Addressing disparities in the care of women with spinal cord injury: The Canadian perspective

To better serve the needs of all individuals, issues related to gender and sexual function need greater emphasis in health care and research. This special supplement to the Journal of Spinal Cord Medicine focuses on women and the challenges they face as a minority in the population with spinal cord injury. The articles and abstracts represent the theme of the 8th National Spinal Cord Injury Conference, “Sex, Gender, and the Health of Women”, hosted by the Canadian Spinal Cord Injury Rehabilitation Association (CSCI-RA) in October 2019.

It is well known that optimal care stems from evidence-based research conducted in diverse populations, including minorities based on gender, race, ethnicity, and disability. Underlying the need for diverse enrollment is the fundamental issue of study design.¹ Demographic considerations should be integral to the entire process, from concept to implementation, and be free of bias. Bias can also affect how research findings are translated to clinical care, as well as the access to care. The supplement editors, Drs. Cathy Craven and Kristin Musselman, raise this issue in their commentary, discussing the importance of addressing biases that can adversely affect provider attitudes and service delivery, as well as the research process.²

Lack of attention to service delivery limits the impact of evidence-based research and contributes to the persistence of inadequate health care as well as the social and emotional difficulties and poor outcomes associated with spinal cord injury. In her commentary, Dr. Craven details the clinical experiences that sharpened her resolve to center the attention of the CSCI-RA on the needs of women with spinal cord injury. Her examples include women seeking help with the challenges of motherhood, domestic violence, and aging.² These examples illustrate the need for rehabilitation professionals to advocate for the tailoring of social support for women with spinal cord injury, and the importance of individualized care by knowledgeable and culturally competent providers. Developing effective solutions depends on open communication among providers and patients, awareness of the influence of biases, and a culture of tolerance and understanding.

The conference program features Lisa Boivin, a member of the Deninu Kue First Nation in Northwest Territories, and a graduate student at the Rehabilitation Sciences Institute at the University of Toronto. Through her art, she shares the compelling story of her family and her people, illustrating the perspectives of indigenous peoples on health, wellness, and disability.³ Awareness of the belief systems represented among clinical populations is important for all health care professionals. In Canada, knowledge of the history and traditions of the indigenous peoples is essential to delivering quality care to this vulnerable population.

JSCM is pleased to collaborate with the CSCI-RA on the dissemination of the content of the 8th National SCI Conference. We are confident that this conference supplement will motivate rehabilitation professionals to act as agents of change by contributing their energy and expertise to addressing health disparities related to sex, gender and the health of women.