Printer-friendly versionWomen, health and action
Send to friendWhat makes us healthy?
We all know about fruits and vegetables, but did you know that the 12 determinants of health identified by Health Canada are: income and social status, employment, education, social environments, physical environments, healthy childhood development, personal health practices and coping skills, health services, social support networks, biology and genetic endowment, gender, and culture.1 What kind of society we live in has a huge impact on our health. That's why this health fact sheet isn't just about eating apples, it's about changing the world. It's about women taking control of our own health and our society's health.
Why do we talk about women and health?
For thousands of years, women have been the guardians of health for their families and have tended to be more concerned about health than men.2 Women also make up the vast majority of health sector workers.3 Women have been in the forefront of activism on health issues.
Although women and men have health issues in common, there are also differences. Canadian women have a longer life expectancy than men, which was not always the case. In the past, many Canadian women died in childbirth. Deaths due to complications in pregnancy and childbirth are still common in most parts of the world. More Canadian men than women die in car accidents and by suicide, but more women than men aged 20-44 die of cancer.4 Women report more depression, anxiety, fatigue and poorer health. More women attempt suicide, but more men are successful,5 thought to be due to the effectiveness of the methods they tend to choose (drugs versus firearms). Some women are more prone to ill health and early death than others: Gender interacts with race, disability, income, environment, genetics and a number of other characteristics.6
The continuing unequal social and economic status of women and men in our society has direct consequences on women's health. For example, women are vulnerable to HIV/AIDS because we sometimes lack power in negotiating safe sex, and are more prone to infection through sexual violence, facts that many education campaigns about HIV/AIDS do not take into account. As well, much research on HIV/AIDS has been done on men, even though in developing countries, an equal number of women and men are affected, women have a lower survival rate than men, and women are at higher risk than men from infection through intercourse.7
This fact sheet does not discuss what most people view as women's health concerns: birth control, breast cancer and menopause. There are plenty of resources out there on these topics. Women's health is far more than breast health. In 1994, lung cancer surpassed breast cancer as the leading cancer killer of women. Heart disease and stroke kills more women than cancer of any kind.8 Despite the fact that heart disease is the number one killer of Canadian women, most of the research has been done on men. The result is that heart disease in women is sometimes misdiagnosed by doctors because the symptoms can be different and the disease is associated with men.9 It is important to look at women's whole health, pay attention to gender factors in all matters of health and wellness, and not just view women as walking reproductive systems. Also, health isn't just about disease, it's about well-being. We want to look at some of the other key factors in health, those that aren't talked about much, and what we can do about them.
Income, paid and unpaid work, and health
According to the British Medical Journal, wealth is "the single most important driver of health worldwide, even more important than smoking."10 Study after study finds that your income is the best predictor of your health and life expectancy.11 Even so, the focus of governments has been on the health care system and on changing individual health practices. While these things are important, we also must pay attention to income inequality in order to build a healthy society.
It's easy to see how poverty makes you unhealthy: living in overcrowded and dilapidated conditions in which disease is easily spread; the stresses of poverty and uncertainty leading to unhealthy coping mechanisms and addictions; not having enough money for nutritious food; having no health coverage for prescription drugs and dental care; having to take unpaid time off from a low-paying job to get to the doctor by public transit and then wait for hours because the doctor has overbooked; working at a high-stress, badly paid job in which you have very little control. For example, a fast-growing area of underpaid, stressful employment mainly for women is call centres/telemarketing. A new study found employees run a significant risk of health problems due to psychosocial and work organization stressors at these low-paid, insecure jobs.12
According to studies, the more income you have, the more likely you are to be healthier and live longer.13 The average income for a Canadian woman was $19,800 in 1997, compared with $32,100 for a man,14 which probably contributes to women's poorer health status.15 Many women must also deal with the stresses of having two jobs - one underpaid job at the shop, restaurant or office and one unpaid job at home doing the child care and housework.16 Studies also show that if you live in a society that has a great deal of income inequality (a wide gap between rich and poor), you are likely to be sicker and die sooner than someone making the exact same amount of money or less in a more egalitarian community.17 For example, after decades of growing economic inequality, the rich in Britain now have higher mortality rates for male adults and infants than the poorest Swedes, even though the absolute incomes of the well-off Britons are higher.18 There is something about inequality in societies that kills people.19 In particular, greater gender equality in political participation, economic autonomy, employment and earnings, and reproductive rights is linked to higher life expectancies for both women and men.20
Since health is overwhelmingly affected by income, we need to change the way we think about health policies. Health promotion strategies alone can't be effective: For example, when controlled for cholesterol, smoking, nutrition, and all sorts of other risk factors and lifestyle contributors for heart disease, lower-income people are still far more to die younger of heart attacks.21 We need to realize that anti-poverty programs are also a health policy. Affordable housing policies are health policies. Better access to education, pay equity, and any policy that seeks to eliminate inequality is a health policy too.22
Self-Esteem
Self-esteem (feeling good about yourself) is one of the cornerstones of taking care of your health. Another is having the resources to do it. If you don't care about yourself, you are unlikely to take care of your health. People with low self-esteem are more likely to do things that harm their health, like smoke, drink too much, abuse drugs, and so on. Low self-esteem also has implications for society, and has been identified as a major factor in crime and violence, teen pregnancy and poor school achievement.23 Self-esteem is often related to how you were treated as a child, as well as since then - by your family and by society.
In our society, the self-esteem of women and girls is eroded by conflicting and unrealistic expectations about how we're supposed to look, pressure to be perfect wives and mothers, and at the same time give 100% to our kids and 100% to paid work.24 Particularly at risk are women and girls who experience racism and other forms of hatred, poverty, and structural barriers. Babies are not born with low self-esteem - they are made to feel unworthy, sick, different, defective, bad, stupid, ugly, by the world around them. Some men also suffer from low self-esteem, and this can turn into cruelty and violence.25
Like all health issues, self-esteem is not only an individual issue, but an issue for all of society. It requires not only individual action to recover from the experiences that made us not accept ourselves, but to join with others to change society so that no one is made to feel less than what they are.
