Living rurally creates geographic and socio-economic challenges for women, which negatively affect their health and well-being. Gender ideologies, expectations and practices that assign domestic and familial unpaid care work as "women's work" serve also to disadvantage women. How these ideological and material forces together affect health are difficult to assess with a health determinants model. Drawing from relational theories of place and gender, articulated in geographic and feminist literature, we offer a nuanced relational framework that builds on insights of health determinants explanations but situates women as recipients and providers of care within a "relations of care" context. We discuss how this framework can contribute to a better understanding of rural women's health and well-being. We focus on the context of neo-liberalism and the subsequent restructuring of rural Canadian society but note how our framework is applicable to other high-income nations, such as Finland, Iceland and Norway. We argue that it is critical to consider how contemporary political and ideological changes interact with place and gender relations to affect conditions of dignity for women as recipients and providers of care in rural places. We conclude with suggestions for policy directions.