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Ontario women live longer but don't prosper: Study

Low-income women at greatest disadvantage as they battle more chronic disease and disability compared to women and men in higher income groups

TORONTO, Ont., June 23, 2009 — While Ontario women live longer than men, a majority are more likely to suffer from disability and chronic conditions, according to a new women's health study by St. Michael's Hospital researcher Dr. Arlene Bierman. What's more, low-income women have more chronic conditions, greater disability and a shorter life expectancy than women in high-income groups.

While inequities in health among men and women have been well documented, the findings strongly suggest that the size of the inequities among women is often larger than the overall differences between men and women.

"Women with less education and low income were found to experience a greater burden of illness overall compared to men and women with higher incomes," said Dr. Bierman. "While we already knew these inequities exist, we are quite startled by just how large the gap is among different groups of women. The good news is that there is much that can be done to close this gap. The inequities we found are associated with chronic disease, so by focusing on chronic disease prevention and management, and improving the living and working conditions that increase the risk of chronic disease, we can improve health outcomes for all women and men."

The joint study, titled POWER (the Project for an Ontario Women's Health Evidence-Based Report), from St. Michael's Hospital and the Institute for Clinical Evaluative Sciences (ICES), is the first in Ontario to provide a comprehensive overview of women's health in relation to gender, income, education, ethnicity and geography. POWER reports on indicators of population health and of how well the health system is performing. Policymakers and health-care providers may use these research findings to improve access, quality and outcomes of care for Ontario women. The POWER Study was funded by Echo: Improving Women's Health in Ontario, an agency of the Ontario Ministry of Health and Long-Term Care.

Key findings released today include:

Chronic conditions

• The majority of women and men in Ontario have at least one chronic condition and many have two or more.
• Thirty-nine per cent of low income women have two or more chronic conditions compared to 28 per cent of women in the highest income group and 21 per cent of higher income men.
• Among women aged 65 and older, 70 per cent of low-income women have two or more chronic conditions compared to 57 per cent of higher-income women and 50 per cent of higher-income men.

Disease risk factors

• Overall, more than half of Ontario adults age 25 years and older reported physical inactivity (51 per cent) and inadequate fruit and vegetable intake (57 per cent), 53 per cent were overweight or obese and 22 per cent were current smokers
• Women are less physically active than men, but eat more fruits and vegetables, and are less likely to be overweight or obese and smoke than men.
• While rates of smoking have decreased over time, 28 per cent of women with less than a high school education report smoking compared to eight per cent of women who had a university degree or higher.

Length of Life

• Low-income women and men are more likely to die prematurely.
• Twenty-six per cent of women and 41 per cent of men in the lowest income range die before age 75 compared to 19 per cent of women and 28 per cent of men in the highest income bracket.

Pain

• Thirty-five per cent of low income women age 65 and older say their activities are limited by pain compared to 18 per cent of higher income women in this age group.
• Among women age 25-64, 26 per cent of low income women, and 10 per cent of higher income women report their activities are limited by pain.

Disabilities

• More than half of low-income women age 65 and older have a disability that requires the help of another person to carry out routine daily activities such as grocery shopping, housework and meal preparation.
• Older women are also about 50 per cent more likely than older men to be admitted to hospital for a fall-related injury, which can result in long-term disability and health problems.

Low income

• Across all age groups, women are more likely to live in lower-income households than men, with gender differences in income greatest among those age 65 years and older.
• Forty-four percent of women age 65-79 and 52 per cent of those aged 80 and older reported lower income compared to 33 per cent and 35 per cent of men in these age groups, respectively.

Common modifiable risk factors such as smoking, diet, and lack of exercise are responsible for much of the chronic illnesses present in both women and men. Chronic diseases are estimated to account for 87 per cent of disability in Canada.

According to the researchers, socioeconomic factors including income, education, housing, and environment as well as health behaviours must be addressed to eliminate the gap and improve population health. The POWER Study recommends:

• A comprehensive chronic disease prevention and management strategy that involves both community-based and health-sector interventions
• Better co-ordination of population-based health promotion, community-based services and clinical care services aimed at improving health among Ontarians
• Incorporation of gender and equity into health indicator reporting and monitoring to reduce disparities in health and health care.

"We must improve our knowledge of the diverse health needs of Ontario women. The POWER Study is a huge step in that direction," said Pat Campbell, CEO of ECHO. "By monitoring our progress in improving health outcomes and reducing disparities, there will be better care for women and more equitable care to all Ontarians. The findings of the study will provide strong evidence to inform priority setting and provide a baseline from which to measure progress in women's health."

For more information on the POWER Study and to access the burden of illness report, visit www.powerstudy.ca. Other findings from the study will be released later this year.

Dr. Arlene Bierman is a researcher in the Keenan Research Centre at the Li Ka Shing Knowledge Institute of St. Michael's Hospital, a scientist at ICES and Echo's Ontario Women's Health Council Chair in Women's Health at St. Michaels Hospital and the University of Toronto (Lawrence S. Bloomberg Faculty of Nursing).

St. Michael's Hospital is a large and vibrant teaching hospital in the heart of Toronto. The physicians and staff of St. Michael's Hospital provide compassionate care to all who walk through its doors and outstanding medical education to future healthcare professionals in more than 20 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care and care of the homeless and vulnerable populations in the inner city are among the Hospital's recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing Knowledge Institute, research at St. Michael's Hospital is respected and put into practice around the world. Founded in 1892, the Hospital is fully affiliated with the University of Toronto.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

Echo's mission is to improve the health and well-being of Ontario women and to reduce heath inequities. We believe that through knowledge transfer and gender-based analysis, Echo will improve the health of women and overall quality of life, relationships, families and communities in Ontario. Echo is an agency of the Ministry of Health and Long-Term Care and is working to ensure Ontario is at the forefront of improving women's health.

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