Using structural equation modeling, this study examined the mesosystemic processes among rural low-income women, and how these processes subsequently influenced self-reported health. Acknowledging the behavioral processes inherent in utilization of health care and formal social support services, this study moved beyond a behavioral focus by shifting attention to the affective and cognitive processes within the mesosystem. Findings from this study demonstrate that behavioral processes alone did not have a direct significant effect on self-reported health problems over time. However, by shifting attention to the affective and cognitive processes, a missing link between service utilization and future reported health emerged. (Contains 1 table, 2 figures and 1 footnote.)