A “troubling number” of poor women in Ontario go without Pap smears, breast exams and mammograms that are critical in screening cancer and saving lives, says a report on health and poverty.
Sick and Tired, released this month by the Community Social Planning Council of Toronto, found the poorest people in Ontario bear significantly higher rates of bad health, chronic conditions and suicide.
It also found lower rates of preventive health care among the working poor and those on social assistance, especially women. “Rates were especially troubling regarding women’s preventive health care where substantial numbers of women in the poor groups had never had a Pap smear test, breast exam or mammogram for those over 40,” the report said.
It found 399 of every 1,000 women on social assistance had never had a breast exam — almost double the number of non-poor women. Among the working poor, the rate was 351 per 1,000.
There was also a stark difference among women who had never received a Pap smear. Among the working poor, 223 of 1,000 had never had a Pap smear, more than twice the rate of 96 per 1,000 among the non-poor. The rate was 163 per 1,000 among those on social assistance.
Dr. David McKeown, Toronto’s medical officer of health, said failing to deliver preventive measures amounts to “a missed opportunity, because if you could close the gap you’d have a much healthier community.”
However, he noted, there are many barriers for poor women who may not have time off work, transportation, child care or enough familiarity with the language and health system to take advantage of those OHIP-covered services.
Dr. Verna Mai of Cancer Care Ontario said the effectiveness of screening is well documented. Mammograms for women ages 50 to 69 can reduce the risk of death from breast cancer by 25 to 30 per cent, she said. Pap smears have led to a steady decline in cervical cancer over the past 20 to 30 years and can prevent it by identifying pre-cancerous cells.
However, she said preventive health can “slip through the cracks” for disadvantaged women juggling other pressing daily issues.
This is particularly true for many newcomer women, said Dr. Meb Rashid, a physician at Access Alliance, a Toronto community health agency serving immigrants and refugees.
Preventive health care is “way down the list” for those juggling jobs, worrying how their kids are faring at school and trying to put food on the table, he said.