodology : A socio-anthropological survey of semi-directive interviews was carried out from 2013 to 2015 with 48 people in rural Lorraine. We investigated ‘isolated’ areas and locations with a shortfall of front-line care.

Results : In the population being studied, though individual standard for paths to care has been fully integrated, family ties remain omnipresent. The selection of health practitioners, for example, is made through a progression of regional processes by the family network. The women are implicated in the provision of care for the most fragile and male spouses act in unforeseen cases and during tragic events. Relatives and familial ties are mobilized to provide individuals in need with a system of vigilant monitoring.

Conclusions : Active across multiple therapeutic trajectories, the family environment is a fundamental factor in the management of health and illness. Gender, age, the type of parents, spatial proximity and economic status were all analyzed to reveal the mechanisms within family interventions. These interactions are the product of a complex exchange of gifts and counter-gifts.

Contribution : The senses of unity generated by issues of health are founded through relationships that include couples, family lineages and the weighty contributions of women. Men are also stakeholders in this network of caregiving, playing leadership roles and in the provision of support during worrisome and more unusual cases. Collateral relationships and elective relationships are also active in these situations along more vertical lines including the provision of a looser connection of supervision and through remote caregiving.