Women's Health in Canada

Women's Health in Canada: Critical Perspectives on Theory and Policy

MARINA MORROW
OLENA HANKIVSKY
COLLEEN VARCOE
Copyright Date: 2007
Pages: 432
https://www.jstor.org/stable/10.3138/9781442685604
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  • Book Info
    Women's Health in Canada
    Book Description:

    This volume fills a gap in Canadian healthcare scholarship by providing a resource for teaching and understanding women's health in this country.

    eISBN: 978-1-4426-8560-4
    Subjects: Sociology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-x)
  3. Acknowledgments
    (pp. xi-2)
  4. Introduction: Beyond Gender Matters
    (pp. 3-30)
    COLLEEN VARCOE, OLENA HANKIVSKY and MARINA MORROW

    The very idea of women’s health is a ‘concept’ in the making (Anderson, 2004). As a concept, it engenders increasingly complex questions and debates which have not been adequately addressed or resolved. Concern with the limited ways in which women’s bodies have been understood, and focus on the ways social conditions and inequities shape health, have driven the emergence and development of women’s health as a field of study. Within the last several decades, approaches to women’s health have developed significantly through the efforts of a wide range of theorists, researchers, grassroots activists, politicians, policy makers, and women more generally....

  5. Part One: Locating Ourselves

    • 1 ‘Our Bodies Our Selves’ in Context: Reflections on the Women’s Health Movement in Canada
      (pp. 33-63)
      MARINA MORROW

      While much attention has been paid to documenting the history of the women’s movement in Canada, there has been less of a concerted effort to chronicle the women’s health movement. The very nature of this movement – a key feature of which is to expand the definition of what is commonly understood as health – means that it overlaps substantially with the key events and issues raised by the larger women’s movement. Throughout the following discussion, the women’s health movement will be examined both as a distinct body of theorizing and activism and as an area integrally related to and embedded in...

    • 2 More Than Age and Biology: Overhauling Lifespan Approaches to Women’s Health
      (pp. 64-90)
      OLENA HANKIVSKY

      An international push to conceptualize women’s health across the lifespan is a fairly recent phenomenon, having started in the 1990s. The introduction of a lifespan perspective can be interpreted as a direct response to a number of factors: persistent conflations of women’s health with reproductive and gynecological health (Pinn, 2003; Healy, 1991); the need to better document, comprehend, and respond to the specific challenges and contributing factors that influence girls’ and women’s lives from birth to death; and the need to ensure that appropriate policies and programs are developed, monitored, and evaluated so that ‘all women across life stages have...

  6. Part Two: Theory and Methods

    • 3 Feminist Methodology and Health Research: Bridging Trends and Debates
      (pp. 93-123)
      MARINA MORROW and OLENA HANKIVSKY

      In this chapter, we bridge recent trends and debates within feminist methodology and link these to women’s health research. Attention is paid to the challenges of operationalizing critical feminist perspectives and methodologies, especially as these relate to understanding the lives of women marginalized through relations of gender, race, class, and other forms of social difference. Within this context we discuss self-reflexivity in relation to power differentials between researchers and those whom they research. Specifically, the challenges of bringing intersectional analyses to research are explored. In so doing, the interplay between theory and research is brought to the fore and the...

    • 4 Postcolonial-Feminist Theoretical Perspectives and Women’s Health
      (pp. 124-142)
      ANNETTE J. BROWNE, VICTORIA L. SMYE and COLLEEN VARCOE

      Recently, the move towards critical inquiry in health has been influenced by a call for postcolonial theoretical perspectives to better understand how gender, class, racialization,¹ and historical positioning intersect to shape the health of individuals, communities, and populations (Anderson, 2000, 2004; Reimer Kirkham & Anderson, 2002). As argued in the Introduction, feminist studies of health are also calling for more complex analyses of gender and its intersection with other forms of social difference. Concepts from postcolonial and feminist theories, when drawn upon in synergistic and complementary ways, have the potential to expand the explanatory powers of each respective theoretical tradition....

    • 5 Gender-Based Analysis and Health Policy: The Need to Rethink Outdated Strategies
      (pp. 143-168)
      OLENA HANKIVSKY

      Most research has not been especially attentive to sex, gender, and, in particular, sex/gender interactions even though they intersect to affect health status (e.g., diseases, conditions, and illnesses), the healthcare system (in terms of access and quality), and health policy (e.g., development, implementation, and evaluation). The historic neglect of sex and gender and the resultant lack of evidence have been documented by women’s groups and health activists who have analysed health research, policy, and programs to determine the extent to which they meet women’s needs (Williams, 1999). These evaluations can be seen as part of an international movement, which started...