Nutrition, health, weight and body image
Sixty percent of high school-aged females are dissatisfied with their bodies. This climbs to 80% for university-aged women. Eating disorders can lead to: loss of menstruation, irregular heartbeats, osteoporosis (a painful disease leading to easily broken bones), depression, kidney and liver damage, heart attack, and death. Profits of the weight loss industry are estimated at $3 billion in Canada.26 Poor body image and destructive dieting practices are not limited to young women. As the title of a book once said, fat is a feminist issue.
On the other hand, the high-fat, low-fibre, junk food, fast food North American diet is literally killing us. Interestingly, although the pressure is mainly on women to lose weight, a greater percentage of Canadian men than women are considered overweight by World Health Organization standards (42% versus 24%).27 Excess weight is related to heart disease, Type 2 diabetes, certain cancers and stroke.28 Industry tries to make us fat and then sell us harmful and ineffective weight loss plans. Fast food chains are the new colonialism. For example, the elders on the island of Okinawa, Japan have the longest and healthy life expectancy in the world, due to their diet of mainly vegetables, rice and fish, daily physical activity, strong spiritual sense of interconnectedness, and positive attitudes toward life, despite experience of war and hardship. The younger people of the island are now showing rates of heart disease and cancer approaching North America's, due to the export of North American fast food chains and ways of life.29
The challenge for feminists is to find a way to promote the respect and acceptance of all people no matter what they weigh or how they look, while continuing to fight against the multibillion dollar food industries that are clogging our arteries with hydrogenated (trans) fats and stripping nutrients and fibre out of foods by refining and overprocessing.30 We wouldn't dream of selling cigarettes in schools, but unhealthy foods that contribute to cancer, heart disease, diabetes and other health problems are routinely marketed to young people and sold in schools.31 The calcium consumption of girls around puberty has a direct effect on whether they will develop osteoporosis after menopause,32 and soft drinks, for example, keep calcium from being absorbed properly.33 Unhealthy eating habits start in childhood.
Industry also spends billions of dollars getting you to think that you can make up for eating poor-quality "low-fat", high-sugar processed foods all day by taking vitamins and supplements. Although certain vitamin pills and supplements can be useful, researchers are still in the process of identifying how nutrients interact, and nothing can replace the amount, quality and balance of nutrients that nature provides in vegetables, fruits, whole grains, beans and soy products.34 Good nutrition is one of the best medicines, but a medicine lower-income people have less access to.
Instead of blaming people who weigh more than the average for individual lack of self-control, we can work together to inform ourselves and others about good nutrition; eliminate snack bar and soft drink vending machines, particularly in schools, or at least make sure there also contain healthy choices such as real juices and fruit; work so that all publicly-funded places such as schools, hospitals and government offices have cafeterias that serve healthy foods; make healthy foods more affordable; and lobby, tax, or sue the companies that market foods that contribute to cancer, diabetes and heart disease.
Physical activity
Physical activity is essential to physical and mental well-being. Physical activity gives you more energy, less stress, better self-esteem, fewer aches and pains, and fights disease. In particular, being active reduces the risk of: heart disease, falls and injuries, obesity, high blood pressure, adult-onset diabetes, osteoporosis, stroke, depression, colon cancer, and premature death. According to Health Canada, inactivity is as harmful to your health as smoking.35 Despite the effect of weight on health, some research shows it may be better to be fat and fit than thin and inactive.36
Most women are working long hours of unpaid and underpaid work and it's hard to make the time for our own health. Federal and provincial government policies that do not adequately support women who care for children or other dependent relatives are affecting women's health.37 As well, there are not enough services for people with disabilities, so they can become as physically active as possible too. Girls are often not encouraged as much as boys to do sports and physical activity, and there are fewer resources for them.
Our cities and culture are not designed for inexpensive physical activity. Sure, gym clubs try to sell you memberships and infomercials try to get you to buy outrageously expensive exercise equipment. But we need cities that are friendly to walkers and cyclists, workplaces where exercise breaks are routine, and a culture that fosters daily physical activity.
We can work together to ensure equal money is spent on girls' and women's sports and recreation in our local schools and community; encourage local shops, schools and workplaces to offer bicycle racks; lobby local government for green spaces, walking trails, bicycle lanes, curbs with ramps for wheelchairs and baby buggies so everyone can get around; build exercise breaks into meetings at work; and lobby for more, not less, physical activity in schools; and invest in our own health and well-being by walking, gardening, dancing or engaging in any affordable or free physical activity we enjoy.
Tobacco and health protection
Smoking causes many health problems, more so for women than men. Some of the major diseases for men and women caused by smoking are: heart attacks and strokes, lung cancer, peripheral vascular disease (leg pain that can lead to gangrene and even loss of limbs), cancer of the mouth, kidney and bladder, cataracts (an eye disease that can lead to blindness), allergies, and asthma. On top of this, women face particular health risks from smoking: cervical cancer, osteoporosis, early menopause, increased risk of heart attacks and stroke (especially if you're taking birth control pills), more difficulty getting pregnant, complications in pregnancy (problems like miscarriage or delivering too early), low birth-weight babies, who often experience health problems of their own.38
This is another area in which transnational corporations have made billions of dollars by marketing a product that harms health. Canada's federal health protection system has come under fire in recent years for not doing enough to protect the health of Canadians, for example in the contamination of the blood system, the safety of breast implants, and the approval of pharmaceutical drugs later found to be dangerous. The issue of toxins and pollutants in certain cosmetics is an international concern.39 Women are taking action on health protection issues40 - check the resource section for more info.
