Women's College Hospital - The Health Gap V2

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The facts
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What is the health gap and why should I care?

Healthcare doesn't always work the same for everyone.

From research to treatment options to access to services and programs, many women are overlooked and underserved because healthcare has traditionally not considered the impact of sex and gender differences.

Research shows that women’s needs, including physiological differences, cultural challenges and life circumstances, are often not taken into consideration. This is the Health Gap. And for women in marginalized and disadvantaged communities, this gap is even wider.

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The FactsLearn the facts by selecting a topic.

Research

Women are often overlooked when it comes to health research studies, yet they have different risk factors for certain diseases, and may also respond differently to various treatments and medications.

Did you know:

Until the 1990s women were not included in most healthcare and medical research studies.
Many prescription drug therapies and treatment protocols still used today have been disproportionally studied on men.
Sex and gender are not always considered and captured in health research.

It’s time to close these Health Gaps.

Chronic Diseases and Conditions

Women are more likely than men to suffer from multiple, co-occuring, chronic conditions such as chronic pain, heart disease and diabetes.

Did you know:

The number of women aged 80 and older reporting two or more chronic conditions is twice as high as the number of older men.
Women are more likely to report severe and long-lasting pain, but are typically treated less aggressively than men. Doctors approach women’s pain as psychological or psychosocial and are more likely to refer women to a therapist rather than a pain clinic.
Mortality rates for heart disease are improving for every demographic group except for young women.
Each year, heart disease kills more women than men but, only 35% of patients in heart disease research studies are women.
Research has shown that following a heart attack, women are 36 per cent less likely to enroll and participate in cardiac rehabilitation because it is not offered as an option to many women for a variety of reasons, including societal presumptions or cultural biases.
Many cardiovascular drugs have been on the market for a long time, but have only ever been tested on men.
In Ontario, rates of gestational diabetes have doubled since 1996.
Most women with gestational diabetes are not offered follow up after pregnancy despite being at significantly higher risk of developing Type 2 diabetes.
Girls with Type 1 diabetes frequently omit insulin injections as a way to lose weight, which can put themselves highly at risk, yet are often treated in the same way as boys.

These are Health Gaps.

Women’s Mental Health

Women suffer from mental health conditions such as depression, anxiety and trauma significantly more than men, yet face more barriers to accessing healthcare services.

Did you know:

Women experience depression twice as often as men yet are three times more likely than men to experience barriers to accessing mental health care.
The prevalence of mental health issues during the reproductive life stages (such as menstrual cycle, pregnancy, postpartum and menopause) adds to the complexity of care and treatment for women. Yet most mental health research and therapy is based on the male experience.
Even though women are more likely to suffer from certain mental health conditions than men, most mental health research and therapy is based on the male experience.
Half of all women in Canada have experienced at least one incident of physical or sexual violence since the age of 16, yet not all healthcare providers have the knowledge or skills to deliver sensitive care to these women.

These are Health Gaps.

Social Determinants of Health

Social determinants of health, including factors like income, employment status and housing, all influence a person’s risk for disease or injury and women are even more vulnerable to these affects.

Did you know:

26% of Toronto residents are living in poverty, and that more women than men are living below the poverty line.
Women who live in marginalized and disadvantaged communities tend to live shorter lives and have more health problems, in part due to challenges accessing proper healthcare.
One in every five women is living in poverty, but for single women, the poverty rates are higher. More than half of single mothers and half of women over 65 who live alone live below the poverty line.
Women who live in low-income, marginalized and disadvantaged communities report higher instances of hypertension, arthritis, diabetes, heart disease and substance use issues.
Women in these communities also face stigmatization and significant barriers accessing health services and attending appointments because of cultural or social circumstances that make it more challenging for them to talk freely about their health conditions.

These are Health Gaps.

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What We are Doing

How we're closing the gap

Women’s College Hospital is working to close the Health Gap through groundbreaking research, innovative models of care, education and specialized programs and services. With a vision and mission to advance and advocate for the health of women and improve healthcare options for all, WCH is working to close the Health Gap in a number of ways:

Explore what we're doing

Women's College Research Institute

Women's College Research Institute is the only Research Institute in Canada with a focus on women's health. Our researchers and scientists conduct research that improves the health of women, helps people prevent and manage complex chronic conditions that have unique implications for women throughout their lives such as depression, HIV, sexual assault and domestic violence, diabetes, and heart disease , and delivers tangible solutions for the most pressing issues facing our health system. Additionally, they are exploring the social, political and economic forces that influence women's health and their access to health care, and are looking to reinvent health care for women and their families using a gender sensitive approach through programs such as the Women’s Xchange.

