Equitable access to health and social services is recognized as a fundamental right in Canada. Women living on a low income experience the harmful effects of structural inequalities when accessing health and social services. Some of those women belong to minority groups such as Indigenous, immigrants and refugees, LGTBQ2S, single mothers, older adults, and those living with chronic illnesses and disabilities. However, little we know about how gender and income as social determinants of health affect access to health and social services for women on a low income. Goals: Our purpose in this qualitative study was to explore how the SDH affect the experiences of Canadian women who live on a low income, with accessing health and social services. Methods: In keeping with a participatory research approach, we are partnering with a not-for-profit organization, and are using an art-based approach (photovoice), hermeneutic phenomenology, as well as one-to-one interviews to illuminate the experiences of women living on a low income. Results: Five women are participating. In our analysis to date we have found three themes: 1) I know what I'm feeling, I know what my body feels; 2) There’s a lack of empathy, lack of compassion; and 3) They didn't break me because I'm going to keep going. Conclusions: Although access to health and social services is considered a fundamental right for all Canadians; it is unfair and unjust how women in this study do not experience that right. This work aims to bring access issues to light and elevate the voices of women living on a low income to create sustainable solutions with them and other community members, including a more compassionate health system and inclusive society in Ontario, Canada.
In Canada, an unacceptable number of women live below the poverty threshold. Some subgroups of women, such as Indigenous, visible minorities, immigrants and refugees, older adults, and single mothers are more likely to live in poverty, as they face multiple systemic barriers preventing their financial stability. Further, socioeconomic status, employment, gender, and access to healthcare and social services negatively impact women’s well-being and health. Yet little is known about how these factors affect healthcare behaviours and experiences for women living on a low income. Our goal is to describe and understand how gender and income influence access to healthcare and social services for women living on a low income. Methods: Partnered with a not-for-profit organization, we explored the experiences of women living on a low income in Kingston, Canada. Using participatory, art-based research and hermeneutic phenomenological approaches, our data collection methods included photovoice, semi-structured interviews and culture circles. A purposive sample was recruited. Analysis was conducted following the social determinants of health framework by Loppie-Reading and Wien. Results: Participants perceived the healthcare and social services systems as unnecessarily complex, disrespectful, and dismissive–one where they are mere spectators without voice. They do not feel heard. They also identified problematic issues regarding living conditions, housing, and fresh food. Despite these experiences, participants are resilient and optimistic. Implications: Learning from participants has indicated priority issues and potential, pragmatic solutions to begin incremental improvements. Changing system design to enable self-selection of food items is one example. Conclusion: For an individual to feel others view them as unworthy of care, especially if those ‘others’ are the care providers, is ethically and morally distressing–and it certainly does not invite system-use. While our early findings reveal considerable system improvements are required, we are inspired by and can learn from the strength of the participants.
In Canada, an unacceptable number of women live below the poverty threshold. Some subgroups of women, such as Indigenous, visible minorities, immigrants and refugees, older adults, and single mothers are more likely to live in poverty, as they face multiple systemic barriers preventing their financial stability. Further, socioeconomic status, employment, gender, and access to healthcare and social services negatively impact women’s well-being and health. Yet little is known about how these factors affect healthcare behaviours and experiences for women living on a low income. Our goal is to describe and understand how gender and income influence access to healthcare and social services for women living on a low income. Methods: Partnered with a not-for-profit organization, we explored the experiences of women living on a low income in Kingston, Canada. Using participatory, art-based research and hermeneutic phenomenological approaches, our data collection methods included photovoice, semi-structured interviews and culture circles. A purposive sample was recruited. Analysis was conducted following the social determinants of health framework by Loppie-Reading and Wien. Results: Participants perceived the healthcare and social services systems as unnecessarily complex, disrespectful, and dismissive–one where they are mere spectators without voice. They do not feel heard. They also identified problematic issues regarding living conditions, housing, and fresh food. Despite these experiences, participants are resilient and optimistic. Implications: Learning from participants has indicated priority issues and potential, pragmatic solutions to begin incremental improvements. Changing system design to enable self-selection of food items is one example. Conclusion: For an individual to feel others view them as unworthy of care, especially if those ‘others’ are the care providers, is ethically and morally distressing–and it certainly does not invite system-use. While our early findings reveal considerable system improvements are required, we are inspired by and can learn from the strength of the participants.
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