Five Themes of Geography Five Themes of Geography - Cabarrus
Five themes
description
Transcript of Five themes
![Page 1: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/1.jpg)
Genuine Progress Index for Atlantic CanadaIndice de progrès véritable - Atlantique
Gender-Based Analysis and Indicators of
Women’s Health in Canada
Health Canada Policy Forum Ottawa, 9 October,
2003
![Page 2: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/2.jpg)
Five themes• Practical utility of gender-based analysis
• Interactive nature of health determinants
• Additional women’s health indicators needed beyond usual population health indictors
• Data improvements and gaps - especially for diversity analysis
• Purpose = policy link = point to key social interventions to improve women’s health
![Page 3: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/3.jpg)
Pop. health context: Romanow and the 3 burning health policy
issues1) How to treat the sick - supply side
2) How to improve the health of Canadians
3) How to check spiralling health care costs - demand side
The next Royal Commission......
![Page 4: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/4.jpg)
Practical: High portion of illness burden is
preventableExcess Risk Factors Account for:
• 40% chronic disease incidence
• 50% chronic disease premature mortality
• 25% direct medical care costs
• 38% total burden of disease (includes direct and indirect costs)
![Page 5: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/5.jpg)
1) Descriptive: Women have distinct health needs. Causes / outcomes differ by gender
2) Normative: Ensure equal treatment, overcome biases that impede wellbeing
3) Practical: Blunt, across-board solutions often miss mark, waste money. Gender analysis allows policy makers to target health dollars
Why a Gender Perspective
![Page 6: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/6.jpg)
Practical: Women’s use of health services
• Canadian women have higher rates of:
– chronic illness, physician visits
– disability days, activity limitations
– lower functional health status
• In every age group to 75, women more likely see physicians than men. Overall - 33% more likely; age 18-54 - 2-3x
![Page 7: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/7.jpg)
• Teen girls higher rates than boys
• Young women have 2x stress cf young men
• Surveys: young women say stress relief and weight loss = primary reasons for smoking
• Therefore programs, brochures, counselling targeted to girls more effective than blanket one-size-fits-all health warnings
E.g….. Teenage smoking
![Page 8: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/8.jpg)
1998 Federal Health Minister
• “I have undertaken to fully integrate gender-based analysis in all of my Department’s program and policy development work...”
• “...to enhance the sensitivity of the health system to women’s health issues...”
• “...more research...on the links between women’s health and their social and economic circumstances.”
![Page 9: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/9.jpg)
1) Income: What does it have to do with women’shealth?
• Poverty most reliable predictor of poor health, premature death, disability: 4x more likely report fair or poor health
• Low income- higher risk smoking, obesity, physical inactivity, heart risk
• Costly: increased hospitalization: Women 15-39 = +62%; 40-64 = +92%
![Page 10: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/10.jpg)
……health of single mothers• Worse health status than married
(NPHS); higher rates chronic illness, disability days, activity restrictions
• 3x health care practitioner use for mental, emotional reasons = costly
• Longer-term single mothers have particularly bad health (Statcan)
![Page 11: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/11.jpg)
Low income children- at risk - 31 indicators
• More likely to have low birth weights, poor health, less nutritious foods
• Higher rates of hyperactivity, delayed vocabulary development, poorer employment prospects.
• Less organized sports, but higher injury rates, and 2x risk of death due to injury than children who are not poor.
![Page 12: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/12.jpg)
Prevalence of low income-women and men: 1991-2000
![Page 13: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/13.jpg)
Low-income children under 18, 1991-2000
![Page 14: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/14.jpg)
Income: Female lone-parent families - 1997 & 2000
![Page 15: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/15.jpg)
Trend:Low income rates of children: Single mother families
---1991-2000
![Page 16: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/16.jpg)
Employment of Female Lone Parents 1976-2001
![Page 17: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/17.jpg)
Low Incomes : 1991-2000Single mothers w/out paying jobs
![Page 18: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/18.jpg)
The Economics of Single-Parenting
• Single mothers with pre-school children spend 12% income on child care cf 4% in 2-parent families. In one pocket .........
• CPI for child care, restaurant food rises faster than wages
• Robin Douthitt: “time poverty”. Full-time single mothers = 75 hour week
![Page 19: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/19.jpg)
2) Equity and health
“What matters in determining mortality and health in a society is less the overall wealth of the society and more how evenly wealth is distributed.
The more equally wealth is distributed, the better the health of that society.”
----- British Medical Journal 312, 1998
![Page 20: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/20.jpg)
If Equality->Health, What are Trends?
Average Disposable H’hold Income Ratios, 1980-98
![Page 21: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/21.jpg)
GINI coefficient 1991-2000
![Page 22: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/22.jpg)
Despite growing educational parity....
![Page 23: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/23.jpg)
Gender wage gap remains unchanged
- Ratio of Female to Male Hourly wages: 1997-2001
![Page 24: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/24.jpg)
Explaining the gender wage gap
• Convergence of women’s hourly wages stalled…. despite clear educational gains.
