It started with an urgent phone call to Professor Charmaine Williams, Associate Dean Academic of Social Work and the Factor-Inwentash Chair in Health and Mental Health.
A group of Toronto community agencies was concerned about problems their clients were facing with the health care system. Could Prof. Williams help to document their clients’ experiences?
Together, they planned an ambitious research study that would generate the largest research data set of its kind. Their findings would be laid out in the report, Every Woman Matters, released in April 2011.
Informed by interviews with 226 Black Women and Women of Colour, the report focused on women with physical disabilities, women who were HIV positive, women who identified as lesbian/bisexual, and women who were homeless or under-housed.
Women described all kinds of barriers to health care access, including the cost of travel, user fees, long distances to health care, wait times for services, competing family responsibilities, work obligations and other demands.
Many spoke of their expectation that they would encounter racism, homophobia, stigma and other types of exclusion in the health system. And there was the issue of language. Women who did not speak English noted a lack of interpreters and language-skilled staff.
“It’s amazing what women are living with,” says Prof. Williams. “So many are not successfully accessing health care.”
Capturing women’s adverse experiences was vital, she says. “So was looking at what is working and putting that knowledge into practice.”
Based on their research, the team developed and tested a program for homeless and under-housed women. It offered primary health care services
on-site at a women’s drop-in centre. A person called a “navigator” guided women through the system, even accompanying them to follow-up appointments, when helpful. Each woman received a ‘Health Passport’ documenting her health history, medications, appointments and other information. (The tool has already been adapted for people living with AIDS.)
Training was given to service providers on homelessness, mental health and anti-oppression.
“Women who came through that model continue, even today, to be accessing health care more effectively,” says Prof. Williams. “People are excited about this approach.”
For Prof. Williams, the entire research project was a classic example of knowledge mobilization.
“It started in the field. And now, the findings can be used by people in the field to support advocacy. I hope it will transform how we deliver health care to this population.”
Project partners were the Women’s Health in Women’s Hands Community Health Centre and the FIFSW, with collaboration from the agencies, Sistering – a Women’s Place, Planned Parenthood of Toronto, Rexdale Community Health Centre, and Parkdale Community Health Centre. Funding was from the Ministry of Health and Long-Term Care.