Women in the dark about massive Ontario study of female health

Posted on March 25, 2012 in Health Policy Context

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TheStar.com – opinion/editorialopinion
Published On Tue Mar 06 2012.   By Carol Goar, Editorial Board

It took six years, 60 researchers and $4.3 million.

Finally, the most comprehensive study of women’s health ever done in Ontario — possibly anywhere — is complete. The concluding chapter — a 10-point road map to health equity — was released last week at St. Michael’s Hospital at a celebration featuring speeches, congratulations and assurances by Ontario Health Minister Deb Matthews that the information in the massive tome would be put to good use.

There’s one problem: The POWER (Project for an Ontario Women’s Health Evidence-Based Report) study has received so little attention that most women don’t know it exists. Neither do their doctors.

That means too many women who suffer heart attacks will be misdiagnosed. Unlike men, they don’t typically experience chest pains or numbness. The most common symptoms of cardiac arrest in women are nausea, vomiting, shortness of breath and intense fatigue.

It means too many expectant mothers will undergo C-sections for low-risk births and unnecessary episiotomies for vaginal deliveries.

It means too many medical practitioners will ignore the strong connection between poverty and chronic ailments, such as obesity, hypertension, diabetes, arthritis and obstructive lung disease, which lead to foreshortened lives.

One of the reasons the 12-volume study hasn’t received much coverage is its heavy use of jargon. Here is an excerpt from last week’s release: “Health equity cannot be achieved without moving upstream and addressing the root causes of disease in the social determinants of health. A multi-faceted approach is required to tackle the many complex problems which contribute to greater chronic disease prevalence and poorer health outcomes in some groups.”

A second reason is that it has been released, chapter by chapter, over so many years that health reporters have lost track of the thread or moved on.

These problems could easily be rectified. The Ontario health ministry, which funded the project through one of its satellite agencies, ECHO, could assign a communications team to produce a user-friendly version of the report and develop an outreach plan. Or it could hire a public relations firm.

But Premier Dalton McGuinty is poised to cut spending and his budget adviser Don Drummond is urging the health ministry to streamline its operations. Both suggest that follow-up is unlikely.

This leaves women who want to take charge of their health with three options. They can read the 1,800-page report. With patience and persistence, they’ll get the gist of it. They can cherry-pick the topics that matter to them. Or they can lobby the government to finish the job.

For those willing to download the report, here are a couple of tips:

Some chapters are aimed chiefly at women, others at policy-makers. The written-for-bureaucrats chapters are distinguishable by their reliance on health/sociological jargon.

The most useful chapters for women seeking practical guidance are: cardiovascular disease, diabetes, depression, reproductive health and older women’s health. The chapters on cancer and musculoskeletal conditions (arthritis, osteoporosis) identify gender disparities, regional disparities and socioeconomic parities, but they don’t tell women much about how to improve their odds.

There is no question the study is a gold mine of information. Its website has attracted online visitors from 132 countries, 49 of the 50 U.S. states and 675 Canadian cities.

Taken seriously, it could be a catalyst for change. Its research team estimates that if Ontario had a truly equitable health-care system, there would be 230,000 fewer people with disabilities and 3,373 fewer premature deaths in the province’s big cities.

“We have more than enough evidence to make health equity a priority and more forward,” said chief investigator Arlene Bierman, a physician at St. Michael’s Hospital.

But the report could have done so much more. It could have alerted women to factors that raise their risk factor for various diseases. It could have helped them ask their doctors more informed questions. It could have led to public pressure for change.

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