New website aims to help inform aboriginal Canadians on sexual health issues

Experts behind a new website devoted to aboriginal sexual health hope it will be a culturally relevant tool for a population vulnerable to health issues such as high-risk pregnancies and sexually transmitted infections.

The launch of AboriginalSexualHealth.ca by the Society of Obstetricians and Gynaecologists of Canada coincided with the kickoff of the organization’s annual clinical meeting in Vancouver on Tuesday, which also marked National Aboriginal Day. The meeting began with a day-long International Indigenous Women’s Health Symposium.

Dr. Don Wilson, chair of the SOGC’s aboriginal health initiatives committee, said the website will target both aboriginal people and health professionals.

“All cultures have their own takes on reproductive health, having children, family life,” said co-chair Dr. Sandra de la Ronde.

“Each culture has its own sort of special importance and ceremony around it, and so this will provide a place where non-aboriginals but also aboriginals can learn more about cultural practices.”

Wilson said the site’s homepage, which features a medicine wheel, was selected as the centre image because it’s symbolic of the cycle of life and how everything in life is connected.

The online component is key, as one of the significant barriers to accessing health care is geography, said Wilson, a member of the Heiltsuk Nation from the north-central coast of British Columbia.

“There are many rural and remote aboriginal communities that don’t have ready access to health-care personnel that are there in their communities, but they’ll still be able to access this information via the Internet, because it’s becoming a more important tool to reach the rural and remote populations.”

Wilson said the information is also intended for urban aboriginal populations to help them understand what resources are available for them to access.

A section aimed at health-care professionals is focused on supporting the delivery of culturally safe care. Another section is designed specifically for aboriginal women and youth. It includes public health materials and information related to contraception, sexually transmitted infections and women’s rights.

Among the contributors is actor Adam Beach, who grew up on the Dog Creek First Nations reserve at Lake Manitoba. The film and TV star addresses subjects such as healthy and safe sexual relationships and sex education in videos produced with the SOGC’s sexualityandu.ca website.

“I think it’s very important for aboriginal people to hear from some people within their own communities about these topics and to bring education and information and advocacy forward in a way they feel comfortable and in a way they can relate to when they see it,” said Wilson.

The project was challenging “because the aboriginal world is not homogeneous,” he noted. Within Canada’s three main aboriginal groups — Inuit, Metis and First Nations — and even from community to community, there can be significant cultural variations.

“We’ve tried to take some representative examples from some communities and from some well-known aboriginal people to convey the necessary information in these domains.”

The SOGC recently released a new joint policy statement approved by more than a dozen organizations including the Assembly of First Nations and the Canadian Medical Association reaffirming sexual and reproductive health rights of aboriginal women and youth.

According to the statement, First Nations, Inuit and Metis women experience a disproportionately high rate of STIs, high-risk pregnancies, complicated and pre-term deliveries, teenage pregnancies and sexual violence. They are also more likely than the general population to have both low and high-birthweight babies, and infants born with fetal alcohol spectrum disorder and other developmental disorders.

First Nations, Inuit and Metis women also experience higher than average rates of obesity, diabetes, postpartum depression and cervical cancer, the statement said.

Wilson said when considering the social determinants of health, most outcomes are ultimately driven by factors like poverty, education or access to health services.

The doctor, who practises general obstetrics and gynecology in Comox, B.C., on Vancouver Island, said one of the biggest issues he sees affecting Canada’s aboriginal women is that some have to be evacuated from their home communities to give birth.

What should be a straightforward event can result in a “tremendous amount of emotional and economic upheaval,” Wilson said. Some women have to leave their communities up to four weeks before they give birth. This could lead to obstetrical interventions such as inducing a woman’s labour so that she can return sooner to her family, he noted.

“From a medical perspective, social inductions should be considered a no-no, but on occasion, we have to do them because there’s other mitigating factors that make it very important for a woman to rejoin her family.”