The Largest Women’s Mental Health Program in Canada

Women’s College Hospital has the largest women’s mental health program in Canada: the interdisciplinary Women's Mental Health Program. This program provides innovative, women-centered mental health treatment, education and research exploring the biological and social factors that shape women's mental health. The program is designed around issues that are specific to women - depression and anxiety associated with menstruation, pregnancy, childbirth and menopause; psychiatric and psychological issues that result from experiencing abuse and violence; and mental health issues associated with medical conditions such as diabetes or heart disease.

A Hospital Designed To Keep People Out Of Hospital

Some of the biggest barriers women face in accessing the care they need are their daily obligations and family responsibilities. So as Canada’s leading academic ambulatory hospital, WCH has developed models of ambulatory care that can deliver comprehensive programs with less disruption to patients’ lives. This includes services ranging from diagnostic investigations and therapeutic treatments to complex surgeries that can all be done without hospital admission and over-night stays. It’s an innovative one-stop-shop approach with various health professionals being co-located in one area so they can deliver highly coordinated care. It also includes a model of ambulatory surgery that avoids the need for overnight stays, with better treatment outcomes and higher patient satisfaction and a reduced risk of getting hospital acquired infections.

A Cardiovascular Program For Women

The Women’s Cardiovascular Health Initiative is Canada’s first comprehensive assessment and lifestyle program for women with existing or potential heart problems. This program is also home to the first and only evidence-based cardiac rehabilitation program in Canada specifically for women. The WCH program has high adherence rates of 85 per cent, compared to other cardiac rehab programs that report adherence rates of less than 50 per cent.

Making Healthcare Accessible

Women face various challenges and barriers accessing healthcare for themselves and/or their families, and Women’s College Hospital (WCH) has implemented a number of partnerships and programs to help make things easier. These include:

Stella’s Playroom – Stella’s Playroom is a free, supervised play-zone for children whose parents are attending appointments making it easier for parents who need childcare to receive treatment;
YWCA Partnership – For women living below the poverty line accessing healthcare can be very difficult. So WCH partnered with YWCA to provide primary care services onsite for the residents of the YWCA Elm Centre; and
Crossroads Clinic – Refugees arriving in Canada face many challenges, including accessing healthcare services. Crossroads Clinic at Women’s College Hospital is the only hospital-based clinic providing comprehensive medical services to refugee families.

Women’s Health Matters

Women’s Health Matters is the only website dedicated to women’s health with free, evidence-based information from the women’s health experts and clinicians at Women’s College Hospital (WCH). It provides health literacy for women:

Feature Articles on health topics that affect Canadian women the most;
Health Centres on topics such as heart health, diabetes, mental health and osteoporosis;
Every month in A Question of Health an expert from Women's College Hospital answers a question about a specific health issue;
The latest developments in women's health in the Health News section;
Discussion Forums offer a virtual meeting place for women to share experiences; and
The myhealthmatters.ca section delivers interactive content including videos, articles, quizzes, recipes and fitness exercise.

Care For Survivors Of Sexual Assault And Domestic Violence

The incidence of sexual assault and violence against women is increasing. One in four women in North America will be sexually assaulted in their lifetime, yet many women do not report their assault to police because of stigmatization, financial dependence on their assailant or risks to their own and their childrens’ safety. Through it’s Sexual Assault and Domestic Violence Care Centre (SA/DVCC) Women’s College is delivering education and building awareness of this growing problem and working with government partners to introduce policies that will help stop the cycle of violence. And the SA/DVCC is available 24 hours a day, seven days a week and is a comprehensive service for victims of violence.

Helping women deal with addictions and substance use

Most addiction treatment takes place in institutions that are far away from healthcare centres, have long waiting lists and primarily use psychosocial counselling. This means that when patients are in crisis often the only place they can turn to is their nearest emergency department, which doesn’t lead to optimal, long term treatment results. So WCH developed the Substance Use Network (SUN), a program that improves access and views addiction as both a biomedical and psychological illness. This unique service uses completely different models of care with an inter-professional team combining addictions services, family medicine, psychiatry and social work. It also offers an ambulatory detox program which allows patients to avoid hospital admission and return home and to their work and family responsibilities while undergoing detox.

Prevention and treatment of hereditary women’s cancers

Women's College Hospital is home to the Familial Breast Cancer Research Unit, a world leader in the diagnoses and prevention of genetic breast and ovarian cancer and in innovative work on women's experiences of cancer. WCRI’s Dr. Steven Narod has been named the most cited breast cancer researcher in the world and his work in the discovery of the BRCA genetic mutation has had a profound impact on the prevention, screening and treatment for breast and ovarian cancers. Following on the discovery of the BRCA gene, in 2015 WCRI scientists discovered another breast cancer genetic mutation that could lead to new treatments that would correct risky gene mutations in women.