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Women, Income andHealth in Manitoba322. Inhibiting and facilitating factors –Several elements inhibited the womensurveyed from having Pap tests. Theseincluded: travel away from their homecommunities, lack of knowledge ofdoctors who were receptive to theAboriginal people, and the feeling thatdoctors’ offices and clinics were coldand uninviting or located in unsafeneighbourhoods. Most womenreported that health care workers(male doctors, nurses) were insensitiveand that “sometimes a negative oreven discriminatory attitude [wasshown] to a person of FirstNations ancestry”.3. Health practices and supports –Most of the women surveyed indicatedthat they obtained most of their healthrelatedinformation from friends andfamily, rather than from health careprofessionals. Some of the womenalso reported that health preventionwas an “abstract concept and has anegative health focus…[while] healthpromotingknowledge and practicesfocus on staying healthy and are apositive approach that providespotential for greater personal controlin making choices.” 67First Nations and Inuit people surveyed forthe First Nations and Inuit Regional HealthSurvey also provided information aboutaccess to health services. The authorsfound that:A vast majority of First Nations andLabrador Inuit people had stated thatthey do not have the same level ofhealth services as the rest ofCanadians... Only 29% of peoplewith activity limitations, compared to35% of people with no limitations,agreed that they have the samelevel of health services. 685.5 KEY INFORMANT INTERVIEWSThe Aboriginal women who wereinterviewed for this paper also providedinformation and insights about these issues.Unemployment and the lack of employmentequity were identified as factors contributingto poverty among Aboriginal women. It wasnoted that single mothers in particular faceunemployment as an obstacle.High rates of domestic violence and abuseof all kinds were seen as serious forms ofinequality faced by Aboriginal women.Women who were interviewed explainedthat often abused women have nowhere togo and no one to protect them. They notedthat people will often deny or ignore theissue of domestic violence and choose topretend that the problem does not exist.The lack of treatment centres specificallydesigned for Aboriginal women wasidentified as another health care inequality.One example given was that of a womanwho was in need of alcohol addictiontreatment but could not receive the helpshe needed as her former abusive partnerwas situated at the only treatment centrein her area.Susceptibility to gambling addictions as aresult of poverty was identified as aninequality. Several women cited bingoas being a source for serious gamblingaddiction among Aboriginal women.Gambling addictions further aggravate theimpoverished situations of these womenwho are already unable to purchase basicnecessities. They described these womenas not able to afford bingo, but addicted to it.The rapid growth of cases of HIV amongheterosexual Aboriginal women was alsoidentified as a very urgent health issue.Environmental degradation was alsoidentified as a form of inequality faced byAboriginal women. One woman explainedhow environmental damage due to floodingcaused by hydro-electric dams hascontributed to increased morbidity andmortality among Aboriginal women.Traditional foods eaten by Aboriginalpeople were nutritious and not refined orprocessed, e.g. wild meat, fish, wild rice,
marsh potatoes, berries, etc. As a result ofenvironmental degradation, many of thesefoods are no longer readily available toAboriginal peoples. Subsequently, thechanges in diet from traditional toprocessed foods has contributed to diseaseand death. Further, they stated that manywomen in First Nations communities do nothave access to clean, safe drinking wateras a result of pollution, flooding andinadequate water treatment facilities.One woman stated that the biggestinequality is that “nobody wants to listento what an Aboriginal women has to sayabout her own health. If an Aboriginalwoman points to her left arm and says,‘it hurts’, they will say ‘no, it hurts