Status of Women Committee on April 4th, 2019

[The Chair, Conservative, Karen Vecchio]

Good morning, and welcome to the 136th meeting of the standing committee on the status of women. Today's meeting is being televised.

Today, we'll continue our study on the challenges faced by senior women, with a focus on the factors contributing to their poverty and vulnerability. For this, we welcome on our first panel, from the Canadian Centre for Policy Alternatives, Katherine Scott, who is a senior researcher. From the International Longevity Centre Canada, we have Margaret Gillis, president, as well as Kiran Rabheru, who is the board chair.

We'll begin with testimony. We'll begin with seven minutes each, starting with Katherine Scott.

[Katherine Scott, Senior Researcher, Canadian Centre for Policy Alternatives]

Thank you to the committee.

As was said, my name is Katherine Scott, and I am a senior researcher with the Canadian Centre for Policy Alternatives here in Ottawa. I am also the proud mother of Charlotte, who was thrilled to attend the committee on Tuesday, as part of the delegation with Daughters of the Vote.

I can't promise to match the eloquence and passion of the young woman who spoke to you on Tuesday, but I am looking forward to talking about the economic challenges facing older women in Canada today.

Poverty and economic insecurity are unique hardships for older women, particularly when combined with the many overlapping challenges of aging, such as chronic illness, loss of mobility, providing care for a spouse, grandchildren, or both, or loss of community support. Given that Canada's population is aging, the gaps in our system of public supports for seniors will directly affect ever-widening numbers of people.

Today, I would argue, seniors are sometimes portrayed as a well-off generation that benefits overly much from generous government supports, at the expense of younger Canadians. This narrative ignores, I would argue, the realities of large inequalities in income and wealth in Canada, particularly among seniors, many of whom remain in poverty, despite the positive impact of CPP and OAS/GIS. It also ignores the very large reality of large disparities between men and women.

Age and gender are only two of the many intersecting factors, such as race, conjugal status, employment and sexual identity that impact economic security. It's the intersection of these experiences and identities that reveal the challenges women face, and what's needed by way of solutions.

In my short presentation, I'm going to point out what we know, and give you some thoughts about what we think is needed by way of building out supports for this important group.

Here's what we know. Seniors' poverty has increased since the mid-1990s, reaching 15.4% in 2017. That's according to the Canadian Income Survey. Rates of poverty are higher among senior women than among senior men. In Canada, in 2017, almost 600,000 older women lived in poverty, as compared to 340,000 men. Rates of poverty, again, among women, are higher in marginalized communities.

The census gives us great information about this. We know, for example, that one quarter of older indigenous women—those over age 65—live in poverty. The figure among women over age 65 who have just immigrated to Canada is 23%. Women in these communities face greater risks. We know, as well, that women who live alone are at particular risk. They are four times more likely to be poor than women living with a spouse or other relatives. Indeed, senior women make up over two-thirds of all seniors living in poverty. They make up over 70% of all singles living in poverty.

There's another large group we need to pay attention to. These are women, and seniors generally, who live with incomes just above the poverty line. More than half—that's 57%—of all older women had after-tax incomes of less than $25,000 a year in 2017, as compared to 38% of men. Of this group, two-thirds of women had incomes between $15,000 and $25,000 a year. We're talking about the majority of senior women in Canada living on very modest incomes. These are not the groups hightailing it down to Florida and the like. We're talking about people living on very modest incomes that are perhaps just above, but certainly not much higher than, the poverty line.

What this tells us is that many have little income above and beyond what's available through basic pensions. They have the basic OAS/GIS, and a modest CPP, depending on their work history. It also tells us why, for instance, core housing need is so acutely high among older women; in particular, women living on their own. It tells us why many face untenable choices each day of paying for the high cost of housing, medication, food or other basics.