De la Ronde has been seeing patients since February at the Wabano Centre for Aboriginal Health in Ottawa. She hopes to develop a maternal-child program similar to one she helped establish at the Calgary Urban Project Society. Around 60 per cent of the population she saw at CUPS were aboriginal — primarily First Nations — many of whom were homeless or prostitutes.

“I saw a lot of families that had been broken up, people that I had met had been products of foster care themselves, a lot of addiction, I saw HIV, but it all went together,” she recalled. “The thing that I noted the most was the strength in those women that had been on the street, some of them from early teens, with their strength to survive.”

The SOGC is in the process of updating its guidelines for providing care to aboriginal people. De la Ronde said they’re hoping to get more information about cultural practices related to family life and childbirth across the country.

Wilson said there has been a steady decline in both maternity and obstetrical care providers over the past few decades as well as in the number of family physicians willing to do obstetrics. What’s more, there hasn’t been a dramatic increase in the number of other health-care providers who could possibly offer such care, such as registered midwives or nurse-practitioners.

“It requires a commitment on the part of the government, on the part of the training institutions and of individuals who go into these fields to be willing to go out into the smaller sites,” he said.

“If we had a magic wand and could create more health-care providers, it would certainly help the situation — no doubt at all.”

At the Heart of the Matter

Cardiovascular disease (CVD) is the number one killer of women in the United States. Although scientists have discovered demonstrable sex differences, treatment options remain the same. In response to this important issue, the Society for Women’s Health Research (SWHR) and WomenHeart: The National Coalition for Women with Heart Disease released the long awaited 2011 10Q Report: Advancing Women’s Heart Health through Improved Research, Diagnosis and Treatment on June 21 to a captivated audience on Capitol Hill.

The 2011 10Q Report is an update to the 2006 10Q Report that identified the top 10 unanswered research questions concerning the prevention, diagnosis and treatment of heart disease in women. Because these and other questions still lack answers, SWHR and WomenHeart are issuing an updated 2011 report.

Over 8.6 million women die annually of CVD and more women than men die each year of heart disease. Experts also estimate that one in two women will die of heart disease or stroke per year. There are known sex differences in symptoms and treatment of CVD, yet medical treatment of women has not changed substantially nor has it resulted in appropriate research into these distinct sex differences. The 10Q Report is a call to action to members of Congress, administration officials, researchers, health care providers, and women.

“The 10Q Report shows the major need to focus research funding appropriately for CVD to understand the important sex differences in heart health,” said Phyllis Greenberger, MSW, President and CEO of SWHR. “SWHR and WomenHeart consulted with cardiovascular experts to identify these top 10 unanswered questions to aid researchers in the study of prevention and treatment of this number one killer of women.”

The lack of understanding of sex differences in CVD can be attributed to insufficient recruitment of women and minorities for clinical trials. Improved participation rates would result in more accurate data and understanding of how CVD affects women differently than men. This in turn would produce more appropriate prevention and early detection plans, accurate diagnosis and proper treatment of all women with heart disease.

“The 10Q Report reveals a startling lack of research into how women and men are genetically differently in CVD symptoms, diagnosis and treatment,” said Lisa M. Tate, CEO, WomenHeart. “To better care for women, these 10 crucial questions must finally be addressed.”

Society for Women’s Health Research

The Society for Women’s Health Research (SWHR), a national non-profit organization based in Washington D.C., is widely recognized as the thought leader in women’s health research, particularly how sex differences influence health. SWHR’s mission is to improve the health of all women through advocacy, education and research. Visit SWHR’s website at swhr.org for more information.

WomenHeart: The National Coalition for Women with Heart Disease

WomenHeart: The National Coalition for Women with Heart Disease is the only national organization dedicated to promoting women’s heart health through advocacy, and patient support. As the leading voice for the 42 million American women living with or at risk of heart disease, WomenHeart advocates for equal access to quality care and champions prevention and early detection, accurate diagnosis and proper treatment of women’s heart disease.