Introduction: Beyond Gender Matters
- Canada has been a model for advances in health care generally and women’s health
- The successes, failures, and contradictions related to women’s health in Canada offer
lessons for improving health as well as a basis for comparative work in other
Women’s health in Canada
- Canada has the ninth highest life expectancy in the world for both sexes, only 2.1
years behind Japan (81.4).
- Although women live longer:
o They die prematurely from largely preventable conditions such as cervical
cancer and lung cancer.
o They die in the prime of life in greater numbers than men, largely because of
breast cancer and other cancers
o They experience higher levels of disability than men
- Life expectancy for high-income women was 1.6 years longer than for low-income
women, and five years longer for men.
- The income gap between the wealthiest and poorest Canadians is widening, with the
proportion of those living in poverty steadily increasing and with people who have
recently immigrated, Aboriginal people and single-parent families at the greatest risk
of living in poverty
- Corporatization and privatization have been touted as both the cause and the answer
to problematic health care resource allocation strategies, increasing acuity of health
care problems, and the declining ability of the health care system to meet the
expectations of Canadians.
Women’s Health and the Canadian Health Care System
- “Access” for women who migrate to Canada is complex and involves multiple barriers
- Among self-employed women, less than half have supplementary health coverage.
- Women on average, earn less than men, have lower incomes and are more likely to
live in poverty, therefore they face greater financial barriers when health care costs
Evolving Theoretical Perspectives on Women’s Health
- Gendered health inequalities and health problems can only be remedied if they are
- The health field requires an understanding in which there is space for a more flexible
and elastic understanding of women and one where the intersections of gender with
other forms of social and material inequity are better theorized.
Sex and Gender
- Gender refers not simply to women and men, but to the relationship between them
and the way it is socially constructed.
Four Approaches to Women’s Health
1. the health of women has often been invisible, and not considered as distinct from the
health of people in general.
2. When women HAVE been considered, often women’s health has been associated
simply with reproductive function 3. Recognition of the limitations of associating women’s health with reproductive
function and the shortcoming of this view within the biomedical paradigm have led to
sex and gender analyses that consider how social circumstances and systematic
gender inequalities profoundly influence women’s lives and health
4. Recognition of the complex influences of the intersections of multiple social
determinants and more sophisticated and complex understanding of concepts such as
sex and gender in relation to women’s health have created new bodies of knowledge
and shifts in policy and programs
Gender Neutral Approaches: Seeing Sex and Gender as Irrelevant
- Women shouldn’t be treated the “same as men” because this makes the health of
women invisible, overlooking the unique needs of a women, and inappropriately
basing women’s health care upon the study of men’s health
- The assumption that a disease or condition and the effects of treatment are the same
for women and men is wrong.
- Especially in CVD, women are still more likely to be misdiagnosed, have greater delay
to treatment, have fewer benefits from treatment, and poorer outcomes
- Canadian women often think that breast cancer is the greatest risk, but CVD is.
Biological and Reproductive Determinism: Seeing Women as Reproductive Beings
- pathologizing refers to seeing a normal process as pathological and medicalization
means that process under the control of medicine. Ex. Menopause
- Women were referred to as fragmented bodies, body parts and diseases, and were
depicted as being passive and silent, thus within the health care system the focus on
women’s health is often on pathophysiology.
Sex and Gender Analysis: Seeing Women as Different from Men
- the importance of differences in experiences of illness is highlighted by the example
of women’s experiences of HIV/AIDS, only recently women’s experiences have been
- Although HIV has been studied in relation to women, such study has been limited, and
programs, policies, and prevention tend to be gender neutral.
- Analyses that take sex and gender into account highlight how biological and social
characteristics and experiences interact to create different effects on women in
relation to a range of health issues such as violence, teen pregnancy and smoking;
Health Canada reported that 31% of women 15-19 smoke compared to 27% of men
of the same age.
- Breast cancer risk itself is increased with smoking
- Smoking also affects women differently than it does men. Ex. Lower fertility, cancer of
the cervix, osteoporosis, and menstrual and menopausal problems
- There are differences between how genders experience and interact with the health
1. Caregivers are mostly women so they interact more with health care
2. When women experience health problems they are often compounded by
their caregiving work
3. Gendered assumptions often shape health care interactions.
- When gender analyses are used in the absence of an understanding of the differences
between sex and gender, and in the absence of attention to the differences among women more widely, the knowledge that is created can be seriously limited in its
Intersectional Analyses: Seeing Differences Among Women
- while one of the areas of greatest difference between women and men is their
respective profiles of mental health disorders differences among women profoundly
affect women’s mental health
- rates and types of mental health problems are influenced most by factors such as
racism and poverty
o ex. Effects of colonialism and residential schooling of Aboriginals
- intersectionality refers to the idea that gender is experienced by women
simultaneously with their experiences of class, race, sexual orientation, size, and
other forms of social difference; intersection between forms of oppression.
- Being subjected to racism compounds poverty.
Women’s Health: Current Issues and Challenges
1. the process of healthcare reform continues without adequate attention being paid to
the gendered effects of such change
2. Canadian federal government has reduced program spending in all policy areas in
ways that are unmatched in any other advanced industrialized nation
3. The commitments and initiatives in the area of women’s health have not been fully
supported politically, adequately resourced or implemented wholly or evenly, and
there are few comprehensive evaluations of their impact and effectiveness. It’s
difficult to determine with any certainty the efficacy of existing health policies
4. The lay public is beginning to think that women’s health has received enough
attention and there appears to be growing resistance and even backlash against
women’s health as a specific field of research
5. Feminists continue to interrogate the concept of women’s health and critique
essentializing tendencies especially the way that feminist health theorizing often has
given gender primacy as a determinant of health over other key determinants.
6. Ways of seeing women and women’s health are kept in place by certain ideologies or
ways of thinking. Liberal