It's perhaps not surprising that we've seen an uptick in employment among seniors. One in 10 women over age 65, in 2018, according to the Labour Force Survey, was engaged in the paid labour market. That's up from 3.2% in the year 2000. That's quite significant. We've also seen quite a startling increase in the employment rates of women aged 55 to 64. Indeed, employment was up 18 percentage points among women aged 55 to 59, between 2000 and 2018. It's up 22 percentage points among women aged 60-64, so it's quite a significant increase of labour market for this particular group.

I would argue that it won't be enough. Increased rates of employment certainly won't be enough to offset inadequate pension coverage, and won't be enough to offset woefully low levels of retirement savings.

The difference between income at retirement among those who have a pension and those who do not is stark. Thirty per cent, for instance, of Canadians between the age of 50 and 64 have no RRSPs or other similar assets, and 18% have no savings or private pensions at all. Women, in particular, struggle on incomes that are considerably low for potentially very long periods of time.

Women are doubly disadvantaged in this regard, first because of their work histories and secondly because of the sizable and persistent and damaging gender pay gap.

Women are still more likely to take time out of paid work to care for young children, ill or disabled family members or elderly parents, and they are more likely to work fewer hours at lower wages for the same reason.

Recent research—and you'll have seen any number of studies in the papers of late talking about it—looks at the motherhood wage penalty, and it paints a grim picture. Women's earnings fall steeply after having a child, and they never fully recover. And this, of course, influences their pension coverage and benefit levels much further, through their entire life, down the road.

What would it take then to enhance the economic security of older women? Promoting labour market participation has certainly garnered some attention at the OECD and the like. There was actually a federal-provincial-territorial committee not too long ago that was looking at this.

Let's cut to the three...and then we can come back to it in discussions.

I would argue that's a quixotic. I don't think that trying to increase labour market participation will necessarily deliver the bang, given the scale of the need. What really we need is a strong public infrastructure of public supports such as affordable housing and pharmacare, as well as strategies to address the working conditions in the low wage labour market and the like in order to achieve a foundation to provide greater security.

I will stop there. We can talk about the other things later.

[The Chair, Conservative, Karen Vecchio]

Excellent. Thank you very much.

We're now going to move onto Margaret Gillis for seven minutes.

[Margaret Gillis, President, International Longevity Centre Canada]

Thank you.

“Old bag”, “geezer”, “old maid”, “little old lady”, “babushka”, “old crone”....

It's depressing to google synonyms for older women and try to grasp the rampant ageism embedded in our society against our mothers, daughters, sisters, partners and ourselves. It's a sad reality, as older women are often stereotyped and overlooked, here in Canada and around the world.

That was clearly evident a few weeks ago at the 63rd session of the United Nations Commission on the Status of Women, where older women were blatantly ignored, even at the international epicentre of human rights.

Thus, I'm delighted to be here today to learn that the standing committee has taken the time to look at the issues faced by older women in Canada. Thanks to all of you for your important work.

I should begin by explaining that the International Longevity Centre is a human rights-based organization focused on the needs of older persons, and as such, all our interventions today will be viewed through a human rights lens.

ILC Canada is partnered with the LIFE Research Institute at the University of Ottawa and is part of a global alliance of 16 countries that was the brainchild of the famous geriatrician Dr. Robert Butler, who coined the term “ageism” back in 1969.

Ageism is defined as a combination of prejudicial attitudes towards older people, old age and aging itself. Like all “-isms”, ageism penetrates and destroys. It belittles and patronizes and it results in the loss of autonomy and dignity. Ageism creates barriers to health, financial resources, education, employment and social and economic justice. In fact, all the issues that you have listed for today's discussion are negatively impacted by ageism.

Older women face the double jeopardy of ageism and sexism, and this can become triple or quadruple jeopardy when racism, homophobia, disability and indigenous identity are added to the mix.

My first recommendation is that today's discussion result in a strategic plan to counter ageism and for Canada to lead a United Nations convention on the rights of older persons.

My colleague has been talking about poverty, which also has a huge detrimental impact on older women. We know that 16% of older women live in poverty and that the median income for older men is 1.3 times higher than for older women. This disparity leads to significant financial stress for older women. We know that women live longer than men, yet they have earned and saved less than men over their careers. Many have worked in lower-paid service jobs with fewer hours and have had leave periods to raise children and to care for aging family members.

