here. - Canadian Women's Health Network

Women, Income andHealth in Manitoba7that focus only on lifestyle will, therefore,not be as effective as a broader approachthat addresses poverty and the economicinequality faced by women.One consistent theme in the research isthe additional burden of ill health borneby Aboriginal women. They are at muchgreater risk of violent death and suicidethan other Canadian women. They havepoorer health than Aboriginal men or otherCanadian women; they develop chronicconditions earlier and suffer more frequentlyfrom heart problems, hypertension,diabetes, arthritis and rheumatism. Thisis compounded by the fact that Aboriginalwomen face formidable barriers in obtainingappropriate health services, includingdiscrimination, distance and cultural barriers.Poverty is also an important factor in thehealth of older women. Many factorscompound this, including poor housing,higher heating costs, increased isolation,fear for personal safety and functionalimpairments that may make day-to-day lifedifficult and painful. The link betweeninequalities in income and health is strongeven for those over the age of 85.Income & Healthin ManitobaWe examined the experience of all Manitobawomen in 1994-95, the most current yearfor which data were available. As in otherjurisdictions, there was a connectionbetween income and health servicesutilization for Manitoba women for mosthealth conditions. That is, women in lowincomeneighbourhoods were more likelyto see physicians both in hospital and inphysician offices than were women in highincomeneighbourhoods. The experienceof women in middle-income neighbourhoodsfell in between.Importantly, the reverse was true for twopreventive screening services. Women inthe highest income neighbourhoods weremost likely to use Pap smears to screenfor cervical cancer and mammogramsto screen for breast cancer.This is not intended to suggest that lowand middle-income women, whose healthcare costs are higher than those with highincomes, use the health care systeminappropriately. The solution lies not inrestricting access to the health care systemwith user fees or other mechanisms but,rather, in improving the health of thepopulation.The health effects of income inequalitiesincrease the burden of illness in all bodysystems. Discussions of women’s healthand socio-economic inequalities must bebroad enough to incorporate and build onthis information. Strategies which focusonly on reproductive and sex-specificconditions will not be successful inreducing inequalities in women’s health.Making Public PolicyHealthier for WomenHealthy public policy for low-incomewomen will require changes both insideand outside the health care system.The health care system has twoimportant roles to play:1. changing the way in which healthcare services are planned, deliveredand evaluated to better meet theneeds of low-income women;2. working with other sectors outside ofthe health care system to help themunderstand the health impactsof their policies.Manitoba health care organizationsinterested in developing health serviceswhich take issues of income, gender andhealth into account have several models toconsider. Three in particular – developed bythe Winnipeg Women’s Health Clinic, theVancouver/Richmond District Health Boardand the Commonwealth Secretariat – offerideas for improving health services to better