Status of Women Committee on May 17th, 2016

[Dr. Cara Tannenbaum]

Off the top of my head, a sex- and gender-based analysis would consider at least three things:

One is that women live longer than men. The average life expectancy for women in this country is about 82 or 83 now, and for men it's 79. There is the gender gap. Women also have a quality-of-life disadvantage in that they live longer with more disability. That is just the health expectancy proportion of the population that is going to need to be served. It is going to be disproportionately women. They will consume more medications, and they will have more chronic disease.

The second thing would be income. We know that older women are twice as likely to be below the poverty line than men. That might be gender. Maybe they didn't work; maybe they didn't have the pension plan. For the non-covered services, such as physio or psychotherapy for grief and things like that, they will not be able to access those non-covered services and will be put on medication.

I think that is my time, so you won't get the third one.

[The Chair, Conservative, Marilyn Gladu]

Excellent.

We will go to my Liberal colleague Mr. Fraser, for the final seven minutes.

[Sean Fraser, Liberal, Central Nova, NS]

Thank you very much. I want to start with a few questions about training, which each of you mentioned. I think you both mentioned either the GBA module or some internal modules that exist now or are being developed.

Dr. Tannenbaum, I think you mentioned that you could give us some examples of how training has led to success. Has it actually improved health outcomes for people?

[Dr. Cara Tannenbaum]

From a research perspective, it's hard to actually correlate who took the training and what their research discovery was. Sorry, but I'm a scientist, so correlation does not imply causation. That's a tough question to answer.

As for what I can tell you, I brought our little infographics to be handed out. They're infographics around “what is sex?” and “what is gender?”, because I do think that's helpful. We have a flyer about the training. I actually have some questions for you all to see if you know how to do sex- and gender-based analysis, so you'll tell me if filling out these questions improves outcomes here in Parliament. We could do a little study there.

On the answer to your question, I'll give you an example from the transgender youth survey: training and awareness about gender diversity has led to less stigmatization around expressing your gender identity. One of our funded researchers did a survey looking at how transgender youth feel. Are they able to talk about it? Are they able to express it? The results of that survey in the media led to schools putting into place inclusiveness policies and gender-diverse extracurricular groups and support groups. Also, there's some evidence that this reduces dropout from schools and possibly even suicidal ideation and suicide.

I don't know if that was a good example. The training has only been in place for a few years. For the data that I talked about, we have a pretest and then a test after the training. For instance, at the beginning of the training, we might ask people, if this is a gender-related variable, is this practice gender transformative, gender blind, or gender unequal? They'll say, oh my gosh, they have no idea what that means. They get a score and then they do the training. After the training, we see if they respond correctly to those questions. We can see if knowledge improves. We ask them how confident they feel, on a scale of zero to 10, that they could do SGBA. At the beginning, most people say.... I don't know what you guys would say. Zero means being not at all confident, with 10 being yes, totally confident. At the end, we see if their score has improved.

Finally, we ask people to evaluate publications and protocols and comment on the impact and knowledge translation of that evidence. We're able to compare the before-and-after answers to see if they're able to do that in an appropriate fashion. I could give you more examples of positive things, but I think it's education, education, and education.

[Sean Fraser, Liberal, Central Nova, NS]

That's very helpful.

Ms. Moriarty, still on training, I think you mentioned that staff in the health portfolio are encouraged to complete the GBA module, but it's not mandatory. Do you think there's an increase in the frequency with which SGBA is applied by those who've actually undergone the GBA module training?

[Cindy Moriarty]

That's a good question, actually. We haven't been tracking that. We've been trying to track how many people take the training, and we have information in terms of how we're seeing an increase in SGBA applied to memoranda to cabinet and Treasury Board submissions, for example, but whether or not those are exactly the same people, I couldn't say. There's definitely an improvement overall in the application across the department.

[Sean Fraser, Liberal, Central Nova, NS]

I think you mentioned that you're developing the specific subject matter module as well. Do you think this is something that's going to help increase the outcomes from the GBA training or, in the case of the health portfolio, the SGBA?

[Cindy Moriarty]

I think what I said is that in the gender and health unit we're not subject matter experts. We can't possibly be experts in everything that goes on in the department, so it's really much more about the process and supporting people.

I really like the phrase from the New Zealand witness in terms of walking “alongside” someone. This sort of goes to my point in terms of this being not a one-time shot. I think training can help raise awareness. I don't know that it necessarily helps develop the skill.

SGBA is something that's embedded in a suite, in a larger policy analysis, right? People go to university for that kind of thing and spend four years learning how to think critically, how to understand research, and how to read quantitative and qualitative research. To embed SGBA in something like that effectively really takes continued time and effort. It's not something that people will necessarily snap up in a two-day course or a three-hour module.

[Sean Fraser, Liberal, Central Nova, NS]

One of the other things that we've seen becoming important to different departments is the monitoring of the implementation and effectiveness of GBA.

