here. - Canadian Women's Health Network

Women, Income andHealth in Manitoba26society over time, because ofdifferences in the structure ofwomen’s employment. For example,in Finland, 90% of women work fulltimethroughout their working life,and their own occupation has astrong influence on their health. 44In Canada, where labour marketparticipation rates among women arelower, and where systemic discriminationmeans that for married women, theirown occupation or earnings may not bereflective of the socioeconomic statusof the family, this is an importantconsideration and one which isdemonstrated in Denton and Walters’finding that occupation was not a strongpredictor of women’s health status.More recently, in her background paperfor the British Independent Inquiry intoInequalities in Health, Sara Arber hasargued for:the importance of using a clearconceptual model of the linkagebetween socio-economic measuressuch as educational qualifications,occupational class, employmentstatus and material resources(such as housing, car ownership andincome) in order to fully understandinequalities in health. It is necessaryto simultaneously analyse all thesefactors using multi-variate models,and for women with partners totake into account both their owncharacteristics and the socioeconomiccharacteristics oftheir partner. 45Researchers in Manitoba may have theopportunity to do this using the results ofthe 1996 National Population HealthSurvey (NPHS). In Manitoba, the provincialgovernment paid for the cost of increasingthe sample size, so that conclusions whichare stronger statistically may be drawnfrom the data. It may be possible to buildon the work of Denton and Walters,specifically for Manitoba, by combining theManitoba NPHS data with ManitobaHealth’s existing health services utilizationdata. This would provide a uniqueopportunity to pursue these questions,and their answers, locally.Like Denton and Walters, Arber lookedat both an objective measure of health(limiting long-standing illness) and asubjective measure of health (selfassessedhealth). She found an interestingdifference between the two measures. Inher study, both car ownership and housingtenure were significantly associated withself-assessed health, but not with limitinglong-standing illness. For both women andmen, those living in public housing andthose with no car in the household reportedpoorer health. She noted that car ownershipwas a particularly salient issue for women’sself-assessed health. 46 She further notedthat “adverse material conditions havea particularly negative effect on selfassessedhealth if women are notin paid employment.” 47In a smaller, in-depth study of women inLiverpool, Ruth Young conducted a “timespaceanalysis” of women’s health-relatedbehaviours, 48 which included factors suchas car ownership and housing status, aswell as income, access to telephoneservice, task sharing within the household,location of employment and access topublic transport. She developed a framework,with four scales of “time-spaceconstraint” which work in concert toinfluence the ability of women to care fortheir own health. These four scales are:1. economic and social resources;2. domestic labour and caring constraint;3. paid employment constraint, and4. individual health status. 49The first three are the result of socioeconomicstatus and the fourth, the healthof the individual woman is correlated withsocioeconomic status. She noted thatwomen are the health managers in a