1. Rethinking Women and Healthy Living in Canada
Margaret Haworth-Brockman, Executive Director
Prairie Women’s Health Centre of Excellence
Gender, Diversity and Health Workshop
February 11, 2013
This work was financially supported by Health Canada.

2. Outline How we came to do this project What the project includes
Our methods
Some examples of our findings
Where to from here

3. Shifts & Silver Linings
New emphasis on Healthy Living for our work
Opportunity to build on expertise in SGBA (to more open audiences?): discourse analysis and practical applications
At PWHCE we had experience:
Profile of Women’s Health in Manitoba
Guidelines for practical applications of GBA for PAHO
Collaboration on Rising to the Challenge, beyond GBA 101
Recent work on Gender and Health Statistics commissioned by the WHO

4. Rethinking Women and Healthy Living in Canada
Collaboration by three Centres of Excellence for Women’s Health
National-level project
A reconstruction and critique of the healthy living discourse
SGBA of healthy living topics
Exploration of a few healthy living strategies
Promising practices
Taking the position that there are important inequalities between and among women that have implications for their opportunities for health, and that sex and gender are key determinants of health, we have undertaken a sex and gender-based analysis of healthy living in Canada. Our work involved an analysis of the healthy living discourse, the examination of nine areas of healthy living practice and research, namely: physical activity, sedentary behaviour, body weights, ‘eating well’ (incl. sodium), food insecurity, tobacco, alcohol, sexual behaviour, and injury (incl. violence), and a review of selected healthy living strategies from 4 provinces – ON, BC, PEI and Manitoba.

5. Integrated Pan-Canadian Healthy Living Strategy of 2005
Goals are to improve overall health outcomes and reduce health disparities.
Does not offer sex-specific targets nor make provisions to address the determinants of health—which include sex and gender—in measurement, reporting or formulation of policies and programs.
Policy Context:
Integrated Pan-Canadian Healthy Living Strategy released in The Strategy identifed reducing health disparities and improving overall health outcomes as its two goals.
Notably, the strategy did not include sex-specific goals or offer gendered considerations, and did not make any provisions to address the determinants of health--which include sex and gender--in measurement and reporting or in the formulation of policies and programs.
Only in the discussion of the consultations with First Nations Women’s organizations did issues of gender arise and it should be said that the Native Women’s Association of Canada actually made three important recommendations during the consultation:
Domestic, racialized and sexualized violence must be taken into consideration.
Realities of Aboriginal women’s lives need to be considered.
Must support women-centered activities and sports.

6. Healthy Living Discourse
Some contradictions:
Individual vs. social responsibility for health
Individual vs. collective and systemic solutions for chronic diseases
Leading to:
Transformation of risk and probability for populations into “certain danger” for individuals
Focus on physical health rather than mental health
Blame for certain types of illnesses
Limited attention to context of healthy living and sex, gender, diversity as well as the determinants of health
To contextualize our data analysis and review of interventions, we started by reading and examining the discourse of healthy living that frames and positions the Pan-Canadian Healthy Living Strategy. The discourse of healthy living reflects neoliberal approach to the economy that favours freedom of the market and a minimal role for the state.
More specifically, the HL discourse is characterized by a tendency to embrace an individual rather than a social view of health and hence to propose individual rather than collective or structural solutions for health problems, including chronic diseases. This is accompanied by the almost magical transformation of statistical, probabilistic models of risk into virtually certain danger for individuals, a focus on physical rather than mental health, a tendency to blame people when they become ill. The healthy living discourse is also largely blind to the impact of sex, gender and diversity on health and the opportunities for health, despite the emergence of a discourse focusing on equity.
A lack of awareness of sex, gender and diversity within the healthy living discourse leads to one-size-fits-all policy recommendations and programs that do not necessarily meet the needs of their participants nor reach out to those most in need of support.

7. A Profile of Women and Healthy Living in Canada

8. Healthy Living Topics
Each snapshot includes current rates, sex-specific details, gendered influences, risk factors, critique of measures, and policy implications.
Women in Canada, 15 years and older - mostly

9. Health Indicator Framework
Figure 2. Organizing framework for gender-sensitive indicators. Adapted, with permission from the authors, from Moussavi et al. {{2736 Moussavi, S. in press;}}.

10. National-Level Data Sources
Canadian Community Health Survey, including: CCHS-Nutrition Module, Cycle 2.2, 2004; CCHS, Cycle 3.1, 2005; and annuals and
Canadian Health Measures Survey, Cycle 1,
Canadian Tobacco Use Monitoring Survey, Annual 2010
Canadian Alcohol and Drug Use Monitoring Survey, 2010
National Trauma Registry, Comprehensive Dataset (NTR-CDS)
General Social Survey-Victimization Cycle 2009
Association of Workers Compensation Boards of Canada, National Work Injury Statistics Program (AWCBC - NWISP)
Census of Agriculture, 2001 and 2006
Public Health Agency of Canada, Sexually Transmitted Infections Surveillance Data

11. Analytical Process Definition of issues & measures
Gathering Information—review of data & add gender contexts, meaning, experience
Analytical Inquiry—asking challenging questions
Implications & Lessons to build gender sensitive strategies
Attend to gender in each step of the analytical process. 11 11

12. SGBA of Healthy Living Strategies
Sex- and gender-informed discussion on healthy living strategies in Canada at various levels of government.
Review of strategy documents plus consultations with policy makers about how gender has been considered in their healthy living strategies.
Detailed examination of strategies in Prince Edward Island, Ontario, Manitoba and British Columbia

13. Gender-Sensitive Practices, Policies and Programs in Healthy Living
Scoping review of research on gender-sensitive promising practices in healthy living.
Selected examples of promising practices, policies and programs related to our ten healthy living topics.
Recommendations for future directions to advance healthy living in Canada for women.

14. Some Quick Results
Women with higher incomes are more likely to take part in physical activity, but are also more likely to drink heavily
Aboriginal women less likely to drink heavily
We know very little about sexual behaviour for women over the age of 49 or those not considered “high risk”
All women show excessive sedentary behaviour
Tobacco smoking rates are largely declining, except among young women and women who use smoking as a coping behaviour
Older women find food labels complicated, and they don’t necessarily prefer cooking programs
Occupational injury data may under-represent women’s injuries in certain sectors

15. Conclusions
A gender lens on healthy living can shift our understanding of, and responses to, the needs of women in Canada.
Responses to healthy living for women in Canada might look different if they incorporate sex, gender, diversity and equity.
A sex and gender lens can allow the Pan-Canadian Healthy Living Strategy and provincial strategies to address the inequities that prevent healthy living for women.
Looking at healthy living through a gender lens might:
shift our understanding of, and responses to, the needs of women in Canada.
Using a sex and gender lens would facilitate the Pan-Canadian Healthy Living Strategy and provincial strategies to address the unequal distribution of risk factors and barriers to healthy living for women.
Responses to the issue of healthy living among women in Canada might look different if they incorporated sex, gender, diversity and equity.

16. The Source www.womenshealthdata.ca
More Information
The Source
Fact Sheets

17. Questions or comments:
Acknowledgements
Co-authors: Ann Pederson, Barbara Clow, Harpa Isfeld, Anna Liwander and Linda Snyder
This project was made possible through a contribution from Health Canada
Thank you!
Questions or comments: