Women’s Health in Nova Scotia

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Transcript Women’s Health in Nova Scotia

Genuine Progress Index for Atlantic Canada Indice de progrès véritable - Atlantique

Measuring Community Wellbeing

IACD Conference, Wolfville, NS 24 June, 2008 Michael and Martha Pennock, Ron Colman

Indicators are Powerful

What we measure:

 reflects what we value as a society;  determines what makes it onto the policy agenda (e.g volunteers);  influences behaviour (students): & What we don’t count doesn’t get attention

Counting it Wrong

• Resource depletion as economic gain • Negatives can make economy grow • Unpaid work counts for nothing • How much income/wealth but not how it’s distributed -> Misleading signals to policy makers and general public (e.g. GHGs)

A good set of indicators can help communities:

 foster common vision and purpose;  identify strengths and weaknesses;  hold leaders accountable at election time  evaluate which programs are working or not  initiate actions to promote wellbeing; + agreed targets can change public behaviour

Therefore – In the GPI:

   Natural wealth, health, free time, unpaid work, and education have value Sickness, crime, disasters, pollution are costs  Reductions in greenhouse gas, crime, poverty, ecological footprint are progress Growing equity signals progress GPI Atlantic = Non-profit, fully independent, NS-based research and education organization founded April, 1997. Web site: www.gpiatlantic.org

Provincial -> Community

• Where rubber hits road in QOL; BUT Statcan data not available at comm. level • Kings County, Glace Bay – Contrasting communities - Consultations, survey design • 2+ hours; Sample size = 3,600 (2 cross-tabs – 95% +/- 3%); Statcan oversight • Response rate = 70+% Kings; 82% GB

Basic GPI question: What kind of community are we leaving our children...?

Survey components include:

• Economic wellbeing – including income, employment and job characteristics • Subjective wellbeing: life satisfaction, happiness • Core values and guiding life principles • Social supports and networks, formal and informal volunteering, and care-giving • Health status, incl. self-reported health, chronic disease prevalence, activity limitations, and prevention (e.g. mammograms, blood pressure tests)

• Lifestyle behaviours, incl. smoking, diet, physical activity • Mental health, including cognitive ability, stress, and depression • Children’s health, including health status, mental health, cognition, and chronic conditions • Environmental behaviours (e.g. transportation patterns) and ecological attitudes • Safety and security, including victimization rates and subjective feelings of safety.

Each category has several indicators (results in charts)

E.g. employment section will have results on: • Unemployment (short + long-term) • part-time employment • work schedules • job characteristics • multiple job holding • discouraged workers • proportion of jobs with employee benefits

Release today – Sample results:

Economic Security

Unemployed Discouraged Multiple Jobs % Households <$20,000

Glace Bay

26.4

40.9

5.1

28

Kings

12.7

16.3

11.0

14

Life-Satisfaction (+ Happiness)

Glace Bay Kings

Very Satisfied 40.3

39.4

Somewhat Satisfied Dissatisfied 50.3

9.3

53.4

8.2

Health Status

• No significant difference in self-reported health • GB had higher rates of disabling pain, chronic diseases, smoking • Strong relationship to income and employment in both communities • Low vs high incomes = 3x rates of severe pain, discomfort, daily smoking, health-related activity limitations; 2x HBP, arthritis, chronic diseases. U.e.: ½ as likely satisfied as w. jobs

Very good to excellent health % cf across income + GB/Kings

Glace Bay Kings -20000 20000 34999 35000 49999 50000 69999 70000+ 33 46 55 58 73 30 41 52 60 67

Health Status and Income

Query: If health status is income related and Glace Bay has a much higher proportion of low income respondents, why isn’t GB self rated health status lower than Kings?

• Higher rates VG/excellent health across most income groups in Glace Bay • As a result, overall rates are equivalent despite the higher rates of low income in Glace Bay and relationship between health and income. But why…..?

15 10 5 0 50 45 40 35 30 25 20 Very

Self-Reported Stress

Somewhat Not very Not At All GB Kings

Sources of Stress

Kings

• Too many demands • Too many hours • Insufficient autonomy • Interpersonal conflict

Glace Bay

• Too few hours • Risk • Fear of layoffs

Stress and Employment

• Two-income families much more highly stressed than one-income families • More two-income families in Kings • Two-income families in Kings more highly stressed than in Glace Bay • Kings – highest incomes = most stressed • (AJHP: Stress = costliest of all risk factors)

70 60 50 40 30 20 10 0

Stress and Household Income

GB Kings -2 0 20 -3 4, 99 9 35 -4 9, 99 9 50 -6 9, 99 9 70 ,0 00 +

Social Support

Glace Bay

Count on in crisis 95.5

Advice Loved Close relative 1/week Neighbour 1/week 94.6

96.8

80.1

77.9

Kings

94.4

91.6

94.7

72.9

63.1

Faith, spirituality, safety…

• Glace Bay had higher rates of self-reported faith, spirituality, church attendance, decision control + half as likely to have been victimized or to know someone who has been victimized In Sum: GB low stress, high faith, safety, social supports = non-material assets that partially compensate for poorer material conditions = key sources of life satisfaction & wellbeing + important information for community development planners (vs conventional tools)

