Nobody listens, nobody wants to hear you: Access to healthcare/social services for women in Canada

Abstract

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.