    • 6 Engendering Evidence: Transforming Economic Evaluations
      (pp. 169-196)
      OLENA HANKIVSKY and JANE FRIESEN

      Two important issues are currently at the forefront of Canadian health policy: fiscal considerations and gender inequalities in health, particularly those affecting women. In the first instance, the commitment to publicly funded health care in Canada is being scaled back in response to a variety of pressures from within the health care system and to an evolving fiscal culture in which cost containment and reduced public health expenditures are prevalent. As a result, evidence-based medicine (EBM) and evidence-based policy making (EBP), which claim to reduce waste, are seen as essential to the health sector. In the second instance, there is...

  7. Part Three: The Social Determinants of Health

    • 7 Women’s Health and the Politics of Poverty and Exclusion
      (pp. 199-220)
      COLLEEN REID

      Ideologies of power, economic reward and exchange, and gender roles and relations are expressed through macro- and micro-level institutions and behaviours (Moss, 2002). In all developed countries, including Canada, these factors have increased income disparities and the rates and depths of poverty experienced by many, particularly single mothers, women with disabilities, Aboriginal women, and older women. Women’s health, health promotion, and social epidemiology literatures suggest that poverty has a significant impact on women’s health. In this chapter, the incidence of women’s poverty and the relationship between poverty and women’s health are reviewed from a critical feminist perspective. A qualitative case...

    • 8 Women’s Health at the Intersection of Gender and the Experience of International Migration
      (pp. 221-243)
      BILKIS VISSANDJÉE, WILFREDA THURSTON, ALISHA APALE and KAMRUN NAHAR

      As a composite of multiple biological and social dimensions, women’s health and illness experiences are shaped by the resources and opportunities available to them as well as by health policies and practices. If based upon a multidisciplinary approach, health policies and practices will be attentive to the array of identities, practices, and visions that characterize Canadian women. Moreover, policies and practices which are sensitive to both gender and the experience of migration will better pertain to women as Canadians in a globalizing world.

      While the multiple dimensions of women’s health are outlined in gender-sensitive literature and advocated through various bodies...

    • 9 Cultures of Dis/ability: From Being Stigmatized to Doing Disability
      (pp. 244-271)
      LISA DIEDRICH

      As the editors note at the outset of their introduction to this volume, ‘“health” is an evolving concept,’ not some essential quality that can be easily measured and quantified. In this chapter, I consider some of the ways that ‘disability’ is also a concept in the making that expands and complicates how we understand the relationship between health and illness. There is perhaps a danger in discussing disability within the context of ‘women’s health,’ especially if the termwomen’s healthmaintains the hierarchical health/illness binary, a binary that disability scholars and activists find problematic.¹ Within such a binary logic, disability...

    • 10 Negotiating Sexualities in Women’s Health Care
      (pp. 272-296)
      CYNTHIA MATHIESON

      There are no illnesses unique to lesbians and bisexual women, yet women who identify as such face specific challenges, as the above citations suggest. Not being able to be open about sexuality has implications for health and health care, as does the impact of disclosure of identities that challenge normative expectations. The health care setting can be viewed as one arena where a woman must negotiate her identity, and the health concerns of women who challenge these expectations with their sexual identities can only be understood by acknowledging up front the negative attitudes held by individuals, institutions, and society.

      Women...

    • 11 Mothering and Women’s Health
      (pp. 297-324)
      COLLEEN VARCOE and GWENETH HARTRICK DOANE

      Mothering is a social experience that is constructed and shaped by structural conditions and intertwined with competing and conflicting social discourses that have significant implications for the health of women. Mothering affects women’s health in diverse ways. Because mothering requires material, economic, and social investments that are not usually compensated in material or economic ways, through mothering women are made more vulnerable to a variety of health risks, especially overwhelming workloads, poverty, and violence. At the same time, the experience of mothering may have a positive impact on women’s health. In this chapter we explore these conditions, discourses, and implications....

  8. Part Four: Key Issues in Women’s Health

    • 12 Women, Drug Regulation, and Maternal/State Conflicts
      (pp. 327-354)
      SUSAN C. BOYD

      This chapter provides a brief overview of ways in which women suspected of using illegal drugs are regulated in North America. Canada and the United States share a border and a common language as well as a history of being former British [and French] colonies. However, even though there are some historical similarities, the regulation of women in Canada is not identical to that in the United States. This chapter explores the regulation of women who use illegal drugs in North America in the criminal justice, medical, and social service systems. The regulation of women’s bodies, reproduction, and the war...

    • 13 Women’s Voices Matter: Creating Women-Centred Mental Health Policy
      (pp. 355-379)
      MARINA MORROW

      In Canada, despite government commitments to health and mental health promotion¹ and to supporting citizen engagement, the degree to which mechanisms have been developed to support the meaningful involvement of people in health care policy decision-making varies greatly from province to province and region to region. The discrimination and stigma associated with mental illness² and the enduring belief that people with mental illness cannot make competent decisions means that the engagement of mental health care recipients³ has lagged in comparison with other populations. This engagement has come with the evolving belief that people with mental illness can make meaningful contributions...

