"It Shouldn't Be This Hard": Women's Experiences Accessing Health Care While Living With a Low Income

A key standard of the Canadian health care system is reasonable access to health services for all-yet, this remains unfulfilled for many women facing financial hardships. Women living on a low income are more likely to experience anxiety, depression, and harmful health behaviors. While researchers have explored access among equity-deserving women, few have used a narrative approach and none have applied dialogic or performative analysis-a method that examines the interactive nature of storytelling and how narratives function as actions that shape identity and social reality-in a qualitative secondary data analysis about women living in Canada. Interview/focus group transcripts from a primary study about five women were revisited to address the new question: What stories do women living on a low income have about accessing health care services in Kingston, Canada? Participants' accounts were framed as theatrical scenes, portraying structural and emotional dynamics shaping their health care experiences. Core scenes emerged: rejection and exclusion-when access is denied or limited; health care information-when directions fail; and the need for reassurance and trust in relationships with health care providers. Limitations in social determinants (e.g., housing, food access, and transportation) were a through line regarding access, and despite which, participants persisted and adapted. Their stories evidence the pressing need for re-designed systems prioritizing equity, compassion, and clear communication. This study shows the realities of those often overlooked in policy discussions and demonstrates the depth of a narrative approach for revealing how care is lived.