here. - Canadian Women's Health Network

of child care has not. Yet child carefees are much higher per year thanundergraduate university tuition fees.At the University of Manitoba, theannual cost of full-time undergraduatestudy in the Faculty of Arts is $3,100.2. SubsidiesThe Province of Manitoba providessubsidies for parents of childrenwhose annual income is below athreshold amount. For a single motherwith one child, the full subsidy ispayable only to those whose netearnings are less than $13,787.Although the difference betweennet and gross earnings will vary, theChild Care Office of Manitoba FamilyServices uses an average figure of25%. In that case, a single motherwith one child in full-time child carewhose net earnings were $13,787would have gross earnings of$17,233. She would, therefore,receive less than the full subsidy,even while living $5,731 below theWinnipeg poverty line.For two parents, with two childrenin care, the situation is even worse.They would lose some of theirsubsidy with combined net incomesof $18,895. Using the Child CareOffice’s figure of 25% to estimate thedifference between net and grossearnings, this family would receiveless than full subsidy withcombined gross incomes of$23,619, a remarkable $10,953below the Winnipeg poverty linefor a family of four.3. Parent Co-PaymentsUntil 1991 parents in receipt of childcare subsidies could be charged anadditional $1 per child per day forchild care. In 1991, that amount wasincreased to $2.40 per day, or $624per year per child. This presents areal burden for many parents,especially for those living inpoverty. Manitoba Family Serviceswill not cover this cost for mothers inreceipt of social assistance, whosechildren are in child care while theytake training or look for work.Women, Income andHealth in Manitoba565. Health Services Issues5.1 Health PlanningManitoba Regional Health Authorities(RHAs) are required to conductperiodic assessments of the healthneeds of their population and tosubmit annual health plans to theManitoba Health. A review of thesedocuments by the author 87 has shownthat RHAs include little analysis ofthe health needs of low-incomewomen in these documents.Interested organizations couldwork together to assist ManitobaHealth in the development and/orselection of health indicators whichare sensitive to both gender andsocioeconomic status, for use byRHAs. They could also work withthe RHAs, to deepen their understandingof the issues of incomeinequality, gender and health asthey develop their next communityhealth assessments.5.2 Allies in DevelopingHealthier Public PolicyAs the bodies responsible for needsassessment, health planning andservice delivery at the local level,RHAs are well positioned to becomeallies for the development of healthierpublic policies, rather than onlyservice delivery agents. But to date,they have taken few initiatives toinfluence the structural determinantsof health, such as poverty.