    • 14 Between Visibility and Vulnerability: Women and HIV/AIDS
      (pp. 380-407)
      MEREDITH RAIMONDO

      In the early years of the epidemic, the activist slogan ‘Women don’t get AIDS, they just die from it’ provided a clear assessment of the gendered impact of HIV infection. Nonetheless, ‘women,’ as a distinct class, have been visible in varying and often inconsistent ways in AIDS research, policy, and services. The complexity of gendered visibilities is not simply a matter of gender inequality. Rather, it reflects the intersection of multiple forms of structural inequality with a complex set of activist demands with regard to gender. In an important work on the status of women in AIDS discourse, activist and...

    • 15 Breast Cancer: Lived Experience and Feminist Action
      (pp. 408-433)
      SUE WILKINSON

      This chapter addresses one of women’s central health concerns – breast cancer – from a critical, feminist perspective (see Wilkinson 2000a, 2004). The first section of the chapter provides a demographic overview of breast cancer in Canada. It presents some incidence and mortality statistics, and considers the ways in which breast cancer incidence, mortality, and risk are influenced by the key social variables of gender, age, social class, race/ethnicity, and sexual identity.

      The second – central section – of the chapter offers an empirical analysis of women’s lived experience of breast cancer. It draws both on my own (UK-based) focus group research, and on...

    • 16 Selling ‘The Change’: A Comparison of the Dangers of Hormone Replacement Therapies in Profit versus National Health Care Delivery Systems
      (pp. 434-455)
      BRIAN RICHTER and CINDY PATTON

      On 9 July 2002, North America’s millions of female baby boomers, now solidly within the ‘menopause spectrum’ awoke to news of a scientific discovery that was said to affect their ability to age gracefully and healthfully. Media reported that the first prospective study (Women’s Health Initiative Trials [WHI]) of the side effects of a drug that had been widely prescribed for 70 years had been abruptly halted when the drug’s risks seemed to outweigh its benefits. ‘Shocked’ a decade or two earlier when the Pill that had partly enabled the sexual liberation of their generation came under attack, boomer women...

    • 17 Women’s Health and Cardiovascular Care: A Persistent Divide
      (pp. 456-476)
      LYNNE E. YOUNG

      Cardiovascular science and practice are deeply rooted in ‘modern’ philosophical traditions that focus on the individual as the unit of concern; hold to positivist scientific and professional practices that are decontextualized and ‘value-free’; and position the researcher or professional as expert in women’s health-related matters. Women’s health, on the other hand, is philosophically located in postmodern/post-structural paradigms that focus on women’s gendered experience; contextualize that experience; make explicit the values underpinning research and practice; and locate women as the experts on their own health. If cardiovascular care and women’s health were philosophically aligned, would there be no evidence of gender-bias...

    • 18 From Global to Local and Over the Rainbow: Violence Against Women
      (pp. 477-506)
      OLENA HANKIVSKY and COLLEEN VARCOE

      Over the last two decades, violence against women has been recognized as a violation of human rights, an important health policy issue, and a problem with enormous socio-economic costs to society. As the varied quotes above suggest, violence against women has multiple dimensions and is a problem at local to global levels. Progress has been made in terms of understanding violence, developing legal and policy responses, and establishing appropriate programs and services. However, the problem endures and remains a global epidemic. Violence against women is so pervasive that, as the above quotes suggest, social practices seem increasingly tolerant of such...

    • 19 Women’s Access to Maternity Services in Canada: Historical Developments and Contemporary Challenges
      (pp. 507-527)
      CECILIA BENOIT, DENA CARROLL and RACHEL WESTFALL

      Pregnancy and childbirth are core female events fundamental to the survival of the human species, yet the social organization of these events shows amazing variation across time and place. One obvious dimension of this variation concerns the care women have available to them to help make a successful transition to motherhood. While specialized care provided by medical doctors falls within this domain, an additional form of maternity care that is often overlooked in our technologically focused society is women’s desire for social support or ‘social care’ in their local communities. Few would dispute that access to medical specialists and advanced...

    • 20 Relocating Care: Home Care in Ontario
      (pp. 528-554)
      PAT ARMSTRONG

      A qualitative change is underway in health care. Care is being relocated – not just physically, but socially, ideologically, and psychologically as well. Social and economic forces within and outside health care are contributing to this relocation. Corporations searching for new profit sources, governments intent on eliminating debts and deficits, and media promoting individual responsibility account for just some of these forces. Because such forces are global, the overall patterns in health care reforms have significant similarities. Nevertheless, they tend to play out differently in different places. Indeed, such forces are evident in and realized in particular places, where local histories,...

  9. Contributors
    (pp. 555-557)