Health Care Professionals, Rurality, and Intimate Femicide

• DOI: 10.1177/1088767917744592
• Author: Alexis Yohros,Alec Szalewski,Amy Reckdenwald
• Published date: 01 May 2018
• Date: 01 May 2018
• Subject Matter: Articles

https://doi.org/10.1177/1088767917744592

Homicide Studies

2018, Vol. 22(2) 161 –187

© 2017 SAGE Publications

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DOI: 10.1177/1088767917744592

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Article

Health Care Professionals,

Rurality, and Intimate

Femicide

Amy Reckdenwald1, Alexis Yohros2,

and Alec Szalewski1

Abstract

Research demonstrates that disparities exist in access to quality rural health care.

With studies showing that intimate partner violence is more severe and homicide is

more prevalent in rural areas, scholars have begun to turn to the inaccessibility of

health care in these areas as an explanation. The current study sets out to further this

limited body of literature by examining the importance of rurality on the relationship

between the availability of health care professionals and intimate femicide at the

county level. Results indicate that rurality moderates the relationship between the

availability of health care professionals and intimate femicide; however, results are

not as predicted.

Keywords

place, domestic violence, health care access, barriers to services, NVDRS

Introduction

While largely understudied, research has begun to establish the importance of account-

ing for place in the study of intimate partner violence (IPV; DeKeseredy & Schwartz,

2009; Peek-Asa et al., 2011; Weisheit, Falcone, & Wells, 2006), intimate partner homi-

cide (IPH; Gallup-Black, 2005; Jennings & Piquero, 2008), and femicide in particular

(Beyer, Wallis, & Hamberger, 2015; Gillespie & Reckdenwald, 2017; Sinauer, Michael

Bowling, Moracco, Runyan, & Butts, 1999). This small body of research has shown

that rural areas have an increased prevalence or risk of IPV (DeKeseredy & Schwartz,

1University of Central Florida, Orlando, USA

2Northeastern University, Boston, MA, USA

Corresponding Author:

Amy Reckdenwald, Department of Sociology, University of Central Florida, 4000 Central Florida Blvd.,

Howard Phillips Hall, Orlando, FL 32816, USA.

Email: Amy.Reckdenwald@ucf.edu

744592HSXXXX10.1177/1088767917744592Homicide StudiesReckdenwald et al.

research-article2017

162 Homicide Studies 22(2)

2009; Peek-Asa et al., 2011; Websdale, 1998; Weisheit et al., 2006) and higher rates of

IPH (Gallup-Black, 2005; Jennings & Piquero, 2008; Sinauer et al., 1999). Literature

has also shown that rural violence differs in comparison with urban violence (Bouffard

& Muftic, 2006), with the differences for rural women lying in type and severity of the

abuse (Peek-Asa et al., 2011; Websdale & Johnson, 1998), and impacted by character-

istics of rural areas and their residents (Websdale, 1998; Weisheit & Donnermeyer,

2000).

Another body of literature has examined barriers to accessing IPV services in rural

areas (Edwards, 2015; National Rural Health Association, 2002; Peek-Asa et al.,

2011). While this literature highlights the impact of geographic isolation, lack of trans-

portation, service availability, and inadequate training for medical professionals to

recognize and screen for IPV, there is scarce knowledge on the availability of health

care professionals in rural areas in the context of IPV or IPH. One study interviewed

medical staff in rural areas and found that rural providers felt there was a shortage of

staff, funding, and training to effectively combat IPV (Eastman & Bunch, 2007). In a

related line of research, scholars have emphasized the importance of gender inequality

in explaining gendered violence (Whaley & Messner, 2002). It is suggested that high

levels of gender inequality is associated with high levels of gendered violence when

men use violence to control women who are viewed as inferior. Under this view,

increasing gender equality should reduce gendered violence and provide women with

opportunities and resources to leave violent relationships. In contrast, it has also been

argued that increasing gender equality may have a detrimental effect by increasing

violence against women, as men feel threatened by a loss of control (Whaley &

Messner, 2002).

The current study intends to bridge the literatures on gendered IPH and access to

health care professionals while considering the impact of rurality. The importance of

structural gender inequality and economic deprivation will be examined as well.

Specifically, influences of the availability of health care professionals (i.e., physicians,

nurses, and dentists), economic deprivation (i.e., poverty, unemployment), gender

inequality (i.e., income, education, employment), and rurality on females killed by

male intimate partners (i.e., intimate femicide) are examined. The purpose of this

study is to determine the role that rurality plays in regard to health care availability and

intimate femicide.

Literature Review

Place, IPV, and IPH

Battered women in rural areas are often overlooked or ignored in research (Websdale,

1995; Websdale & Johnson, 1998, for review of studies comparing IPV in rural and

urban areas see Edwards, 2015) despite victimization experiences in rural settings

being very different and affected by several key issues such as geography, isolation,

subcultural attitudes surrounding gender, enforcement officers, economic disadvan-

tages, education level, and availability of services (Dudgeon & Evanson, 2014; Neill