Gender inequality in Canadian women's healthcare access

¶ … inequality in Canada, one of the most interesting, and depressing, factors is the way in which seemingly unrelated demographic factors work together to present difficulties above and beyond those faced by any single group, while simultaneously demonstrating how these seemingly unrelated factors all stem from the same underlying problems. This is particularly true when it comes to women's healthcare, an issue which has already received inadequate attention and support even before one factors in other elements that make access to that healthcare more difficult. When reading the articles discussing this subject, " Redefining Home Care for Women with Disabilities: A Call for Citizenship," Affirming Immigrant Women's Health: Building Inclusive Health Policy," and " Becoming "The Fat Girl": Acquisition of an Unfit Identity," I was especially struck by how the specific difficulties faced by disabled women, immigrant women, and overweight women are ultimately based on their status as women and the assumptions and stereotypes which focus on that. It is easy to imagine that social problems do not really stem from something as simple as gender (especially because I, probably like most people, would really like to imagine that this is the case), but when considering the results of these three articles one cannot help but recognize that for how advanced society might be, and for how much we might like to imagine that problems continue to exist simply because they are so complex and difficult to confront, many of the issues facing at least half of the population really do stem from something as simple as women not getting the same support and consideration as men.

In " Redefining Home Care for Women with Disabilities: A Call for Citizenship," Kari Krogh discusses the particular difficulties faced by women with disabilities when it comes to securing home care, and she argues that these difficulties are so severe so clearly the result of a systematic inequality in the distribution of support that women with disabilities are essentially denied their rights as citizens. The facts regarding this inequality are clear, because it is obvious that women are not given the same level of support as men; for example, women not only receive less home care support than men, but they are actually more likely than men to suffer from the kinds of chronic disabilities that require home care, such as arthritis. While the facts regarding the disparity between men and women when it comes to home care were surprising simply because I did not imagine that this gender gap would be so obvious at this point in human history (and that it would go unrectified after this gap had been so clearly demonstrated) what made Krogh's are so remarkable was the connection it drew between this gap and citizenship. It is fairly easy to imagine people's medical problems as unfortunate but unrelated to their place within society in general, but Krogh destroys this comfortable assumption by highlighting the fact that insufficient home care support for women with disabilities ends up affecting areas of their lives that would otherwise be protected through their rights as citizens, such as access to education and employment. In this way, Krogh demonstrates that healthcare and disability is as much a civil rights issue as anything based on gender or race.

If inadequate access to home care constitutes an infringement on the rights of women as citizens, then the experience of immigrant women in attempting to secure effective healthcare is fraught with even more difficulty, because they have to contend with language and cultural barriers as well. Marian MacKinnon and Laura Lee Howard's article on the subject was particularly illuminating because it highlighted how women in general seem to be treated as individuals without the same kind of agency and self-motivation as men when it comes to healthcare, and this fact is only exacerbated in the case of immigrant women, because they have to try that much harder to be heard and appreciated. The study interviewed a number of immigrant women about their experiences attempting to secure healthcare, and one of the most common and striking things they mentioned was a feeling that healthcare providers did not listen to them or take their concerns seriously, but rather would do cursory examinations and then suggest obvious but often unrelated advice, such as taking over the counter pain medication. These observations coincide with the issues described in Krogh's essay, because both demonstrate the extent to which women's healthcare problems are simply not taken as seriously as men's.

The third essay, "Becoming "the fat girl": Acquisition of an unfit identity," was especially interesting when read alongside the other two, because it demonstrated the end result of the phenomenon described in the other essay. Essentially, women's experiences with notions of fatness and fitness as it relates to their bodies and identities reveals that these notions serve to effectively strip women of their gender, thus placing them further outside the segments of society deemed worthy of protection and support. If the first two articles reveal a practice of implicitly denying women's health issues the same attention granted to men's, Carla Rice's article demonstrates a complete denial of overweight women as women, which removes them even from the gender dichotomy, which, while inequitable, at least recognizes women as a class of human beings with their own particular needs. The perpetuation of "the fat girl" thus serves to further disenfranchise and dismiss women in a way that notions of male fatness and fitness do not.

