The Social Determinants of Healthcare Access for Rural Elderly Women - A Systematic Review of Quantitative Studies

Mohammad Hamiduzzaman*, Anita De Bellis, Wendy Abigail, Evdokia Kalaitzidis
College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia

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© 2017 Hamiduzzaman et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia; Tel: 00962-796383002; E-mail:



This review aimed to explore and analyze the social determinants that impact rural women’s aged 60 years and older healthcare access in low or middle income and high income countries.


Major healthcare databases including MEDLINE and MEDLINE In-Process, PsycINFO, PubMed, ProQuest, Web of Science, CINAHL and ERIC were searched from April 2016 to August 2016 and a manual search was also conducted. A rigorous selection process focusing on the inclusion of rural elderly women in study population and the social determinants of their healthcare access resulted in 38 quantitative articles for inclusion. Data were extracted and summarized from these studies, and grouped into seven categories under upstream and downstream social determinants.


Prevailing healthcare systems in combination with personal beliefs and ideas about ageing and healthcare were identified as significant determinants. Socioeconomic and cultural determinants also had a statistically significant negative impact on the access to healthcare services, especially in developing countries.


Potentially, improvements to healthcare access can be achieved through consideration of rural elderly women’s overall status including healthcare needs, socioeconomic determinants and cultural issues rather than simply establishing healthcare centers.

Keywords: Healthcare access, Rural elderly women, Social determinants of health, Systematic review, Socioeconomic, Population.