Hepatitis C and the social hierarchy: How stigma is built in rural communities

Abstract

Although Hepatitis C has profound impacts on individuals living in communities, most research has been conducted in a hospital or laboratory setting. Additionally, there is a lack of research exploring the social effects of Hepatitis C in rural communities. In this qualitative study, we focus on perceptions on Hepatitis C within a rural community, describe how the local residents perceive social hierarchy within their community, and explore the process of stigma building. Informed by a grounded theory approach, we employed a snowball sampling strategy in a southern rural area to conduct in-depth, open-ended interviews. In our findings we describe how local restaurants were often utilized as places to exchange personal opinions on various community issues among the upper hierarchical members, consider the ways social hierarchy influences people’s perceptions, and explore community members’ response to the problem of ignored viral infections within the community. We found the community leaders are earning the trust by living in the community for an extended period of time; therefore, they tend to be elderly yet remain active as members of various committees. Additionally, we argue that the common view of “family-like support” in rural communities is largely a myth; it is a romanticized view of the rural living held and perpetuated by the upper-class people in the community. Therefore, instead of depending on idealized or imaginary social support, rural communities need to consider organizing a system of formal support.