Taken together, these three essays demonstrate the ongoing segregation of women in society and culture, a segregation that is stunning considering the ostensible developments made in the recognition of human rights and gender equality. Although the three articles discuss different problems faced by women in Canada, the most striking part of all three is the way in which these problems all derive from the fact that women are still denied the same kind of recognition and agency granted to men.

Journal #2

Capitalism has always produced and reinforced inequalities, both in terms of the amount of money different people have and the particular gender and ethnic differences between those people, but over the last twenty years this process has taken on a global character due to the globalization of trade and in the case of Canada, the establishment of a free trade due to the North American Free Trade Agreement. While one might assume that this would simply cause an expansion of the inequality inherent in capitalism at the same rate as it has always proceeded, albeit on a larger scale, or even that the globalization of trade might actually reduce inequality by allowing people in different countries greater access to potential customers and jobs, the inequality which has developed as a result of this globalization upsets these assumptions, because it is inequality on a scale previously unimaginable, or at least unimaginable by me until I considered the discussion of women's experiences in a globalized Canada presented in four important articles.

Roberta Hamilton's article " Global Restructuring, Canadian Connections, and Feminist Resistance" offers a good overview of the issues discussed in more detail in the other three articles, but the truly interesting revelations of the problems created by globalization ultimately appear in the other articles, because Hamilton is somewhat more concerned with a theoretical approach to this issue than in directly relating the experiences of individuals. For example, in Sedef Arat-Koc's article "Whose Social Reproduction? Transnational Motherhood and Challenges to Feminist Political Economy," reveals that while globalization may have resulted in jobs for migrant workers, the intersection of ethnicity, traditional culture, and politics has meant that these migrant workers suffer from severe physical and psychological problems as a result of their nebulous status, both culturally and geographically. This is particularly true of mothers, because they are expected to maintain the traditional role of nurturer even as they are forced to move thousands of miles away in the search for work. This represents a kind of inequality previously unforeseen under traditionally national capitalism, because the oppressive forces of traditional ideologies and the political consideration of immigrants' host countries serve to increase inequality exponentially, essentially multiplying the difficulties instead of merely adding them (although even that would be undesirable). Arat-Koc's essay demonstrates how globalization, far from freeing women from the preexisting limitations they face in regards to managing the conflicting pressures to enter the workforce and raise, actually magnifies these pressures by removing possible support systems; women are away from their families and countries of citizenship so they cannot rely on them for support or the protection of rights, and as non-citizens of the countries in which they work, they have very little access to any state or official support either in terms of supporting their children left behind or protecting their labor rights while working.

These latter problems are revealed in Roxanna Ng's article "Garment Production in Canada: Social and Political Implications" when she discusses the state of the garment industry in Canada following globalization. Garment production has historically been a major part of Canada's economy, so the institution of a free trade zone might lead one to assume that the garment industry is one area in which inequality might be reduced due to an increase in potential customers, thus necessitating more jobs and greater opportunity for native and migrant workers alike. However, this has not been the case, because instead of producing more jobs and supporting the maintenance of large factories, globalization has led to a kind of race to the bottom, where transnational corporations contract garment-making out to smaller and smaller companies, which cannot offer the same benefits as a large factory, and in many case constitute nothing more than sweatshops populated by immigrant women.

This process has affected the agriculture industry as well, where every summer largely female migrant workers are shipped in by the planeload to pick vegetables before being shipped back out again at the end of the season as revealed by Deborah Barndt in her article "Fruits of Injustice: Women in the Post-NAFTA Food System." Again, this process, while yielding jobs women, has really only served to exacerbate preexisting tensions and inequalities so that the transnational food growing and harvesting businesses ultimately reiterate preexisting gender, ethnic, and class tensions on a smaller scale. While Bardnt does suggest some instances of resistance to this new economic and social order which magnifies and multiplies the inequalities of the previous order, these examples do not really offer genuine hope to someone shocked by the detrimental effects of globalization, because it is difficult to be excited for a single migrant worker learning rooftop gardens and other alternatives to factory farming even as thousands of other low paid workers continue to populate the transnational food industry.