To mitigate that, we recommend action on pay equity, including policy and investments that support educational training for women and provide support for caregivers. We must ensure GIS and OAS policies do not negatively impact older women and that every effort be made to find and register those who are eligible for programs.

Cardiovascular disease, strokes, malignancies, osteoporosis, and cognitive and psychiatric illnesses are the most frequent and often most devastating health issues in older age. Older women, as I mentioned, live longer than men and consequently are more likely to develop chronic illness.

As a case in point, 7.1% of Canadians suffer from dementia, but two-thirds of those are older women. The burden of caring for dementia largely falls on women, which may result in significant mental, physical and financial stress. Policies that enhance caregivers' quality of life must be a vital part of our health care system.

Older women often fail to receive the same quality or amount of health care as men. For instance, women with heart disease receive fewer diagnostic procedures and fewer treatments, and women with kidney disease receive dialysis later than men and get fewer transplants. This gender disparity can literally be fatal for women. Understanding the differences in disease frequencies, presentations and response is vital for optimal health for older women.

There is also a paucity of research on mental, as well as physical, health for aging women and this needs to change. The Mental Health Commission of Canada notes three key factors for effective health: prevention, health promotion and early detection. These are essential components of a sustainable, effective and equitable health care system.

Finally, we realize that the cost to society of not acting on these recommendations is dire.

Appropriate housing is a basic human right for all Canadians. For older people, that means clean, accessible housing that meets their needs for independence, dignity, safety and social participation, yet here is the reality for older women in Canada: 27% are in core housing need, meaning after housing costs they don't have enough money for food, medication and transportation.

Women make up seven out of 10 Canadians living in residential care, which can lead to the loss of social and community connections, self-esteem, autonomy and choice.

Lastly, to our national shame, we are witnessing an increase in first-time homelessness among older women. While we applaud the national housing strategy, it needs to better address the housing needs of older women.

ILC Canada and other like-minded organizations are vigorously advocating for a United Nations convention on the rights of older persons. We believe a UN convention would be transformative, because research-based evidence is clear: Conventions work because they better the lives of rights recipients.

A UN convention would see older people as rights holders and codify those rights in a single document. A convention would act as an anti-discriminatory tool to challenge negative stereotypes. Rights conventions improve government accountability and transparency and require the active participation of older persons. They raise public awareness and create better, healthier societies where older people prosper.

Canada has a long and proud history of leading and supporting conventions. There is no reason for our country not to work to better the lives of older Canadians, the vast majority of whom are women, along with the lives of other people around the globe.

I am going to leave you with some thoughts to ponder.

At what age does a person lose his or her rights?

At what age should a person be without preventative health care or access to education or training?

At what age should a person lose autonomy, self-determination and choice?

At what age should a person be less protected from discrimination, violence and abuse?

The answer is never. As we grow older, our rights should be enhanced, not diminished or lost.

Thank you.

[The Chair, Conservative, Karen Vecchio]

Excellent. Thank you very much.

We're now going to start our first round of questioning, for up to seven minutes each.

Salma, you have the floor.

[Salma Zahid, Liberal, Scarborough Centre, ON]

Thank you, Chair; and thanks to the witnesses for important insights and the data you have collected.

My first question is for Ms. Scott.

In the data and research you have gathered, have you developed any data on differing outcomes and challenges faced specifically by minority senior women; and how much is the intersectionality considered when it comes to making decisions on seniors' issues?

[Katherine Scott]

That's a great question and certainly something that, as a researcher, I have been looking at quite closely.

The fact of the matter is that we have extraordinarily great resources and information in Canada, but too often they are actually provided at the national level and they don't provide the depth and granularity needed to really paint a nuanced picture of groups such as racialized women, newcomers to Canada or indigenous women. That's certainly something that StatsCan has on its radar.

There is lots more to do and more investment needed to enhance the information that we have, certainly to provide not only at the national policy level, but actually to support community decision-makers as well. It's vital to think about the information and the sources that we need in order to support informed public policy.