The World Health Organization estimates that poor environmental quality is directly responsible for around 25% of all preventable ill-health in the world today.41 Activists in Canada and around the world are looking at the link between environmental toxins and breast cancer, reproductive and immune disorders.42 We know there is direct relationship between air pollution and premature death from respiratory and heart diseases.43
Many popular household cleaners such as bleaches, oven and drain cleaners, toilet bowl cleansers contain chemicals that are poisonous, catch fire easily, and eat away at your skin. Many of these products have not been tested for how they can affect our health over the long term.44 Guess who does most of the cleaning in most households: women.
Garbage, sewage and toxic messes such as the Sydney tarponds are often located around low-income neighbourhoods, where people can't afford to leave.45 There are particular effects on women of poor physical and social environments around the world.46 A clean environment is a good health policy that saves money and saves lives.47 Everyone deserves fresh air, clean water, and an environment free of pollutants, and these are crucial to long-term health.
Social support, sense of community, spiritual beliefs
Social isolation and loneliness are as great a predictor of disease and premature death as smoking, obesity, lack of exercise and high blood pressure.48 In our society, women do most of the caregiving, both on an underpaid and an unpaid basis: Mothers, wives, nurses, child care workers, home care workers.49 Instead of viewing this work as essential, our society does not value this work and largely sees it as a frill. Without this work, more people would be mentally and physically sick, as being cared for is a basic human need.
We don't know for sure why spiritual beliefs and practices have a positive impact on health: Perhaps it is the sense of community and social support, perhaps the calm and connectedness that comes from meditation or prayer, or from exposure to the values of care, compassion, generosity and leading a healthy life that are prevalent in most religions and mystic traditions.50 These values are also essential at a societal level, for a peaceful, happy and healthy world. Women have criticized major religions for entrenching an unequal status between women and men, and religions have also harmed some people.51 Some are working for change within their spiritual traditions, and others are seeking their own spirituality.
There are actions we can take to build healthy and caring communities. The Healthy Communities Movement works toward communities that provide a clean, safe physical environment; meets the basic needs of all its residents; has residents that respect and support each other; involves the community in local government; promotes and celebrates its historical and cultural heritage; provides easily accessible health services; has a diverse, innovative economy; rests on a sustainable ecosystem.52
Health care systems
Women are the majority of paid workers in the health care system, users of the system, and unpaid family caregivers on whom caring work gets dumped when hospitals shove people out the door and home care services are inadequate.53 Not surprisingly, health care privatization "affects women more and differently from men because of their unique relationship to the health care system."54 The federal government years ago took a huge chunk of money out of health care, replaced only a fraction of it, and a number of provinces followed.55 Now, instead of considering real reinvestment in the system and expanding health and social services to better promote well-being, the government is moving toward privatization and other options that have failed miserably elsewhere.56 Women also make up the majority of low-income people in Canada.57 Any move toward user fees and privatization, which has led to the highest health costs in the world, poor access, poor health and higher death rates in the US,58 may affect women and low-income people most. What we need is more equality, not less.
There has been a shift in the health care system in Canada, toward shorter hospital stays and more drug therapies. As a result, more health care is paid for privately than ever before, leading to huge differences in access, particularly to prescription drugs, dental care and services such as home care.59 Lower-cost natural and alternative health therapies that some people find helpful are also not covered. The consideration of direct marketing of pharmaceuticals to consumers is another issue: Drug companies want to spend billions of dollars to try to convince you that you need their products, instead of adopting health habits that will cut down your risk of disease in the first place, or addressing issues like economic inequality that is at the root of much ill health. Women are taking action on these issues - check out the resource section.
Violence
Violence is a major cause of injury to women, ranging from cuts and bruises to permanent disability or death. In Canada, 43% of women injured by their partners had to receive medical care, and 50% of those injured had to take time off work.60 Women who have experienced physical or sexual abuse, as kids or adults, are at greater risk of health lifelong problems, such as injury, chronic pain, gastrointestinal disorders, anxiety and clinical depression. Violence also undermines health by increasing self-destructive behaviours, such as smoking, and substance abuse.61 Women who have been sexually assaulted and/or battered are significantly more likely than other women to commit suicide.62 Women with disabilities are particularly vulnerable to abuse.63
In addition to experiencing violence as women, some women have experienced violence because of their race or sexual orientation. Poverty can keep women trapped in abusive relationships, as they do not have the money to get their own place. Refugees have often escaped the violence of war, torture or persecution, and this can have a profound impact on their mental and physical health.
Racism and the health of immigrant, refugee and racialized women
Racism itself can cause illness.64 Racism can invoke feelings of powerlessness and low self-esteem,65 which have health consequences. Some groups of women face particular health problems, such as women who are survivors of female genital mutilation (FGM). Sometimes race itself can predispose people to certain illnesses, such as the higher breast cancer risk for Black women66, and diabetes for Aboriginal women.67
Sometimes a complex interaction of race, gender, income, education, language and cultural barriers and access to services puts some women at much greater risk of ill health than others. For example, immigrant women from China living in BC have cervical cancer rates that are twice as high as white women in that area. Only 56% (compared with 67% of all BC women) reported having had a Pap smear in the last two years, and 26% had never had one. Those least likely to have this simple test were women from Mainland China, those who never married, had the lowest levels of formal education, no fluency in English, those with the lowest income, and those having spent the least amount of time in North America.68 The availability of services in your own language from someone who respects you can be a matter of life and death.
Immigrant, refugee and racialized women will not have the same access to health and health care until racism is eliminated and immigrants and refugees have access to the resources they need to become full participating citizens in control of their health.