This observation is actually the main criticism one could make of all of the articles discussed here; while they all reveal the realities of inequality as a result of globalization, and NAFTA in particular, any of the examples of resistance they provide seem feeble and ultimately worthless in the face of such overwhelming political, economical, and ideological oppression. While they may represent an opportunity for women and other migrant workers to express some kind of autonomy on a small scale, these acts can never be anything more than symbolic, and only ever to a small audience (even as small as one). Of course, even just revealing these inequalities is the first step towards combating them, but it would have been somewhat more hopeful had any of the articles provided evidence that substantial, sustained resistance is really possible.

Journal #4

One of the most tragic an ongoing forms of inequality in Canada is the history of ethnic and racial inequality, and I was most struck by how fully the larger society has failed to effectively appreciate its ongoing complicity in the repression of Aboriginal and other non-white peoples in the systemic and ongoing failure of the social and criminal justice systems.

Patricia Monture-Angus discusses the implicit failure of society and the justice system in her essay "Lessons in Decolonization: Aboriginal Overrepresentations in Canadian Criminal Justice," but perhaps the real ongoing tragedy is revealed by Ann Duffy and Nancy Mandell in their article "The Growth of Poverty and Social Inequality: Losing Faith in Social Justice," due to the way in which poverty serves as a kind of primer for introduction into the justice system. While Duffy and Mandell's analysis is useful simply for the facts it provides regarding the extent of poverty in Canada, the most immediately useful aspect of their essay, at least for me, was their discussion of the difficulties in defining and measuring poverty. This discussion is so important because it not only reveals the different levels of poverty one must consider, from the homeless and hopeless to the working poor, but also implicitly reveals one reason why this poverty is so pernicious and easily disregarded by such a large portion of those people with the political and economic means to do something about it. By narrowly defining poverty as only the most visible examples of it like the homeless, people are able to fool themselves into thinking that it is a much smaller problem than it really is, and thus not requiring the concerted effort truly necessary to combat it. By noting the difficulties inherent in attempting to discus the breadth of poverty in Canada, Duffy and Mandell's article demonstrates the need to operate with permissive definitions of poverty so as not to exclude anyone who needs assistance, because when it comes to human beings, it is always better to err on the side of being more generous.

If Duffy and Mandell's article explores the general issues facing someone seeking to confront the inequalities which arise out of economic disparity, Jennifer Nelson's article "The Space of Africville: Creating, Regulating, and Remembering the Urban 'Slum'" demonstrates the ethnic inequalities which are perpetuated and exacerbated by this economic inequality. The treatment of Africville by the surrounding government and public represents an embarrassing and depressing stain on Canadian history and society, but Nelson's article goes beyond a recognition of this necessary shame in order to see how the attitudes and policies of those in power effectively prohibited Africville developing economically, and then used this poverty as an excuse to force the eventual eviction of its residents and the dismantling of the community. Nelson's article is insightful because of the way it reveals the cyclical paradigm which serves to perpetuate power and make ethnic stereotypes a reality, thus further legitimizing the deployment of these repressive stereotypes. By denying the residents of Africville access to the same public services as the surrounding area, the local government forced the community into poverty and decay, and then used that poverty and decay as justification for the further denial of support.

Taken in conjunction with Duffy and Nelson's article as well as Monture-Angus', Nelson's discussion of Africville helps to demonstrate how ethnic, racial, and economic bigotry is not only damaging in its own right for that way in which it establishes meaningless divisions between people, but also because of the way it informs systematic decisions which serve to deny minorities and access to certain opportunities and services, creating a self-sustaining cycle of disenfranchisement and disregard. This phenomenon is so dangerous precisely because it appears to remove the responsibility for this denial of services away from those individuals in power and attempts to place the blame on the powerless, effectively institutionalizing discrimination and oppression so that it is all the more difficult to confront.