Genealogy Tells: Informing Health and Aging Policies Using East Tennessean Older Women's Family Histories, Perceptions, and Experiences of Health Inequity

Older women face unique health inequities challenges. This study aims to provide an understanding of older women’s perceptions and situated experiences regarding the gendered health inequities they face and the social determinants (SDH) thereof. It examines how these health inequities are situated in older women’s genealogical (familial) and geographical health and mortality outcomes histories and how their perceptions and experiences of health inequities and their familial mortality outcomes histories are characterized by the geopolitical and social norms in which they live. The purpose of this project is to present policy and decision-makers with insights about and recommendations from older women on their needs and wants in order to mitigate those health inequities. The data for this study was collected through semi-structured interviews with twelve women in Appalachian East Tennessee. Areas examined include: the women’s perceived impact of federal, state, and local policies and interventions on the participants; the role of social norming and health narratives, particularly stigmatization and discrimination around ageism, sexism, and health marginalization of older women, and the resultant older women’s internalization of health norms; the familial role in health inequities; the usage of family health histories and older women’s genealogies of health and mortality outcomes; and the role of place and place-effects. This study also aimed to examine the place-based and temporal geopolitical, social and cultural norming and social conditioning of older women in relation to their perceptions, attitudes and beliefs. This study sought to determine if these norms impact the participants’ awareness or lack of awareness of their family health histories. This study showed that internalization of these norms, and the replicating of beliefs, attitudes, and perceptions that older women have around health inequities and familial mortality outcomes may be reproduced in their own families. The women provided their own recommendations for ways to mitigate the health inequities they face. This has implications for policymaking and intervention design in co-production with older women in order to mitigate older women’s health inequities.