Core Values - Guiding Life Principles

% rating 8 to 10 Glace Bay Kings

Family Responsibility Freedom Friendship Financial Security Generosity Pleasure Spiritual Career Success Material Wealth 95.2

93.2

87.5

88.4

80.6

78.4

70.8

67.2

68.0

32.4

94.4

93.2

89.1

86.4

72.4

73.4

68.6

52.5

58.3

22.8

Importance of Core Values

% Rating 8-10

Family Responsibility Freedom Friendship Financial Security Generosity Pleasure Spiritual Career Success Material Wealth

Self 94.9

93.3

88.4

87.3

76.3

75.8

69.6

59.5

62.8

27.4

Others

55.9

50.8

80.6

54.2

76.9

36.6

76.1

29.4

92.4

67.8

Value Alienation?

• Large majority of respondents in both communities believe they are socially motivated individuals living in a materialistic society • Is dominant commercial culture, materialism out of touch with what matters most to people?

• Factor analysis: Positive social values intrinsically related to positive wellbeing while materialistic values were not - Consistent with growing research literature

Practical utility for policy. E.g:

• Glace Bay has significantly higher current smoke rate but lower ever-smoked rate = Quit rate much higher in Kings County -> Schools initiative • Identify health needs, prevention/screening: E.g. Kings significantly higher rates than GB for mammogram (64% vs 40%), CBE (45% vs 35%). Both low on Pap smear (47% vs 45%)

Mental health: Depressed feelings associated with child risk factors 40 35 30 25 20 15 10 5 0 GB Kings 0 1 # factors 2+

20 15 10 5 0 Results suggest new policy options

% workers willing to trade all or part of a future pay increase for shorter work hours

30 24.3

25 14.3

Kings Glace Bay

What would increase life satisfaction? Kings County

Spend more time with family/friends Less stress 72 % 71% More money More possessions 53% 16%

Greater focus on economic security vs consumption

• E.g. Core values: 3x high importance to financial security vs material wealth • So policies that enhance job security, ensure living wage, social safety net appear closer to values than growth policies alone • E.g. Benefits: Part-time workers less than half as likely to have most benefits + very strong relationship with income. E.g. GB: less than 5% lowest income have benefits. Cf Netherlands

Ecological Attitudes and Behaviours

• 83% said their way of life produces too much waste, & focuses too much on current consumption, not enough on conserving resources for future generations • 85% said “most of us” buy and consume more than we need; 2/3 said they could consume less if they chose • Stronger in Kings and among high-income (81% could consume less)

Understanding the ecological footprint

Nova Scotia Footprint Q1 6.2

Income Quintile Q2 Q3 Q4 6.6

7.0

8.1

Q5 10.7

Household income $/year -20,000 20,000 to 34,999 35,000 to 49,999 50,000 to 69,999 70,000+

+ more SUVs

Total Average #f Vehicles/ Househo ld 1.0

1.4

1.5

1.8

2.0

1.6

Average Kms./ Vehicle/ Year 17,777 19,268 20,861 20,966 22,600 20,853 Househ old Kms Per Year 13,772 22,629 27,530 34,665 40,384 28,916 Av. Commuting Distance to Work for H’hold commuters 14.4

12.9

16.4

14.4

15.9

15.1

Income and wellbeing – to a certain point…

“Despite the weak relation between income and global life satisfaction or experienced happiness, many people are highly motivated to increase their income.” (Daniel Kahneman Economist, Princeton University) “Economies thrive when individuals strive, but because individuals will only strive for their own happiness… they mistakenly believe that producing and consuming are routes to personal wellbeing” (Daniel Gilbert: Stumbling on Happiness. 2006)

And at most practical level:

• E.g: Kings: Volunteerism: 49% would give more time if asked: Esp: males - 55%; low income – 58% ; young (15 to 24) 76% • E.g: Glace Bay: Identified problem areas police chief immediate action

At the community level, fewer barriers to action. Power of evidence - can really inform practical decisions

+ Process = Result. E.g.:

• Indicator selection, creating survey = community building • Farmers exchanging information • Report releases in Sheffield Mills, Jeddore farmers, fishermen present • New ideas: e.g. restorative justice • Results bring disparate groups together

Next Steps…. Update + baseline data now at Acadia and CBU: further analysis

Can we do it?

Percentage Waste Diversion in Nova Scotia 60 50 40 30 20 10 0 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000

Volunteerism: Atlantic Provinces lead (formal rate)

Measuring what we value to leave prosperous and healthy communities for our children

Genuine Progress Index for Atlantic Canada Indice de progrès véritable - Atlantique

www.gpiatlantic.org