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Largest
Canadian study on rural women's health
finds urban solutions do not address rural problems
Canada's
health system failing women in rural and remote regions
Centres
of Excellence for Women's Health
Press Release
June
8, 2004
The Centres
of Excellence for Women's Health today released the final
report from a two-year study on the health of rural, remote and Northern
women. This is the largest qualitative study in Canada to date
to address the health concerns of this important community.
Rural, Remote
and Northern Women's Health includes data collected from focus
groups and workshops with women from diverse communities across Canada,
including fishers and farmers, and from Aboriginal, Francophone
and Anglophone communities from coast to coast to coast. The report
also draws on data collected from a National Consultation meeting
held in Saskatoon (2003). More than 200 women from rural, remote and
Northern regions in every province and from the territories in Canada
were consulted during the study process.
The rich diversity
of Canada's rural regions shone forth in the study, and despite significant
social, cultural and geographic differences, researchers found common
rural health issues and priorities.
Significant
health gap between Canada's rural and urban women
Study authors
found a general lack of access to health information and access to
health care services for women's health in rural regions. Study participants
noted that current systems for health information are poorly coordinated
and inadequately promoted, while health services are often infrequent,
irregular and limited.
Rural women spoke
of the financial, emotional and social costs from the frequent need
to travel away from home to obtain essential health services. Gas
or flights are expensive, as are hotel rooms, parking, food, childcare
and forfeited income. Traveling for health care is also related to
high levels of stress associated with being away from the family,
especially during a health crisis. Even basic travel costs may not
be covered, depending on the federal, provincial or territorial jurisdiction
responsible.
"These multiple
costs and inconveniences are largely borne by women, as they are often
responsible for scheduling activities, maintaining the home and monitoring
the emotional climate of the family," says study author Rebecca
Sutherns.
The study also
highlights the lack of rural female health practitioners, complementary
health practitioners, or health care individuals trained in cross-cultural
issues. Many rural women spoke of not bothering to seek care until
they were very sick. As a result, appointments for preventive measures
are rarely made. As one study participant noted, "those that
need services fall through the cracks. They have to make their life
emergencies wait."
Good
health for rural women means addressing poverty, not just health care
Poverty and financial
insecurity arising from unemployment or low wage and seasonal work
was highlighted by the study participants as impacting their health
the most. Study author Marilou McPhedran, says that "women and
their families cannot maintain their health in the absence of financial
security."
Women's experiences
of healthy living extend far beyond visits to health care providers.
For example, rural women are disproportionately burdened with poverty
and domestic violence in Canada, with certain groups, such as Aboriginal
women and elderly women being particularly disadvantaged.
The researchers
emphasize that social policies outside of the 'health care silo' -
including finance, labour, social services and transportation, can
have as much influence on health and health status as service provision.
"It's time for health policy to reflect health research by recognizing
that economic and social investments are investments in health,"
McPhedran argues.
Invisible women:
rural women ignored by Canada's policy makers
Margaret Haworth-Brockman,
lead author and Executive Director for the Prairie Women's Health
Centre of Excellence says that "recent health reforms in the
provinces and territories may have disproportionately disadvantaged
rural and remote women."
Rural women, she
believes, are largely invisible to policy makers who operate out of
urban contexts and rarely take into account the perspective of rural
women's lives and concerns. "They are the 'invisible women,'
of health policy" Haworth-Brockman adds, "whose voices and
concerns are rarely heard."
Rural, Remote
and Northern Women's Health is careful not to make the same mistake.
Women interviewed for the study were given the opportunity to share
their major concerns and contribute their insightful solutions to
the health care crisis. From suggestions for local or mobile services,
to embracing a wider range of health practitioners, such as midwives
and nurse practitioners, their creative and thoughtful ideas for the
future form the backbone of the study recommendations.
"This study
demonstrates that including rural and remote women in the policy decision-making
process that directly affects their health, and the health of their
families, is an essential first step," says Haworth-Brockman.
"Many women
told us they had not ever had a chance to speak about what is important
to them. Despite living in very different circumstances, there was
a great deal of similarity in their desire to be heard, to be respected
and to contribute their practical solutions to the health care debates,"
she adds.
"It is time
we listened."
This study was funded by the Women's Health Bureau, Health Canada,
with assistance from the Office of Rural Health, and the Institute
for Gender and Health, Canadian Institutes for Health Research.
Fact Sheet
Rural and Remote
Women in Canada
*Despite the federal
Canada Health Act promising accessibility and universality of health
care provision, rural, remote and Northern Canada remains chronically
under-serviced in terms of acute primary (disease) care and primary
health (well-being) care that includes disease prevention, health
promotion and community health care.
*Over 1 in 5 Canadian
women live in a rural area.
*Rural women have
appreciably lower labour force participation rates, higher fertility
rates and a higher likelihood of being poor than their urban counterparts.
*Canadian women
living in rural communities have a higher risk of dying from motor
vehicle accidents, poisoning, suicide, diabetes and cancer.
*Women in rural
communities are at a higher risk of violence, economic insecurity,
primary industry occupations hazards. Aboriginal women and senior
women are particularly vulnerable.
*Rural research
outside of Canada has shown that rural women have greater family and
community responsibilities due to coming from larger families, starting
their own family earlier, having more children and playing key roles
in family businesses and in community affairs.
*Rural women often
have to travel long distances to obtain health care, and are often
without easy access to transportation; as a result, they are less
likely to use health services.
*Rural women have
limited access to women-centred care. A lack of confidentiality about
services received can be a problem in small communities.
* Women in rural,
remote and Northern areas of Canada often experience triple disadvantage,
because of their gender, their location, and the interactions between
the two. For women facing additional barriers of racism, poverty or
lack of education, the negative health effects can be multiplied further.
*As slightly more
than half of the population of Canada and of rural, remote and Northern
Canada, women are far more than a "special interest group."
They are the majority of voters, health care providers, caregivers
(paid and unpaid). Because women are underrepresented among elected
politicians and other decision makers, their political value is often
ignored.
Source: Rural,
Remote and Northern Women's Health: Policy and Research Directions
Final Summary Report
Prairie
Centre of Excellence for Women's Health
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