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This article by Christina Frangou originally appeared in Best Health Canada on February 9, 2021.

Three women’s health centres across Canada have joined forces to educate Canadians on the health gap and raise funds for women’s health research.

With the Covid-19 pandemic threatening to stall advancement toward gender equity in health, Canada’s three largest women’s health foundations have joined forces to promote better information and more investment in women’s health research.

“We’re looking to ensure that women’s health is at the forefront of the conversation around Covid-19 recovery and beyond,” says Genesa Greening, CEO and President of the BC Women’s Health Foundation.

In January, the BC Women’s Health Foundation, the Alberta Women’s Health Foundation and Women’s College Hospital Foundation in Toronto launched the Women’s Health Collective Canada (WHCC), a national alliance dedicated to increasing public awareness about women’s health and raising the standards of care for women across the country.

The project has been several years in the making, but is now being driven by a new urgency as the pandemic takes a heavy toll on women both at home and on the front lines.

“Women bear the majority of the burden of social determinants of health and we are not doing a good enough job to really understand how that plays out in women’s health outcomes,” says Greening.

In 2018, the three CEOs —Greening in B.C., Sharlene Rutherford in Alberta and Jennifer Bernard in Toronto — got on the phone and committed to forming a national alliance that would prioritize women’s health and fund medical research to specifically address the unique needs of women.

Plans for the alliance were already in the works when Covid-19 landed within Canada’s borders. They knew inequalities were likely to deepen as the coronavirus took hold.

“Research studies on previous epidemics and pandemics have shown that women are disproportionately affected and we know that when women are unhealthy, our economy and communities both suffer,” says Greening.

Women have endured a long legacy of inequities in health research, Greening points out. Many of the drugs and therapies used in medicine today come from research conducted primarily on men. Until 1993, when the US government passed a law requiring that women and minorities be included in all clinical research, women were often left out of clinical trials—viewed as being too complex, given their hormonal changes and concerns about pregnancy.

This large-scale omission of women from research may explain why women suffer more adverse reactions to prescription medications than men, says Greening. Three-quarters of adverse events from prescription medications occur in women, she points out.

“We live with a legacy that there are therapies on the market and clinical approaches to care that were never really tested on women,” says Greening.

Major Gaps in Knowledge about Women’s Health

As part of its launch, the WHCC surveyed 1,000 Canadian adults about their knowledge of women’s health. They found that women and men underestimate many health problems endured by women.

Only one in ten respondents knew that men have adverse reactions from prescriptions medications less often than women. Even fewer knew that as many as one-third of women suffer from sexual dysfunction.

About 40 percent of respondents believe women experience lower rates of heart disease than men, despite ongoing and well-publicized campaigns to raise awareness about this condition in women. One in five respondents thought more women experienced heart disease; most who believed this were women.

In fact, heart disease is the number one cause of death for women older than 55. Menopause is major risk factor.

Confusion over Reproductive Health

Only 17 percent of men and women recognized that one in five women have periods severe enough to interfere with their daily activities.

Respondents also underestimated the rate of miscarriages among Canadian women—22 per cent in nearly equal numbers of men and women believed that one in 20 pregnancies ends in miscarriage. Only 17 percent knew that miscarriages occur in about one in five pregnancies.

Many respondents were baffled by hormonal birth control. Half of men did not know whether birth control affects a woman’s ability to conceive. One-quarter of men and women mistakenly believed that fertility depends on how long a woman has been taking birth control. Only 16 per cent knew that it has no known effects on fertility.

Nearly half of men and one-third of women do not know the prevalence of post-partum depression rates. Among women, 24 per cent said that one in three women are diagnosed with depression or anxiety disorders in the months following birth, and 23 per cent said the rate is one in five. Women believe post-partum depression occurs more frequently than men do.

In 2019, Statistics Canada reported that almost one-quarter (23%) of mothers in Canada who recently gave birth reported feelings consistent with either post-partum depression or an anxiety disorder.

How the WHCC Can Make a Difference

“We want to change the conversation and reduce the gap of knowledge,” said Greening.

To get there, women will need access to better information about their health, which requires more research specific to women’s unique needs.

Greening says the WHCC hopes to raise funds for more research on women’s health, including data on factors such as race and socioeconomic status.

“It’s not just gender — it’s the intersectionalities within our gender and how women disproportionately are responsible for caretaking and for managing the health of their families,” says Greening.

She points out that most people living in poverty in Canada are women and girls. “All of these things play into understanding how women navigate the healthcare system,” she says.

She worries that the pandemic will decrease overall investment in women’s health research. The non-profit sector has experienced an overall decline in philanthropy and contributions over the course of the pandemic, she said. At the same time, many of the researchers who specialize in women’s health are women, who bear increased caregiving burdens at home. Research has shown that women are producing fewer academic papers than their male counterparts during the pandemic.

Even before Covid-19, women’s health represented an under-funded area of research in Canada. Over the last decade, only one percent of salary awards went to women’s health researchers in Canada, and in B.C., women’s health grants made up only eight percent of Canadian Institutes for Health Research grants, according to a 2019 report from the BC Women’s Health Foundation.

“Who gets funded and what gets funded, who gets included and who makes the decisions are still predominantly men. And that is showing up in women’s health outcomes,” said Greening.