Aboriginal women
Aboriginal women face much greater rates of heart disease, cancer, suicide, diabetes, tuberculosis, and HIV/AIDS than other women in Canada.69 Racism, higher rates of poverty, loss of self-determination, and the residential school experience combine to affect every aspect of health. From the 1800s to the early 1980s, Aboriginal kids were often forcibly separated from their families and sent to residential schools where many were physically and sexually abused, and beaten for speaking their own language or practicing their spiritual traditions. This resulted in generations who were taught to hate themselves, and who did not learn parenting skills from their own parents, or whose parents were also damaged from the system.70 The effects of loss of control over your political, legal, linguistic, religious, family, and economic systems cannot be underestimated. A recent study showed that Aboriginal teen suicides were highest in communities with little control over their own management, and lowest in communities with self-government.71 Many Aboriginal communities are in the process of healing and retaking control of their destinies. Aboriginal women will not have the same access to health and health care until these issues are resolved.
Women with disabilities
Women with disabilities are often assumed by doctors and others to be asexual, and not asked questions about reproductive health or fertility. Doctors and others often talk past them to their attendants or family members, as if they are not there or unable to understand. Women with disabilities are often assumed to be unhealthy, when disability is not necessarily due to a chronic disease. Women and girls with mobility impairments are often left out of physical activity, when there are activities that could be beneficial to their health. Being disabled and female also skyrockets your chances of being low income and vulnerable to violence,72 both of which have direct health impacts. Women with disabilities will not have equal access to health and health care until we deal head-on with the ignorance, prejudice, hatred and structural barriers faced by people with disabilities.
Lesbian and bisexual women
Many health practitioners assume their clients are heterosexual, and don't ask the right health-related questions. Because of the stigma still associated with being gay, some lesbians and bisexual women avoid getting health care altogether, or go along with the health practitioner's assumption. If they do reveal their sexual orientation, they may not receive appropriate treatment - lesbians are less likely to receive regular pap smears to test for cervical cancer, because doctors assume they are not at risk for sexually transmitted diseases (STDs).73 Stigmatization and social marginalization also means some lesbians and bisexual women may be more likely to engage in behaviours that endanger their health,74 and may be at a disproportionately high risk for obesity and substance abuse, perhaps because food and drugs are used as compensations for the stress and low self-esteem that can accompany having to lead a double life. This marginalization also means a greater risk of violence and suicide. Some physicians even refuse to treat lesbian, gay, bisexual or transgendered people, or tell someone coming in for a medical problem to go home and pray for forgiveness for being gay. Some lesbians and bisexual women may also not have the same coverage as straight people through their partner's private or employer health insurance.75 Lesbian and bisexual women have less access to health and health care because of homophobia.
9th international women's health meeting
Women's health is a world-wide issue, with many women around the world still dying from preventable illness resulting from poverty, lack of social status and power, and lack of access to basic health care. The IWHMs are an international grassroots forum for women who work locally, nationally and globally to deliver and advocate for essential health services and rights for women and girls, based on the recognition that women continue to be marginalized from the mainstream of economic and social life. The 9th International Women's Health Meeting will be held in Toronto from August 12-17, 2002, co-chaired by the Canadian Research Institute for the Advancement of Women (CRIAW) and the Riverdale Immigrant Women's Centre. Two other key partners are the Canadian Women's Health Network and the Réseau québecois d'action pour la santé des femmes. For more info contact: CRIAW at 613-563-0681 or www.iwhm-rifs.org
Resources and opportunities for action
ORGANIZATIONS
Canadian Women's Health Network 1-888-818-9172 TTY: 1-866-694-6367 www.cwhn.ca
Woman-centred health resources, networking opportunities, an e-mail news list and a print magazine.
Canadian Health Coalition (613) 521-3400, ext. 219 www.healthcoalition.ca
Dedicated to enhancing Canada's public health system, stopping the privatization of medicare and cutbacks to health care and health protection, opposing genetically engineered foods, and more.
Centres of Excellence for Women's Health
One of the goals of the Centres of excellence program is to carry out research in collaboration with community agencies, with particular attention to the social and economic determinants of health.
Maritime Centre of Excellence for Women's Health (includes Black Women's Health Project): 1-888-658-1112 www.medicine.dal.ca/mcewh
Centre of Excellence for Women's Health--Université de Montréal: (514) 343-6758 www.cesaf.umontreal.ca
National Network on Environments and Women's Health: (416)736-5941 www.yorku.ca/nnewh/
Prairie Centre of Excellence for Women's Health: Winnipeg: (204) 982-6630, Regina: (306) 585-5727, Saskatoon: (306) 966-8658 www.pwhce.ca
BC Centre of Excellence for Women's Health: (604) 875-2633 www.bccewh.bc.ca
DisAbled Women's Network (204) 726-1406 www.dawncanada.net
A national organization comprised of women with disabilities working to achieve control over their lives.
Pauktuutit Inuit Women's Association (613) 238-3977 www.pauktuutit.on.ca
A national association representing Inuit women in Canada. Publishes resources on violence, midwifery, Fetal Alcohol Syndrome, substance abuse, HIV/AIDS and other health issues.
Aboriginal Nurses of Canada (613) 236-3373 www.anac.on.ca
Professional association for Aboriginal nurses. Engages in advocacy and has publications on Aboriginal healing, traditional medicine, First Nations women working on AIDS, surveys and workshop proceedings.
Canadian Research Institute for the Advancement of Women (CRIAW)
(613) 563-0681 www.criaw-icref.ca
Fact sheets on Violence Against Women and Girls, and Women and Poverty. Available in hard copy or on the web site. Published That Body Image Thing: Young Women Speak Out!
National Action Committee on the Status of Women (416) 932-1718 www.nac-cca.ca
A coalition of more than 700 member groups working for women's equality.
Women's Health in Women's Hands (416) 593-7655 whiwh@web.net
A Toronto-based team of health professionals who work from an inclusive, feminist, anti-racist, anti-oppression framework, specializing in working with immigrant and refugee women particularly women from the Caribbean, Africa, Latin America and South Asia. Produces booklets and resources.