I was able to generate some information from the census. As you know, the census is done once every five years. That really is probably not enough. There is a lot of great administrative data often that provides some information, but it's not publicly available. We really have a challenge in front of us to think through what's needed to support informed policy and reform in this matter.

[Salma Zahid, Liberal, Scarborough Centre, ON]

Ms. Gillis, would you like to add something to that?

[Margaret Gillis]

No, you've covered it well.

[Salma Zahid, Liberal, Scarborough Centre, ON]

I was looking into the May 2017 report from the Wellesley Institute that looked at diversity, aging and intersectionality in Ontario home care. We know that home care is going to be an increasingly important part of the seniors care metrics. As we know, in centres such as Toronto, minority seniors account for an increasing proportion of the seniors population.

I represent one of the Toronto ridings. According to the report, Toronto experienced a 131% increase in the number of visible minority seniors between 2006 and 2011. For Canada, it was 31% overall, but specifically for Toronto, it was 131%.

The report found that minority seniors have cultural, language and other barriers to accessing publicly funded home care. They were less likely to access publicly funded home care, more likely to rely on private care or family, and more likely to have unmet home care needs.

Are we doing what we need to do in order to address the intersectionality needs in seniors care delivery? What do we need to be doing that we are not doing?

Ms. Gillis, maybe you would like to start.

[Margaret Gillis]

I'm happy to start with that; and Kiran, you might want to add to it.

You have put your finger on a big problem, and there are a couple of issues that we need to unpack within the comments you've made.

First of all, in terms of getting information out and unpacking the availability of the public system for people who are not accessing it, there is a lot of history in different government programs of going out to actually find those people and bring them in so that they're getting access to it.

GIS and OAS are one example. Right now, HRSDC is looking at innovative ways to access people who aren't getting GIS and OAS, so there are models. We should be thinking about that for the folks you're talking about, particularly if 131% are not getting access in Toronto. That's just crazy.

Second, that's an area where we really need to look at funding and at how the system works, so that it covers people's needs. Research needs to be done on that and we need to start looking at better programming.

That's my two cents' worth.

Kiran, do you want to add anything more?

[Dr. Kiran Rabheru, Board Chair, International Longevity Centre Canada]

Ms. Zahid, that is such an important question. Let me just take it one notch above where you started.

Every single person in this world needs three things to have a good quality of life: We need a good place to live; we need something useful, purposeful to do; and someone to love. If we don't have one of those three things, our quality of life suffers.

There are lots of models in this world that do better than Canada. Japan has a really good model for community care. Even the United Kingdom, amongst the western world, actually has some good models where especially minority groups are served better.

Building on what Margaret just said, we do need to look at those and improve our system of social housing and supports in the community closer to home.

[Salma Zahid, Liberal, Scarborough Centre, ON]

Ms. Scott, would you like to add something?

[Katherine Scott]

I was listening to that. I grew up outside the GTA, and it is so true that in our large urban centres we are really facing a home care crisis. Partly it's aging, but the extraordinary diversity, certainly of the GTA community, is putting pressures on a system that simply has not been designed or adequately equipped to deal with the need of either providing support to all diversity families in their homes or providing institutional support.

It's interesting that, in terms of response, the beds in home care or nursing homes, for instance, actually might be arguably even less accessible today with the rising pressures on them than they were 20 years ago. We have not kept pace.

Investments here are critical, because certainly women's unpaid labour continues to be drawn upon. Caregivers are on the front lines of this crisis. Their own health suffers. That has certainly been my experience in my family.

To do nothing is to continue to exploit the labour of women. This is a very concrete, black-and-white example of where failures of public supports, and certainly of imagination and vision, leave families across the country hanging. It's acute in communities where institutionally or historically there have not been services to those communities that reflect cultural needs or their languages, particularly in seniors' care.

There is going to be a period of catch-up, but putting our heads in the sand is simply not the answer here. We have to really make a commitment to understanding the role of public supports and services to families as they go through this transition and try to enhance the quality of life of seniors. As Kiran was saying, Canada has fallen back and is behind.

