Canada's health system
failing women in rural and remote regions
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."