Institute on Race, Health Care and the Law www.udayton.edu/~health
An American organization dedicated to improving the health status of African Americans, Asian Americans, Latino (a) Americans, Native Americans, and Pacific Americans by helping legislators, policy makers, lawyers, health care professionals and consumers examine race, health and human rights. Lots of resources, including on women's health and female genital mutilation.
Réseau québécois d'action pour la santé des femmes (514) 877-3189 www.rqasf.qc.ca
Fact sheets and resources on health from a feminist perspective.
Ontario Healthy Communities Coalition 1-800-766-3418 www.opc.on.ca/ohcc
Publishes Healthy Environment, Healthy Communities Tool Kit.
Canadian Association for the Advancement of Women in Sport
(613) 562-5667 www.caaws.ca/english/index.htm
Promotes gender equity in sports and physical activity, and publishes many resources.
Centre for Science in the Public Interest (613) 565-2140 www.cspinet.org/canada
A North American non-profit, consumer organization doing research and advocacy on nutrition and health, with particular attention to the nutritional deficiency of fast foods. Publishes Nutrition Action Healthletter.
DES Action Canada 1-800-482-1DES www.web.net/~desact
Seeks to prevent further tragedies such as the health problems created by the federally sanctioned use of the drug DES to prevent miscarriage, by providing information and lobbying to strengthen Canada's health protection system.
National Eating Disorder Information Centre (416) 340-4156 www.nedic.on.ca
Institute of Gender and Health www.cihr.ca/institutes/igh
A new virtual institute that finances research on how sex and gender interact with other factors to influence health.
WEBSITES
Women's Health Matters, Sunnybrook and Women's College Health Sciences: www.womenshealthmatters.ca
A searchable website, with women's health news.
Canadian Health Network www.canadian-health-network.ca
An internet-based health information service funded by Health Canada, with links to credible health sources.
Aspects of Women's Health from a Minority/Diversity Perspective, paper by Dr. Glenda Simms
www.hc-sc.gc.ca/canusa/papers/canada/english/minority.htm
Healthy World On-line www.healthy.net
Extensive health information and links.
Active Living www.hc-sc.gc.ca/hppb/fitness/activeliving.htm
Suggestions about individual and community approaches to increasing physical activity.
Medscape Women's Health Page www.medscape.com/Home/Topics/WomensHealth/womenshealth.html
The latest in medical journal articles on women's health. Free, but you must register to use this site.
Nutrition Navigator, Tufts University School of Nutrition Science and Policy http://navigator.tufts.edu/
Rates mainly American and Canadian nutrition web sites for accuracy, and suggests the best.
Alternative Health News Online www.altmedicine.com
A collection of informative alternative health sites on the internet.
Caregiver Survival Resources www.caregiver.com
Online version of Caregiver magazine. Includes searchable archives and a discussion forum.
PUBLICATIONS
Women and Health Care Reform A fact sheet from the National Coordinating Group on Health Care Reform and Women, available at www.cwhn.ca/health-reform/index.html or 1-888-818-9172.
Our Bodies, Ourselves for the New Century, by Boston Women's Health Book Collective. (New York: St. Martin's Press, 1998) This book created by and for women approaches health from a holistic and political perspective.
Revolution from Within: A Book of Self-Esteem, by Gloria Steinem (New York: Little, Brown & Co., 1992)
Documenting Visibility: A Selected Bibliography of Lesbian and Bisexual Women's Health, by J Luce with J Neely, T Lee & A Pederson (Vancouver: BC Centre of Excellence for Women's Health, 2001). Available in electronic and print versions. (604) 875-3793 www.bccewh.bc.ca/bib.htm
The Complete Idiot's Guide to Women's Health for Canadians, by Sherry Torkos. (Toronto: Alpha Books, 2001)
Women's Voices in Health Promotion, by M Denton, M Hadjukowski-Ahmed, M O'Connor & I U Zeytinoglu. (Toronto: Canadian Scholar's Press, 1999) www.cspi.org/books
Newsletter of the Women's Network on Health and the Environment (416) 928-0880 weed@web.net
CIHR 2000: Sex, Gender and Women's Health, by L Greaves. (Vancouver: BC Centre of Excellence for Women's Health, 2000) About sex, gender and women's health in health research. Available at www.cwhn.ca/resources/cihr2000/index.html, or 1-888-818-9172.
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Endnotes
1. Health Canada, Health Canada's Women's Health Strategy (Ottawa: Minister of Public Works and Government Services Canada, 1999) p. 13. Also at: www.hc-sc.gc.ca/pcb/whb
2. Statistics Canada, How Healthy are Canadians? Health Reports, 12(3) 2001.
3. Statistics Canada, 1996 Census: Labour Force Activity, Occupation and Industry, Place of Work, Mode of Transportation to Work, Unpaid Work, The Daily, March 17, 1998.
4. Health Canada, 1999.
5. Health Canada, Working Together for Women's Health, A Framework for Women's Mental Health. (Ottawa: Health Canada, 1993) p. 30.
6. Health Canada, 1999.
7. Health Canada, Health Issues Snapshots. (Ottawa: Women's Health Bureau, Health Canada, 2000) Posted at: www.hc-sc.gc.ca/women/english/snapshots.htm#body
Date last modified: 17 July 2000
8. Health Canada, 1999.
9. Health Canada, 1999, p. 15.
10. Andrew Haines and Richard Smith, Working together to reduce poverty's damage, British Medical Journal, (22 Feb 1997) vol. 314, p.529.