I think you mentioned, Ms. Moriarty, that there's an annual report at the deputy level.

[Cindy Moriarty]

Yes.

[Sean Fraser, Liberal, Central Nova, NS]

Are there any other items that you feel are particularly important in terms of the monitoring, the implementation, and the effectiveness that has improved GBA in the health portfolio or with CIHR?

[Cindy Moriarty]

The exercise of monitoring is always helpful. When someone asks me at the end of the day what I've achieved and I have to come up with something, it really makes me think twice about what I'm doing and what I'm accomplishing. There's a certain self-interest and motivation there, to be sure, but to be frank, we have been monitoring more the use and application of the policy.

As much as I appreciate the compliments to Health Canada, we're probably still very much in our infancy. We've done I think a pretty good job in terms of embedding the practice, of getting it to be more routine terms of applying it. We don't get a lot of questions from people about why they have to do this, but on the quality of how that sex- and gender-based analysis is done, or the impact of those outcomes, which in Health we'll sometimes see years and years down the road, if at all, that's much more difficult to measure.

[Sean Fraser, Liberal, Central Nova, NS]

Dr. Tannenbaum.

[Dr. Cara Tannenbaum]

I think that's actually the critical point. You could go to see a specialist and have the initial diagnosis, but it's the follow-up that matters.

Here's where I think CIHR can help; our researchers would love to be called upon to talk about the evidence around a policy. You would just need to call me, and we could put a rapid response system in place. These really are what Cindy calls the content experts. I don't think we could expect you to know what people have spent their lifetimes researching.

I think drafting the policy early is important, but what happens when that policy is in place? We try to look at the unintended impact of, let's say, the marijuana policy, or smoking. We'll try to learn from smoking. Minors can't buy cigarettes. Well, we learned that a 17-year-old girl has a much easier time getting a cigarette than a 17-year-old boy. Why? There are lots of reasons, and most of them have to do with gender. Did anyone perceive the unintended consequences?

What are we doing to monitor the impact of a policy? Are we evaluating? There was a fitness tax credit. If your children did hockey, basketball, horse riding, sailing, and all kinds of male sports, you could get a tax credit. It didn't say dance, hip hop, or running. Did more parents apply for the tax credit for their sons than their daughters? You'll only know that if you do the analysis two years after the policy was implemented. To me, that's the real evaluation that we want.

[Sean Fraser, Liberal, Central Nova, NS]

Thanks very much.

[The Chair, Conservative, Marilyn Gladu]

Thank you very much to our witnesses, and thank you for the materials. That's wonderful.

If there's anything else you want to impart to the committee, you could send the information to the clerk.

Committee members, I want to remind you that at Thursday's meeting we begin to draft our report. You will have the pleasure of being chaired by Ms. Damoff, so be kind and gentle. I expect a full report when I get back.

Ms. Malcolmson.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

I'd like to ask a question again about the RCMP witnesses. At the end of the last meeting we heard that they aren't able to come. I want to understand that a little better and express my great disappointment, especially when we heard from the Status of Women Canada witnesses who talked about the—

Oh, sorry. Pardon me. It's National Defence and the armed forces. We heard this great example from the witnesses from Status of Women Canada that the Chief of the Defence Staff has a commitment to GBA in all operational planning. It's unique in the world. I just wanted to make sure that the armed forces knew our deadline and how important this is. As a new member I need to understand a little more. Can we compel witnesses to appear? Could they not have sent us a written brief or something?

[The Chair, Conservative, Marilyn Gladu]

We asked them if they would submit a written brief. We did not get one. They told us they couldn't appear before May 31, which was past the deadline that we needed to meet if we were going to come up with a report.

At this point in time you can ask the minister to compel them to appear. That would be an option, but with the timeline that we have, the analyst has advised that we won't be able to get a report out.

We can call witnesses after we start drafting a report, but to incorporate any of their content would be very difficult. The committee has to decide whether it's more important to achieve a report before Parliament rises or whether they want to extend it to the fall.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

I'd be interested in Ms. Vandenbeld's perspective on this. I'm sorry we didn't get a chance to talk about it beforehand. Maybe I'll put another question out there. If in September we were to call the minister or to call someone from the armed forces, we might be able to add a little more value without slowing down the report. I'm curious what our options are.

[The Chair, Conservative, Marilyn Gladu]

I think it's up to the will of the committee. After the session's report, they can still call a witness on another topic. They just have to make a new motion, I think.

We will get the answer on that for you. It's duly noted.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

I would also like to know what our process is around being clear. Maybe next time we'll get ahead of a problem like this.

Thanks.

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

Mine was actually not on that point.

[The Chair, Conservative, Marilyn Gladu]

The clerk has the—

[Anita Vandenbeld, Liberal, Ottawa West—Nepean, ON]

Oh, you have the answers.

Thank you.

[The Chair, Conservative, Marilyn Gladu]

Excellent. Problem solved.

Meeting adjourned.