The Australian health system is lauded as one of the best in the developed world, providing safe and affordable healthcare for all. So, it is surprising that 15.3% of respondents to the sixth Jean Hailes for Women’s Health national survey reported they could not afford health care when they needed it. Further, 31.1% of women in rural and remote areas could not get medical appointments when they needed one.
The national, not-for-profit organisation released the survey results in December 2020 providing insights into women’s health experiences, needs and behaviours. The aim of the survey is to identify emerging issues and trends and inform health promotion to best respond to the health and information needs of women.
The survey sample was older and had higher levels of education compared to the general female population in Australia. Forty-eight percent of respondents were aged between 45 and 64 years, compared to the population cohort, 31.3%. Almost two-thirds of respondents held an undergraduate or higher degree, double the national figure. Two-thirds of women lived in major cities and the remainder in rural or remote areas.
It is acknowledged the results are not reflective of all women. Limitations include the need to have English and computer literacy, the limited response from women of Change to Culturally and Linguistically Diverse (CALD) and Aboriginal and Torres Strait Islander backgrounds and that many respondents were likely to be health conscious and motivated to participate.
Key findings include results of weight and physical activity (PA) status. More than half of
respondents described their current weight as overweight (43.7%) or obese (12.4%). For comparison, in 2017-18, 29.6% of women were overweight and 30.2% were obese nationally.
Sixty percent of respondents reported doing at least 2.5 hours of moderate PA per week which is the recommend minimum. This compares neatly with the national 2017-18 rate of 59% of women meeting the recommendation for PA. Survey respondents who were overweight or obese were more likely to be physically inactive, compared with healthy weight respondents. Being active helps maintain a healthy weight but also confers a host of other health benefits.
On LGBTIQ, 8.3% identified as LGBTIQ with 0.7% transgender and 0.3% intersex. In terms of sexual orientation, 7% of respondents identified as bisexual or lesbian. The 2018 Australian Population Studies reported 3.4 per cent of females described themselves as non-heterosexual. This figure excluded survey participants who refused to answer the sexual identity question or who replied, ‘don’t know’ so this national figure could be higher.
The importance of providing identified health information and services to LGBTIQ women cannot be overstated.
“What we often see is a generalist response and our communities fall through the net because we know from our data that LGBTI women and communities prefer to access services that are highly skilled in meeting their health needs,” says Nicky Bath, CEO of the National LGBTI Health Alliance.
In relation to disability, nearly 10% of respondents lived with a disability which is lower than the 17.8% of Australian women who have identified as having a disability.
The survey reported 39.1% of women with a disability could not afford healthcare when needed and 32.7% could not get an appointment when required. Nearly half considered their health poor or very poor and 18.9% reported being in a controlling partner relationship.
“This is an important study which sheds light on key health issues, trends, concerns and outcomes,” said Ross Joyce, CEO of Australia Federation of Disability Organisations. “This survey demonstrates that for women with disability the results are particularly poor when compared to the results for those without disability, and again highlights the well documented ongoing disadvantage they face daily. We also know that similar disadvantage exists for girls and young women with disability.”
Measures of intimate partner domestic violence were included for the first time. Disturbingly, 23.9% of women in a relationship or in contact with an ex-partner in the past 12 months experienced some forms of intimate partner violence. Controlling partners comprised 11.1% of relationships and the figure for women with a disability was higher, 18.9%.
Romola Hollywood, Director of policy and advocacy, People with Disability Australia says, “We have known for some years that women and girls with disability disproportionately experience higher rates of violence, including sexual violence, than our non-disabled peers.”
Mr Joyce says, “These results are a disgrace and we all need be held accountable to do more and address these key health issues for all women and for women with disability in particular.”
In relation to COVID-19, 33.6% of respondents reported worse health than before COVID-19. This was pronounced in women aged 25-44, those with a disability, and LGBTIQ women, with more than 40% reporting worse health than before COVID-19. In fact, over 50% of women reported that their ability to access healthcare services had been affected in some way by the COVID-19 restrictions.
Timely and affordable access to health services is essential for all women, including the 43.5% of
women aged 45-64 years who sought information about menopause. Over a third of women in this age group also wanted information about weight management and anxiety.
Women’s interest in health information changed with age. The three top health topics of women aged 65-74 years were bone health and osteoporosis, weight management and healthy eating and nutrition. For women 75+ years, the top four areas of interest were bone health and osteoporosis, bladder health, dementia, and incontinence.
Information about women’s health, including healthy ageing, sex and sexual health and anxiety is found on the Jean Hailes for Women’s Health website. Online information will not solve the problem of the high number of respondents who were unable to afford health care when they needed it. However, the survey enables women to have their say, and policy and health providers respond to their needs and concerns.