11. Dennis Raphael, Health inequalities in Canada: Current discourses and implications for public health action, Critical Public Health, 10, no. 2 (2000): 193-216; Pat Armstrong, Hugh Armstrong and David Coburn, Unhealthy Times: Political Economy Perspectives on Health and Care (Oxford: Oxford University Press, 2001); Dennis Raphael, Health effects of economic inequality, Canadian Review of Social Policy, 44(1999): 25-40; JA Auerbach and BK Krimgold, Income, socioeconomic status, and health: Exploring the relationships (Washington, DC: National Policy Association, 2001); I. Kawachi, BP Kennedy, and RG Wilkinson (Eds.), Income Inequality and Health (New York: New Press, 1999); RG Wilkinson and M. Marmot (Eds.), Social Determinants of Health: The Solid Facts (Copenhagen: World Health Organization, 1998) www.who.dk/healthy-cities; D. Acheson, Independent Inquiry into Inequalities in Health (London, UK: Stationary Office, 1998) www.official-documents.co.uk/document/doh/ih/contents.htm; David Ross and P Roberts, Income and Child Well-Being: A New Perspective on the Poverty Debate (Ottawa: Canadian Council on Social Development, 1999); Monica Townson, Health and Wealth (Ottawa: Canadian Centre for Policy Alternatives, 1999); US Department of Health and Human Services, Socioeconomic Status and Health Chartbook in Health, United States, 1998: www.cdc.gov/nchs/products/pubs/pubd/hus/2010/98chtbk.htm; M. Bartley, D. Blane, and S. Montgomery, Health and the life course: Why safety nets matter, British Medical Journal, 314(1997): 1194-96; D. Coburn, Income inequality, lowered social cohesion, and the poorer health status of populations: The role of neo-liberalism Social Science and Medicine 51(2000): 135-146; JW Lynch, G. Davey Smith, GA Kaplan, and JS House, Income inequality and mortality: Importance to health of individual income, psychosocial environment, or material conditions, British Medical Journal 320 (2000):1200-04.
12. Carol Putnam, Anne Fenety and Charlotte Loppie, Who's on the Line? Women in Call Centres Talk about Their Work (Halifax: Maritime Centre of Excellence for Women's Health, 2001)
13. See endnote # 11.
14. Statistics Canada, Women in Canada 2000: A Gender-Based Statistical Report (Ottawa: Minister of Industry, 2000) p. 135.
15. Health Canada, 2001.
16. Health Canada, 1999.
17. RG Wilkinson, Unhealthy Societies: The Afflictions of Inequality (New York: Routledge, 1996); JR Kaplan, E. Pamuk, JW Lynch, JW Cohen, and JL Balfour, Income inequality and mortality in the United States, British Medical Journal 31(1996):1037-45; BP Kennedy, I. Kawachi, R. Glass, and D. Prothrow-Stith, Income distribution, socioeconomic status, and self-rated health in the United States: Multi-level analysis, British Medical Journal 317(1998):917-21; JW Lynch, GA Kaplan, ER Pamuk, R Cohen, C Heck, J Balfour, and I Yen, Income inequality and mortality in metropolitan areas of the United States, American Journal of Public Health 88(1998):1074-80.
18. DA Leon, D. Vagero, O. Otterblad, Social class differences in infant mortality in Sweden: A comparison with England and Wales, British Medical Journal 305 (1992):687-91; D. Vagero and O. Lundberg, Health inequalities in Britain and Sweden, Lancet 318(1989):1-5.
19. Some suggest this is at least partly because weakened social safety nets and malaise created by the lack of social cohesion in unequal societies, which also results in more violent crime, alcoholism, and a number of other signs of social disintegration as well as poorer health for all, including the wealthy. An excellent overview article on this is Dennis Raphael, From increasing poverty to societal disintegration: How economic inequality affects the health of individuals and communities, in P Armstrong, H Armstrong and D Coburn (Eds.) Unhealthy Times: Political Economy Perspectives on Health and Care (Oxford: Oxford University Press, 2001) pp. 224-246.
20. Kawachi I, Kennedy BP, Gupta V, Prothrow SD, Women's status and the health of women and men: a view from the States, Social Science & Medicine 48, no.1 (1999):21-32.
21. MG Marmot, Social inequalities in mortality: The social environment, in RG Wilkinson (Ed.) Class and Health: Research and Longitudinal Data (London: Tavistock, 1986)
22.For example, in a comparative study of 18 industrialized nations, researchers found that progressive public policies, such as universal family benefits, are directly related to lower infant mortality: I Wennemo, Infant mortality, public policy and inequality - a comparison of 18 industrialised countries 1950-85, Sociology of Health and Illness 15(1993): 429-46.
23. Findings of California's statewide Task Force to Promote Self-Esteem, discussed by Gloria Steinem, Revolution from Within: A Book of Self-Esteem ( Boston: Little, Brown and Company, 1993) pp. 26-29. She cites several examples of the Task Force's positive effects: "In one school district that addressed self-esteem among teachers...those who said they planned to retire dropped from 45 percent to 5 percent in one year. In a high school that explored connections between self-esteem and unwanted teenaged pregnancy, the number of such pregnancies fell over three years from 147 to 20. In a mostly Hispanic school district that was also the poorest per capita in the state, student discipline problems fell by 75 percent after self-esteem became a subject of discussion."
24. Gloria Steinem, Revolution from Within: A Book of Self-Esteem ( Boston: Little, Brown and Company, 1993)
25. Steinem, p. 258.
26. Health Canada, 2000.
27. Statistics Canada, 2001, p.17.
28. Statistics Canada, 2001, p.16.
29. Bradley Willcox, Craig Willcox, and Makoto Suzuki, The Okinawa Program (New York: Clarkson Potter, 2001)
30. Nutrition Action, a newsletter of the Centre for Science in the Public Interest, is a good resource on the nutritional contents of fast foods, and how food contributes to health and ill health. See our resource section.