righthere – and point to her right arm.”Finally, another woman made thefollowing comment, “I don’t even havethe words to describe the inequalities thatexist in the health care system forAboriginal women...”6. Stress and Socio-economic StatusWhile a detailed examination of theliterature on stress and socio-economicstatus is beyond the scope of this paper,it is interesting that one of the apparentdiscrepancies in the literature on genderand inequalities in health is the questionof stress. In a 1994 report to the HealthPromotion Directorate of Health Canada,using data from the 1990 Health PromotionSurvey, Vivienne Walters, Rhonda Lentonand Marie McKeary found that women inhigher income groups were more likely toperceive their lives as stressful thanwomen in lower income groups. 69 Thiswas consistent with earlier work done byWalters and Denton in the Hamilton area. 70In the 1994 report, they also found thatwomen with lower levels of education hadless stress than women with a universityeducation. 71 Understanding these findingswill require in-depth interviews with womento understand how the term “stress” isunderstood, and how those understandingsdiffer culturally and in women with differentlevels of education and income.Women, Income andHealth in Manitoba337. Health and the SocioeconomicStatus of Older WomenMost studies of socioeconomic inequalitiesand health have only examined workingage populations. In her background paperprepared for the British IndependentInquiry into Inequalities in Health, SaraArber commented on the relative lackof attention paid by researchers toinequalities in both women’s health andthe health of older people, as follows:The relative neglect of inequalitiesamong these two major populationgroups may be seen as reflecting bothsexism and ageism. One reason forthis relative neglect is that theconventional measures of class areoften seen as being not applicable forsections of the population who arenot currently in paid employment.However, our research shows starkinequalities in health based on thelast main occupation of women andmen for each age group, includingage 85 and over. 72 (emphasis added)The Final Report of the IndependentInquiry contains a summary of the factorswhich contribute to poor health amongolder women, including:1. Older women have a higherlow income rate than older men.2. Low income decreases their chancesof maintaining autonomy and
Page 1 and 2: WOMEN, INCOME ANDHEALTH IN MANITOBA
Page 3 and 4: TABLE OF CONTENTSPageA. EXECUTIVE S
Page 5 and 6: EXECUTIVE SUMMARYTHE LINK between p
Page 7 and 8: Women, Income andHealth in Manitoba
Page 9 and 10: B. INTRODUCTIONMuch work has been d
Page 11 and 12: Consistent with the majority of soc
Page 13 and 14: Health and Well-Being of Children i
Page 17 and 18: members of different visible minori
Page 21 and 22: 3. How has the connection between i
Page 23 and 24: E. INCOME AND THE HEALTH OF WOMEN -
Page 27 and 28: majority of British households,rega
Page 31: The following chart, based on a cha
Page 35 and 36: opportunities for women may beone o
Page 37 and 38: 2. Manitoba Data - Income and Healt
Page 39 and 40: CHART 3HEALTH CARE EXPENDITURES ON
Page 41 and 42: 3. What Does This Mean?As in other
Page 43 and 44: procedures. It is noteworthy that t
Page 45 and 46: 2. The Commonwealth Secretariat -Mo
Page 49 and 50: H. MAKING PUBLIC POLICY HEALTHIER F
Page 51 and 52: against women and its consequences
Page 53 and 54: 3.3 CHILD TAX BENEFITThe Government
Page 55 and 56: Household Basic Rent Rent Including
Page 57 and 58: If RHAs are open to suchcollaborati
Page 59 and 60: APPENDIX 1:SUGGESTIONS FOR FUTURE R
Page 63 and 64: APPENDIX 3:HEALTH SERVICE UTILIZATI
Page 65 and 66: APPENDIX 4:INTERVIEWS WITH ABORIGIN
Page 73 and 74: ELEMENT #11GENDER SENSITIVE TRAININ
Page 77 and 78: ENDNOTES1. Sarlo, Christopher, “P
Page 79 and 80: ENDNOTES (continued)45. Arber, Sara
Page 81 and 82: ENDNOTES (continued)88. Mustard, Ca
Page 83 and 84:
REFERENCES (continued)Clarke, H.F.
Page 85 and 86:
REFERENCES (continued)Macintyre, Sa
Page 87 and 88:
REFERENCES (continued)Vancouver/Ric
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