Denmark has a welfare system and relatively small geographical distances. However, the systems are strained, especially in rural areas, which can impact the lives of persons with Spinal Cord Injury (SCI) and increase inequality. This study explores the lived experiences of individuals with SCI living in rural and urban areas regarding their perceived health, quality of life, and integration by applying a phenomenological-hermeneutic approach using reflexive thematic analysis of sixteen semi-structured interviews with persons previously admitted to the SCI Center of Western Denmark. Three themes were developed: Place of Dwelling Matters, Fight for Rights, and Relations Count. Individuals with SCI in Denmark view their place of dwelling as vital. While they report good health and access to hospital care, they face significant challenges in navigating the municipal health and social systems, with wide variations in support. Those in poorer rural areas, often with limited personal and economic resources, experience the greatest unmet needs. Trusting relationships with municipal assessors are essential to ensure health, quality of life, and integration. The strained municipal economy shifts responsibilities to civil society. However, individuals with limited personal skills in rural areas benefit less from these initiatives. Despite equal rights under the welfare state, rural residents face inequalities due to financial constraints and demographic trends. These disparities exacerbate a growing rural-urban divide in personal resources and access to services, highlighting the need for improved organization of the Danish welfare system as the system's limitations disproportionately affect the most vulnerable individuals in rural areas.
Keywords: Inequality; International classification of functioning and disability; Municipal healthcare; Rehabilitation; Rural-urban; Spinal cord injury; Welfare system.
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