31. It is well-established that high-fat, low fibre foods (e.g. french fries, hamburgers, hot dogs, fried chicken, chips) and sugar-laden foods (e.g. chocolate bars, cookies, soda pop, sugar-added fruit drinks) eaten in large quantities over long periods of time can lead to poorer health, not just because they contribute low amounts of nutrients per calorie, but also because they displace the consumption of lower fat, high fibre foods rich in antioxidants (cancer-fighting agents) and nutrients, such as vegetables, fruits, whole wheat pasta and bread, other whole grains, beans, and soy products. The typical North American diet is hazardous to our health: Jane Brody, Jane Brody's Nutrition Book (Toronto: Bantam, 1987); US Department of Agriculture, US Department of Health and Human Services, Nutrition and Your Health, 4th edition (Washington, DC: US Government Printing Office, 1995)
32." The density of your bones ... will depend, in part, upon the extent of your calcium intake as a child. The greater this peak bone mass, the less likely your bones are to become porous and fragile later on." Osteoporosis Society of Canada, www.osteoporosis.ca/OSTEO/D02-01b.html#aging
33. Jane Brody, Jane Brody's Nutrition Book (Toronto: Bantam Books, 1987) p. 184.
34. Jane Brody, Jane Brody's Nutrition Book (Toronto: Bantam Books, 1987) p. 184; Richard Harkness, Everything You Need to Know About Reducing Cancer Risk (Prima, 1999);Bonnie Liebamn, "How to cut your risk of diabetes", Nutrition Action 28, no. 4 (2001):1-8; Victoria Dolby, All About Soy Isoflavones and Women's Health (New York: Avery: 1999).
35. Canadian Society for Exercise Physiology, Health Canada, and the Active Living Coalition of Older Adults, Canada's Physical Activity Guide to Healthy Active Living for Older Adults (Ottawa: Health Canada, 1999) www.hc-sc.gc.ca/hppb/paguide/older/index.html
36. S, Blair et al., "Influences of cardiorespiratory fitness and other precursors on cardiovascular disease and all-cause mortality in men and women," Journal of the American Medical Association, 276, no.3 (July 17, 1996): 205-10.
37. Marika Morris, Jane Robinson, Janet Simpson, The Changing Nature of Home Care and its Impact on Women's Vulnerability to Poverty (Ottawa: Status of Women Canada, 1999)
38. Health Canada, Back Talk Facts, Module #3, www.hc-sc.gc.ca/hppb/tobaccoreduction/publications/media/btalk3/fctbkfin...
39. Ephrat Livni, "Cosmetic toxins studied", ABC News Nov. 28, 2000: Coverage of a report by a US Environmental Working Group about the dibutyl phthalate content of certain cosmetics, and the prevalence of high levels of DBP particularly in reproductive-age women, tested by the US Centers for Disease Control.
40. The Working Group on Women and Health Protection is concerned and active on the overmedicalization of women's health, changes to the Food and Drugs Act, direct-to-consumer drug advertizing and the adverse drug reactions reporting program: www.web.ca/~desact
41. World Health Organization, "Health and environment in sustainable development: 5 years after the Rio Summit", Press release, 18 June 1997. www.who.int/archives/inf-pr-1997/en/pr97-47.html
42. Greenpeace campaigns: Persistent Organic Pollutants (POPs): 1-800-320-7183 www.greenpeacecanada.org/e/campaigns/toxics/POPS.html
43. Judith Macphail, The Health Effects of Ground-Level Ozone, Acid Aerosols & Particulate Matter (Ottawa: Ontario Medical Association, 1998)
44. Ontario Healthy Communities Coalition, Environmental Health / FAQs (Fact sheet prepared for the Canadian Health Network, 1999) www.canadian-health-network.ca/html/faq/chntopiccategory_8e.html
45. For background on the Sydney Tar Ponds: Sierra Club of Canada, Sydney Tar Ponds Fact Sheet: Nightmare on Frederick Street (1998) www.sierraclub.ca/stp
46. J. Sims, An Anthology on Women, Health and Environment (Geneva: World Health Organization, 1994) www.who.int/environmental_information/Women/women_health_and_environment... This resource comes with a teacher's guide.
47. Bruce Armstrong, Chemoprevention (Kings Cross, New South Wales, Australia: Cancer Control Information Centre, on World Health Organization site, May 16, 2001, www.who.int/ncd/cancer/publications/abstracts/abs9810_03.html)
48. Lisa Berkman, Social support, social networks, social cohesion and health. Social Work Health Care, 31, no.2 (2000): 3-14; TA Glass, CMde Leon, RA Marottoli and LF Berkman, Population based study of social and productive activities as predictors of survival among elderly Americans. British Medical Journal 319, no. 7208 (Aug 21 1999): 478-83; Dean Ornish, Love and Survival (New York: HarperCollins, 1998)
49. For the stats on women's paid and unpaid work: Statistics Canada, Women in Canada 2000: A Gender-Based Statistical Report (Ottawa: Minister of Industry, 2000)
50. GK Jarvis and HC Northcutt, Religion and differences in morbidity and mortality, Social Science and Medicine 25(1987):813-24; DA Matthews and DB Larson, The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects, vol. 3 (Rockville, Maryland: National Institute for Heallthcare Research, 1995)
51. An overview of clinical studies about the effects of spirituality on health found that religious participation was beneficial to healing 81% of the time, neutral 15% of the time, and harmful 4% of the time. Religious doctrine that leads to fear, guilt, shame, lowered self-esteem, intolerance, obsession, or perfectionistic expectations will have negative effects on physical and mental health: DA Matthews and DB Larson, The Faith Factor: An Annotated Bibliography of Clinical Research on Spiritual Subjects, vol. 3 (Rockville, Maryland: National Institute for Heallthcare Research, 1995); BJ Willcox, DC Willcox and M Suzuki, The Okinawa Program (New York: Clarkson Potter, 2001): Chapter 11 gives an overview of clinical studies on spirituality and health, and describes the female-led spiritual practices of the elders of Okinawa, Japan, who are said to have the longest life expectancies and best health in the world.