• After controlling for hours worked, educational attainment, work experience, industry, occupation, and socio-demographic factors, StatsCan concluded that: ……..
• ….“roughly one half to three quarters of the gender wage gap cannot be explained.” (Drolet, 2001)–
![Page 25: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/25.jpg)
Differences among Cdn women: e.g. Regional wealth
gap grows: Atlantic region cf Ontario, Canada:
• 1990 = $0.82 disp.income NS for $1 in Ontario. 1998 = $0.73
Financial Security Atlantic Canada
• 1984: 5.4 % of national wealth. • 1999: 4.4 % “ “
(7.8% of Canadian population)
![Page 26: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/26.jpg)
Wealth gap in Canada:• Richest 10% own 53% of wealth
• Richest 50% own 94.4%, leaving 5.6% for poorest 50%
• Poorest ¼ of Canadians own 0.1% (or one-thousandth of wealth)
• Among poorest 20%, 1/3 fell behind 2+ months in bill, loan, rent, mortgage
= Importance of diversity approach
![Page 27: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/27.jpg)
3) Employment- a key determinant of women’s
health Issues:
• Both overwork and unemployment are stressful- (Japanese study)
• Polarization of work hours -increasing the level of inequality in family earnings.
• Women’s health - function of paid + unpaid work - gender division of labour in household
• Women doubled employment, BUT still do nearly two-thirds of household work.
![Page 28: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/28.jpg)
% of Women and Men Employed Canada 1976-2001
![Page 29: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/29.jpg)
Women with young children - sharpest increase in
employment, Since 1976:
women without children have increased their employment rate by 26%;
women with youngest child 6-15 by 62%; women with youngest child 3-5 by 83%; women with youngest child 0-2 by 124%
![Page 30: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/30.jpg)
Employed women with children
![Page 31: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/31.jpg)
But distribution is uneven -Employment and
Education• 75.4% of female university graduates
have a job, cf 79.3% of male graduates.
• But… women with less than grade 9 are less than half as likely to be employed as males – 13.6% of women cf 29.4% of men
• Gender analysis not just m/f but diversity - sub-groups of women - esp. vulnerable
![Page 32: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/32.jpg)
Women increased professional status - I.e. strong educational
improvement
![Page 33: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/33.jpg)
Job security - temporary work
![Page 34: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/34.jpg)
Job security – union coverage (helps explain PEI
equity)
![Page 35: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/35.jpg)
High decision latitude at work - related to lower
stress
![Page 36: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/36.jpg)
Official unemployment rate
![Page 37: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/37.jpg)
BUT.... Unemployment + underemployment
![Page 38: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/38.jpg)
Youth unemployment 15-24 explains entire gender
gap
![Page 39: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/39.jpg)
4) While f-t women work 39 hrs cf 43 - men, women still do most unpaid
housework
![Page 40: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/40.jpg)
Employed mothers (f/t) work average 75-hr week -
pd+unpd
Statcan: Women moving to longer work hours:
• 4x likely smoke more, 2x likely drink more
• 40% more likely decrease physical activity
• 80% more likely have unhealthy weight gain
• 2.2x more likely experience major depressive episodes cf women on standard hours
![Page 41: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/41.jpg)
Stress and health behaviours - smoking
![Page 42: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/42.jpg)
Less stressful alternatives(societal vs individual
solutions)
![Page 43: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/43.jpg)
Social supports are important
• Social networks may play as important a role in protecting health, buffering against disease, and aiding recovery from illness as behavioural and lifestyle choices such as quitting smoking, losing weight, and exercising.
– See: Mustard, J.F., & Frank, J. (1991).The Determinants of Health. (CIAR Publ. No. 5).
![Page 44: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/44.jpg)
Social Supports: pop. 12+, 2001
![Page 45: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/45.jpg)
Key Social Supports-Volunteerism and Family• Health Canada uses volunteerism as a
key indicator of a “supportive social environment” that can enhance health.
• Volunteerism declining: 1997-2000 Canada lost 960,000 volunteers. 1997 = 29% men, 33% women vol’d 2000 = 25% men, 28% women
• Remaining volunteers work 9% more hours
![Page 46: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/46.jpg)
Family violence = key indicator of women’s
health• CIHI, Statcan identify crime as “non-
medical determinant of health.” But women’s health analysis requires special indicators - family violence, like unpaid work, is key indicator.
• Family identified as key pillar of social support - determinant of health. But family violence may undermine social support, health
![Page 47: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/47.jpg)
Family=high % of all violence
• Spousal violence = 18% of all violence reported to police.
• Women = 85% of all reported spousal abuse = 6x rate for men
• Nearly 1/3 of all reported female victims of violence in Canada attacked by spouse
• Unreported - much higher = 8% all women with partner attacked past 5 years.
![Page 48: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/48.jpg)
Importance of diversity approach. E.g 1: Aboriginal
women’s health• Life expectancy = 76.2 cf 81 (non-Abor.)
