Inequalities put women’s health at risk, Heart & Stroke report finds

A new report from the Heart and Stroke Foundation of Canada highlights “significant inequities” in women’s heart and brain health care that disproportionately affect racialized and Indigenous women, members of the LGBTQ2S+ community and those living with low socio-economic status, among others.

The report, released Wednesdaysays gaps in research and care – compounded by a lack of awareness of the distinct risk factors for heart disease and stroke that women face – put lives at risk.

The report says that in general, women who have a heart attack are less likely than men to receive the treatments and medications they need or get them in a timely manner, and they are more likely than men to die in the following year. In 2019, 20% more women in Canada died of heart failure than men, and 32% more women died of stroke than men, according to Heart and Stroke. The report says heart disease and stroke claimed the lives of more than 32,200 women in 2019, or one life every 16 minutes.

Heart & Stroke said the women featured in this report include cisgender and transgender women as well as trans and non-binary people “with shared experiences who may not identify as female.”

The report highlights groups of women who face greater health inequalities than others, including racialized women, Indigenous women, women from the LGBTQ2S+ community, women of lower socioeconomic status, women with disabilities and women living in remote areas.

BIPOC (Black, Indigenous and People of Color) women often have predisposed risks for cardiovascular disease, but Canadian guidelines for understanding these risks are not based on ethnicity, the report says. According to a 2014 report, in collaboration with the Heart and Stroke Foundation, researchers found that out of 1,000 pregnant women in Ontario, gestational diabetes is twice as common among South Asian women as among white European women. Similarly, African-Caribbean, Hispanic, and Chinese North American women are at greater risk of heart disease due to predispositions that many are unaware of.

Women of lower socioeconomic status and those living in rural areas also face greater health risks due to their lack of access to health resources, education, or nutritious and affordable food in the country. daily.

Additionally, women and people with shared experiences who may not identify as female in the LGBTQ2S+ community not only face increased health risks, but also face discrimination when seeking medical care. . According to a TRANS Pulse survey44% of trans people in Ontario said their health needs were unmet in 2019, as many reported avoiding emergency rooms or seeing their family doctor due to past negative experiences where they felt rejected or misunderstood.

Dr. Alexandra Bastiany, the first black woman in Canada to become an interventional cardiologist, said the multiple layers of a woman’s life play a huge role in how heart disease is diagnosed and treated.

“Being a woman is one thing, it’s already a risk factor for not getting the right treatment, but that’s not counting all the other things that can affect our patients,” Bastiany told CTVNews.ca during an interview. telephone interview on January 20.

GAPS IN IMMOBILIZED MEDICAL TRAINING

According to the report, almost 40% of Canadians do not realize that heart disease and stroke are the leading cause of premature death in women. This is especially dangerous for BIPOC women, according to the report, because the health of racialized women can be affected by several factors, including racism, historical trauma, language and cultural barriers.

Bastiany, who practices at Thunder Bay Regional Health Sciences Centre, said her move from a clinic in Montreal to a more remote community in northern Ontario has increased her awareness of Indigenous communities and the needs of aboriginal women there.

“Because of past experiences and historical trauma, there’s definitely a mistrust in the system and I’m working to try to bridge that and try to improve it on a small scale,” she said.

Bastiany said there needs to be more awareness and practical experience for healthcare providers on how to approach BIPOC patients. This would not only allow them to feel safe in their doctors’ care, but also build trust with the medical system that has failed them in the past, she said.

“There is so much space to improve the training and I don’t think the online modules are enough. I think there needs to be practical, real-world experience that we need to have at the start of the training because that creates a better doctor,” she says.

HOW WOMEN CAN DEFEND THEMSELVES

The report also included various testimonials from women who were unable to recognize symptoms of heart disease on their own or were referred by their health care provider.

Women face greater cardiovascular risks due to factors such as pregnancy, which can lead to high blood pressure, or polycystic ovary syndrome (PCOS), which can lead to an increased risk of obesity and potentially lead to disease. heart or stroke. Additionally, some heart conditions that can occur in men are more common in women, such as takotsubo cardiomyopathy — commonly known as broken heart syndrome — which can be triggered by stress.

In these cases, Bastiany said it’s imperative that women understand any pre-existing risk factors in their health and recognize any abnormal patterns to ensure they get medical attention when they need it.

According to the report, heart disease and stroke in women may not present as severe chest pain during a heart attack, particularly because women are more likely to experience multiple symptoms at once. Shortness of breath, nausea, vomiting, or discomfort in the neck, jaw, shoulders, upper back, or upper stomach are more common in women.

Many women are unaware of the risks they face for heart disease – such as pregnancy, age or menopause – which can lead to high blood pressure and an increased risk of stroke later in life. that’s why screening and education are key, Bastiany said.

“It’s important for people to know their risk factors and know their medical situation, so they can defend themselves and know when something is wrong,” she said.

Additionally, she said women shouldn’t be afraid to ask for a different opinion about their health if they feel like they’re being rejected by their healthcare provider.

“Patients shouldn’t be afraid to seek a second opinion. When you feel like medical staff are biased, or don’t really pay attention or really listen to what they’re saying, I think that’s is fine to ask someone else,” she said.

Although the Heart and Stroke Foundation says there have been improvements over the past five years in including women’s needs in cardiovascular health studies and treatments, there is still work to be done. In particular, the organization calls for improved guidelines on women’s heart and brain health for diagnosis and rehabilitation, based on the specific needs of women. In addition, there is a need to focus on education and awareness in the medical field and among women in general so that patients can feel encouraged to talk to their health care providers without restricting themselves, says The report.