It is complicated by the federal-provincial jurisdiction. Home care and many of these supports are clearly in the provincial domain, but certainly we have transfers here from the federal government.

[The Chair, Conservative, Karen Vecchio]

I completely agree. Thank you so much.

We're now going to move over to Kellie Leitch for her seven minutes.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Thank you very much, Chair; and thank you all for taking the time to come and present to us today.

I represent a riding that has become essentially the Victoria of Ontario. I have Collingwood, Wasaga Beach.... Three of the 10 oldest demographic postal codes in the country are within my riding, so I am acutely aware of some of the issues.

The thing that comes up the most and I hear about, possibly because I am a physician myself, is access to health care, the wait times, the idea of waiting 24 months to have a hip replacement and the impact of that on quality of life. The issue is that the governments, whether they be provincial or federal, don't seem to be accountable for their care, even though they take responsibility for it.

Could you comment on that and what you think might be some of the solutions around creating that accountability? Maybe it should be something in the act, or maybe it should be something with respect to how the provinces or the federal government should be approaching this.

When we had health transfers in the past, we put accountability around what it would be for. Do you have some comments on that for seniors?

[Dr. Kiran Rabheru]

Thank you for that fantastic question.

I really think that this is such an important point that we need to spend more time discussing, but just in the short time we have here.... Margie and I actually wrote to the minister when the health accord was being rolled out, about a year and a half or two years ago, with some recommendations on how we can make our health care system better moving forward.

We divided the recommendations into several parts, but the main one was about looking at primary prevention to help people who are healthy to stay well; looking at how we can help people who are at risk by providing them supports, care and wellness in their own communities so that they don't fall into that third category, the ones who are actually sick; and, providing good supports for people with mental and physical illness closer to their homes, within their community of supports and health, but not as much in the hospitals.

I think we need to keep people away from hospitals as much as possible by providing communities of care and support—social, transportation, poverty, all of these social determinants of health—closer to their homes, because that is where the money is being spent at the moment. For every dollar that we put into the health care system, we're only getting about 20 cents at the bottom.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Right.

[Dr. Kiran Rabheru]

That is the bigger issue, but we need more time to talk about the details.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Yes, I'd be delighted to hear about the details.

[Dr. Kiran Rabheru]

Yes, absolutely. We would be happy to talk to you about them.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

I have a second question for all of you with regard to the point that I think you made, Mr. Rabheru, about purposefulness in one's life. I don't know if each of you have a comment on a specific program or a specific idea that you would recommend to the government. I've sat on both sides of the House, and it's much more helpful when we know specifically what you're asking for, as opposed to the broad generalities of trying to boil the ocean. If you have something very specific that you know already exists and that maybe should be augmented, or something specific that you think would be valuable, that would be helpful.

Maybe you could start, Katherine, because you had an answer to a question for me. That would be great. By the way, your daughter was fabulous on Tuesday.

[Katherine Scott]

Thank you so much.

I'm happy to do that with some specific recommendations. I'll start with this. We were talking about home care. I would encourage the government to increase the amount of monies available to the provinces and territories for home care through the established transfer and to look at establishing a national care strategy that ensures—including conditionality, which is what you're talking about—the equitable provision of supports and services across the country.

We've moved away from that. We seem to be in an era where the federal government no longer directs its cash to the provinces. Certainly, the CCPA has always taken the position that it's wholly appropriate to attach conditions for the expenditure of the monies to promote equitable outcomes.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Margaret.

[Margaret Gillis]

My suggestion would be that we do something specific on social isolation and look at the impact on older people. What kinds of programs work? They have some great ones in the U.K. and other places in the world that we can mimic.

In the U.K., the doctors are now writing prescriptions for you to go out and join poetry groups or go to the art gallery. There are specific things. I think that's a huge one. It has huge health outcomes. You'll know, as a doctor, how important that is. Being socially isolated is like smoking cigarettes. We really need to get at that.