• Higher rates hypertension, cervical cancer, circulatory & respiratory diseases
• Diabetes = 3x non-Abor. Fem = 2x male
• HIV/AIDS = 2x non-Abor. 50% female Abor AIDS cases = IV drug use cf 17%
• 9% Aboriginal mothers under 18 cf 1%
![Page 49: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/49.jpg)
Aboriginal women’s health
• 3x mortality due to violence. 25-44 = 5x
• Alcohol-related accidents = 3x
• Fetal alcohol syndrome. Over 50% view alcohol abuse as problem in community
• 3x suicide rate cf non-Aborig. women
![Page 50: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/50.jpg)
E.g.2:Regional disparities require special attention /
intervention E.g Cape Breton….
• High unemployment and low-income rates,
• Much higher incidence of chronic illness, disability, and premature death than Halifax
• Highest age-standardized mortality rate in Maritimes
• Highest death rate from circulatory disease, heart disease in Maritimes – 30% above national average
![Page 51: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/51.jpg)
Of 21 Atlantic health districts, Cape Breton has highest rates
of:• Cancer death (231.8 per 100,000) – 25%
higher than the national average, lung cancer
• Deaths due to bronchitis, emphysema, and asthma (9.2 per 100,000) –50%+ higher than the national average
• High blood pressure– 21.7%, (24.3% women 19% men = 72% higher than the Canadian rate. The next highest rates are in south-southwest Nova Scotia
![Page 52: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/52.jpg)
Cape Breton = highest:
• Arthritis and rheumatism: 31% of women, 23% of men
• Activity limitation (34%), followed by Colchester, Cumberland, and East Hants counties (30.1%)
Life expectancy: 72.8 years for men, and 79.4 for women. (Canada: 75.4 years - men and 81.2 years -women
![Page 53: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/53.jpg)
Disability-free life expectancy
• Cape Bretoners have an average disability-free life expectancy of only 61.8 years, seven fewer than the national average, and the lowest of all the 139 health regions in Canada.
• This means that Cape Bretoners can expect to live considerably more years with a disability than other Canadians.
![Page 54: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/54.jpg)
Potential years of life lost
• highest number of potential years of life lost due to both cancer and circulatory diseases.
• Cape Bretoners lose 2,261.9 potential years of life per 100,000 population due to cancer – 41% higher than the national average of 1,603.7,
• and they lose 1,684 potential years of life per 100,000 population due to circulatory diseases – 65% higher than the national average of 1,020.7.
![Page 55: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/55.jpg)
Women have generally healthier behaviours
• Women healthier diets. 5+ servings fruit/veg/day: F = 43%; M = 32%
• Daily smokers: F = 19%; M = 24%
• Overweight (BMI = 27+): F = 28%, M = 36% Obesity (BMI = 30+): F = 14%, M = 16%
• Heavy drinking: F = 11%, M = 28% BUT...
![Page 56: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/56.jpg)
But female smoking rates declined later
and slower
![Page 57: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/57.jpg)
Teen Smoking rates by Gender age 15-19, 1996 vs. 2001
40%
21%24% 24%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
1996 2001
Male Female
![Page 58: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/58.jpg)
More women physically inactive
![Page 59: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/59.jpg)
Health behaviours vary regionally:
e.g.: % Overweight, pop, 20-64, 2001
![Page 60: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/60.jpg)
Mammogram: Women, 50-69, routine screening within last two years, 2001
![Page 61: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/61.jpg)
Cape Breton, W. Nfld = low mammogram screening, high
breast cancer death rate
![Page 62: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/62.jpg)
Pap smear test% of women 18-59 years, 2001
![Page 63: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/63.jpg)
The physical environment is an important determinant of health- Health Canada
“At certain levels of exposure, contaminants in our air, water, food and soil can cause a variety of adverse health effects, including cancer, birth defects, respiratory illness and gastrointestinal ailments.
Factors relating to housing, indoor air quality, and the design of communities and transportation systems can significantly influence our physical and psychological well-being.”
![Page 64: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/64.jpg)
Access to Health care• Women use more health care services
than men, thus are disproportionately affected by barriers.
• Atlantic Canadians have greater difficulties accessing care than most other Canadians.
• The barriers result from less availability of key health care services in rural areas, rather than from longer waiting times.
![Page 65: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/65.jpg)
In Sum:
• Women have distinct health issues.... that have social and economic roots
• Diversity approach –special needs of Aboriginals, disabled, minorities, recent immigrants, disadvantaged regions, etc.
• 3 interventions that can improve women’s health, save health costs: 1) reduce time-overwork stress 2) eliminate gender wage gap 3) reduce poverty of single parents
![Page 66: Five themes](https://reader035.fdocuments.net/reader035/viewer/2022062519/56814f5d550346895dbd0e91/html5/thumbnails/66.jpg)
Can it be done?...1900s/1980s...