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The rural South is home to a variety of cultural identities, all of which influence the ways in which southerners perceive and access healthcare. This essay touches on racial and ethnological cultural identities within the south which include, but are not limited to: white, Hispanic, and Black. Within each of these racial identities are varying aspects of family dynamics, community, and diet which all play a role in rural southerners’ healthcare choices and attitudes. For some individuals living in the rural south, healthcare means regularly visiting a doctor when they are unwell; others turn to holistic home-remedies and are more hesitant about seeing a provider. These experiences will be explored through the lens of oral histories from the Southern Oral History Program based at UNC. Individuals’ perspectives on healthcare and the treatment methods they employ are deeply intertwined with local socio-cultural elements of the rural American South.

Complementary and Alternative Medicine

Holistic remedies are employed by individuals in the rural South when traditional healthcare systems and treatments are not a choice due to factors such as barriers and preferences. Jon Wardle, a professor of public health, labels such remedies “Complementary and Alternative Medicine [CAM]” and defines them as “a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine (medicine as practiced by holders of MD or DO degrees and by their allied health professionals)” (9). These remedies range from herbal supplements to acupuncture to aromatherapy; a study done in rural North Carolina found that folk medicine/home remedies and vitamin/mineral supplements were the most extensively used Complementary and Alternative Medicine practices among this population” (9). Data from one study on three rural south-central North Carolina countries suggests that Black women use the greatest amount of several home remedies due to their caregiving role and associated knowledge (5). Nancy Holt, a rural southerner of mixed heritage, recalls the root medicine her mother used to treat illness in which she would curate “potions” out of bushes and branches (2). Many such holistic home remedies are the result of traditional practices passed down over generations through southern families (7). In an oral interview, Freddie King, a Black man from rural Dunn, reported using a traditional practice in which he would let a chicken fly over his head in order to cure chicken pox (4).

Data suggests that Complementary and Alternative Medicine practices are most frequently used by high-risk groups living in rural areas, such as older people and ethnic minorities, partly because conventional health services are “stretched in rural areas” (9). The existence of home remedies stems from limited access to traditional (allopathic) healthcare, racial discrimination in the healthcare system, and cultural knowledge of healthcare (5). The use of CAM in rural southern communities might prove beneficial from an economic perspective as many home remedies and other CAM practices are very financially accessible, especially for individuals that cannot afford traditional healthcare.

Cultural Preferences and Community Impact

The positive and negative perspectives that individuals have towards healthcare are shaped by the culture of their community, family upbringing, and the healthcare system. For some individuals, the choice to not regularly see a physician for health concerns stems from close family members’ experiences. Maria Torres, a certified nurse aide from Benson, NC, reveals that she is hesitant to visit the doctor when she falls ill and that this hesitancy has been shaped by her mom’s perspectives of healthcare and their Hispanic culture. She explains, “Well, usually—since I come from a Hispanic family, usually my mom would try to treat me with at-home remedies or something…” (8). She later reveals that these home remedies consisted of electrolyte drinks, VapoRub and lots of teas. Attitudes towards healthcare can also depend on the culture of the local community and connections among individuals. Leslie Culp Rummage, a white woman from Stanly County, highlights the role of community and community perspective in her story of healthcare.

When asked by the interviewer, “Do you feel like this is a healthy community?”, Leslie explains, “I do, but in a rural area, people, like I said, are more focused on physical labor and not as much on exercise. My dad has a lot of breathing problems now, and it’s probably related to the environment he worked in…People in rural areas around here still like fried food, so diet probably is not as healthy” (6).

Health habits such as diet and exercise are shaped by cultural expectations and practices within the local community, especially when the community is tight-nit as it often is in rural areas.

Some individuals, especially minority groups, fear racial stigma that occurs in healthcare and are more likely to delay seeking care. In other cases, “dismissal of culture and traditions as superstitions” interferes with proper treatment and leads to mistrust of the healthcare system in rural areas (1). This is highlighted when looking at prenatal care; in one such study it was found that “partners, female relatives, and community health-workers were among the most influential in promoting negative views, all of which reduced a women’s likelihood to access care during pregnancy” (1). Terry Alston Jerry, a black woman from Warren County, shared, “So I just think that as Black women and Black people, sometimes we’re not seen or heard” when talking about pregnancy and healthcare (3). This demonstrates the importance of community perspective and connections when making medical decisions in the rural south.


The cultural impacts of southern racial and social identities on healthcare preferences and perspectives emphasize the need for comprehensive understanding of background and treatment goals in regards to the patient-provider relationship. These oral histories and other anecdotes highlight the importance for clinicians to understand CAM and cultural preferences in order for patients to be accurately referred to CAM practitioners when necessary and treated with their cultural expectations met. An understanding of the influence of a patient’s culture and community on their relationship with the healthcare system can be very helpful to promote better health in a way that is practical and comfortable for the patient.



1. Coombs, N. C., Campbell, D. G., and Caringi, J. “A qualitative study of rural healthcare      providers’ views of social, cultural, and programmatic barriers to healthcare access”. BMC Health Services Research, 22, 2022, 1-16. doi:

2. Holt, Nancy. Interview with Nicholas Allen. 13 June 2018, Y-0033, in the Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

3. Jones, Terry Alston. Interview with Susie Penman. 11 June 2019, Y-0050, in the Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

4. King, Freddie. Interview with Maddy Kameny. 27 June 2018, Y-0035, in the Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

5. Quandt, S. A., Sandberg, J. C., Grzywacz, J. G., Altizer, K. P., & Arcury, T. A. (2015). Home Remedy Use Among African American and White Older Adults. Journal of the National Medical Association, 107(2), 121–129.

6. Rummage, Leslie C. Interview with Caroline Efird. 15 June 2018, Y-0046, in the Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

7. Sewani-Rusike, C. R., & Mammen, M. (2014). Medicinal plants used as home remedies: a family survey by first year medical students. African journal of traditional, complementary, and alternative medicines : AJTCAM, 11(5), 67–72.

8. Torres, Maria. Interview with Joanna Ramirez. 25 June 2018, Y-0056, in the Southern Oral History Program Collection (#4007), Southern Historical Collection, Wilson Library, University of North Carolina at Chapel Hill.

9. Wardle, Jon, Chi-Wai Lui, and Jon Adams (2012). Complementary and Alternative Medicine in Rural Communities: Current Research and Future Directions. The Journal of Rural Health, vol. 28, no. 1, pp. 101-112.


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