52. Ontario Healthy Communities Coalition, What Is a Healthy Community? No date. www.opc.on.ca/ohcc/
53. National Coordinating Group on Health Care Reform and Women, Women and Health Care Reform. Fact sheet. (Ottawa: Centres of Excellence for Women's Health Program, Health Canada, 2000)
54. Quote is from: Centres of Excellence for Women's Health, Research Bulletin, Volume One Number Two, Winter 2001. Other evidence: S. Cameron, M. Horsburgh & M. Armstrong-Stassen, Effects of Downsizing on Rns and RNAs in Community Hospitals. Working Paper #96-6. McMaster University and University of Toronto Quality of Nursing Worklife Research Unit, Hamilton and Toronto, 1994; AFEAS, Denyse Coté, Éric Gagnon, Claude Gilbert, Nancy Guberman, Françine Saillant, Nicole Thivierge, and Marielle Tremblay, Who Will be Responsible for Providing Care? The Impact of the Shift to Ambulatory Care and of Social Economy Policies on Québec Women (Ottawa: Status of Women Canada Policy Research Fund, 1998); Jane Aronson and Sheila Neysmith, The retreat of the state and long-term care provision: Implications for frail elderly people, unpaid family carers and paid home care workers, Studies in Political Economy 53(Summer 1997); Evelyn Shapiro, The Cost of Privatization: A Case Study of Home Care in Manitoba (Ottawa: Canadian Centre for Policy Alternatives, 1997).
55. Federal cash transfers to provinces for health won't return to what they were in 1993/94 until 2002/03, despite escalating costs and a greater demand for health services due to an aging population. Canadian Healthcare Association, Press Release: Federal Economic Statement ignores opportunity to immediately increase urgently needed funding for system, Canadian Healthcare Association says . (Ottawa: CHA, October 18, 2000)
56. P Armstrong, H Armstrong and C Fuller, Health Care, Limited: The Privatization of Medicare (Ottawa: Canadian Centre for Policy Alternatives, 2000)
57. Statistics Canada, 2000.
58. The US has the highest per capita spending on health care as a percentage of the gross domestic product (GDP), and also the industrialized country with the highest proportion of private health spending: Canadian Medical Association, "Health Care Budget 1999," Presentation to the House of Commons Standing Committee on Finance, pre-budget consultations, September 22, 1999; There are 43 million Americans with no health coverage: 1997 data from US Bureau of the Census: Household Economic Studies. Table146: Persons without health care coverage by geographic division and State: United States selected years 1987-97. Posted at National Center for Health Statistics, Centers for Disease Control and Prevention, Fastats A-Z, Health Insurance Coverage: www.cdc.gov/nchs/fastats/pdf/hu99t146.pdf ; Canada/US life expectancy comparison: Organisation for Economic Co-operation and Development, OECD in Figures (Paris: OECD, 1999) Health status table available at: www.oecd.org/publications/figures/1999/E_10-11_Health_Status.pdf
59. Armstrong et al, 2000.
60. Karen Rodgers, Wife assault: The findings of a national survey, Juristat 14, no.9 (1994).
61. Lori Heise, Mary Ellsberg and Megan Gottemoeller, Ending violence against women, Population Reports, Series L, no. 11 (Baltimore: John Hopkins University School of Public Health, Population Information Program, December 1999)
62. Heise, Ellsberg and Gottemoeller, 1999.
63. Jillian Ridington, Beating the Odds: Violence and Women with Disabilities (DisAbled Women's Network, 1989)
64. See Nancy Kreiger and Stephen Sidney, "Racial Discrimination and Blood Pressure: The CARDIA Study of Young Black and White Adults," American Journal of Public Health 86, no. 19 (Oct. 1996):1370-378; Wornie L. Reed, "Suffer the Children: Some Effects of Racism on the Health of Black Infants," in Peter Conrad and Rochelle Kern (Eds.), The Sociology of Health and Illness: Critical Perspectives (New York: St. Martin's Press, 1994), pp. 314-27, quoted in Boston Women's Health Book Collective, Our Bodies, Ourselves for the New Century (New York: Touchstone, 1998) p. 683.
65. Josephine Enang, Mothering at the margins: An African-Canadian immigrant woman's experience, Canadian Women's Health Network (Spring 2001), pp. 7-8. www.cwhn.ca
66. CL Kosary, LAG Ries, BA Miller. (Eds.) (1995) SEER Cancer Statistics Review. Bathesda, MD: US Department of
Health and Human Services, Public Health Services, National Institutes of Health, National Cancer Institute.
67. Statistics Canada, 2000, p. 254.
68. T Gregory Hislop, Chong Teh, Agnes Lai, Tove Labo and Victoria M. Taylor, Cervical cancer screening in BC Chinese women, BC Medical Journal 42, no. 10 (December 2000):456-460.
69. Statistics Canada, 2000, p.254.
70. Canadian Panel on Violence Against Women, Changing the Landscape: Ending Violence-Achieving Equality (Ottawa: Minister of Supply and Services Canada, 1993) pp. 143-192.
71. MJ Chandler and CE Lalonde, Cultural continuity as a hedge against suicide in Canada's First Nations, Transcultural Psychiatry 53, no. 2 (1998): 193-221.
72. Poverty: Statistics Canada, Women in Canada: A Statistical Report, 3rd edition (Ottawa: Minister of Industry, 1995) p. 166; Violence: Ridington, 1989.
73. Health Canada, 2000.
74. Young female intravenous drug users who have sex with women are at greater risk of HIV infection than other young women injectors, according to results of a study conducted in five US cities, presented at the 12th International Conference on Harm Reduction. The researchers believe that stigmatization and social marginalization contributes to the increased likelihood that this group of women will engage in high risk behaviours. For more information, see the summary on the Medscape site at http://womenshealth.medscape.com/36134.rhtml?srcmp=wh-041301
75. Hope Vanderberg, Conference Summary: Are LGBT Patients Receiving Adequate Healthcare? American Medical Student Association 51st Annual Convention March 28-April 1, 2001 Anaheim, California.