With Carissa Gravelle at Heart and Stroke Foundation. The link between experiences of discrimination and your health and wellness is undeniable. It’s all about the “social determinants of health”. Discrimination based on gender and other connected factors like our race and ability impacts our health in so many ways. For example, we get treated differently based on our gender in healthcare settings. Our access to relevant health services and options differs wildly depending on our gender. Even the medical research that gets funded and acted on depends on our gender.
In honour of International Day of Action for Women’s Health, we’re focusing on gender and health matters we may know bits and pieces of but probably need to learn more about.
Our guest Carissa Gravelle is passionate about anti-racism, diversity, inclusion, young people, under-represented populations, mental health, and wellness. Carissa has worked in the non-profit sector for over a decade spearheading equity, diversity, inclusion, and access initiatives. Carissa works to advance health equity for marginalized populations and believes in the importance of educating through storytelling and meaningful conversations to change perceptions and inspire social change.
Transcript
00:00:05 Carissa
We’re definitely still seeing that women are underrepresented in research. There are significant gaps in awareness, research, diagnosis, and care for women’s heart and brain health.
00:00:15 Andrea
What about heart and brain health for women?
I’m Andrea Gunraj from the Canadian Women’s foundation.
Welcome to Alright, Now What? a podcast from the Canadian Women’s Foundation. We put an intersectional feminist lens on stories that make you wonder, “Why is this still happening?” We explore systemic routes and strategies for change that will move us closer to the goal of gender justice.
The work of the Canadian Women’s Foundation and our partners takes place on traditional First Nations, Métis, and Inuit territories. We are grateful for the opportunity to meet and work on this land, however, we recognize that land acknowledgements are not enough. We need to pursue truth, reconciliation, decolonization, and allyship in an ongoing effort to make right with all our relations.
00:01:07 Andrea
The link between experiences of discrimination and your health and wellness is undeniable. It’s all about the “social determinants of health.”
Discrimination based on gender and other factors like our race and ability impacts our health in so many ways. For example, we get treated differently based on our gender in healthcare settings. Our access to relevant health services and options differs wildly depending on our gender. Even the medical research that gets funded and acted on depends on our gender.
In honour of International Day of Action on Women’s Health, we’re focusing on gender and health matters we may know bits and pieces about but probably need to learn more about.
Our guest Carissa Gravelle is passionate about anti-racism, diversity, inclusion, young people, under-represented populations, mental health, and wellness. Carissa has worked in the non-profit sector for over a decade, spearheading equity, diversity, inclusion, and access initiatives. Carissa works to advance health equity for marginalized populations and believes in the importance of educating through storytelling and meaningful conversations to change perception and inspire social change.
00:02:19 Carissa
My name is Carissa, my pronouns are She and Her. I am currently situated in my hometown on the unceded, unsurrendered land of the Algonquin Anishinaabe people. My current role is a Senior Specialist of Health Equity and Partnerships at the Heart and Stroke Foundation.
I’m a social worker. I started off my career advocating for children and young people, and my first role actually was a counselor for pregnant and parenting young people. And then I moved into various child advocacy and mentoring programs, and then landed in community development work with young folks, newcomers, and other marginalized groups. That work actually really inspired me to go back to get my bachelor’s degree in Equity, Diversity, and Human Rights. And I’ve been a consultant in the EDI and anti-racism space since 2020.
I’m super passionate about my work, family, my close friends. I love to cook for my loved ones. I enjoy experiencing different culinary cuisine, travelling, spending time in nature. I love to read. I would love to write a book one day—that’s one of my aspirations in life.
I resonate deeply with my Zodiac sign, Taurus. When I meet other Taurus’, we’re kind, gentle, ambitious, determined, genuine, hardworking, and very stubborn creatures who like to lead rich and fulfilling lives.
00:03:27 Andrea
How have brain and heart health matters affected you and your family on a personal level?
00:03:32 Carissa
This has really deeply impacted my family on various levels. First off, my adopted mother had dementia at the end of her life and a lot of that time my family and I spent thinking about, you know, “What were the things that may have triggered that condition?” She had a quick decline at the end of her life.
So, in addition to that, generations of women on my biological, maternal side have high blood pressure. My great grandmother, my grandmother, my mother—we all have high blood pressure.
I had pre-eclampsia during my pregnancy with my son. And I was young at the time. It really wasn’t communicated what that meant for my life and lifestyle after the pregnancy. I really kind of just felt that “Oh ok, I guess I have this because I’m pregnant,” but there was no messaging in and around those lifestyle things I had to be aware of moving forward with my life after giving birth.
During my pregnancy, I became high risk at 25 weeks, and then again, I was induced at 37 weeks. Later on in life, like I’ve thought that I should monitor my blood pressure every so often, but it didn’t really escalate again until I was 33 years old.
And just after COVID, I think like a lot of people, like, I gained a bunch of weight in a short period of time and then I developed sleep apnea, and exercise-induced asthma, and hypertension as a result of the, I guess, sudden weight gain.
And what really scared me was I had a lot of conversations with my mom, my grandma, after, like, getting diagnosed at 33. I kind of asked them when they got diagnosed and it was, like, much later in life, so to me that was alarming, but I also knew I had it during pregnancy, so I should have kind of expected it—although, I wish that someone in the healthcare field had told me that I should look out for this.
And so, I had to take drastic changes because I really didn’t want to be medicated for hypertension at 33. I couldn’t see myself being on a prescription medication from, you know, now until, you know, the end. So, I took serious steps to reclaim my health. I lost about 50 lbs. I, you know, really watched what I ate, exercised regularly, and once that weight came off and I made those lifestyle changes, the exercise-induced asthma went away, and the sleep apnea went away.
And so now, I still have to monitor my high blood pressure regularly. If I’m feeling a little bit off, I’ll typically—I have an at-home cuff that I use, but even just regularly on a daily basis, I have to check it sometimes because, as you know, with high blood pressure, it’s a silent killer. Oftentimes, we don’t know when our blood pressure is high, it just is, right? So, keeping stress low is something that I have to do often.
And I think because my mom and my grandmother also suffer from high blood pressure, it’s something that we’re constantly having conversations about. And my son, you know, being part of this campaign with me for Heart and Stroke, he even wants to check his blood pressure and he’ll ask me, “Oh, should we check your blood pressure?” and I’ll ask him about the numbers and I think it’s really important that he’s aware of how important that is now and he’s learning about the numbers and if potentially he could be at risk later on in life, or his child or what not, because we know it’s passed through our family history.
So, yeah, it’s really kind of just been a lifestyle change that we’ve had to adapt, but I am happy that I have the support of my family to help me navigate my way through it.
00:06:34 Andrea
What are the gaps when it comes to the issue of gender and heart and brain health? How are people affected differently depending on who they are?
00:06:42 Carissa
We’re definitely still seeing that women are underrepresented in research. There are significant gaps in awareness, research, diagnosis, and care for women’s heart and brain health, especially a lack of gender-specific research leading to a limited understanding of how heart and brain conditions manifest differently in women compared to men.
Medical curriculum isn’t really set up to teach about women’s unique medical needs, so physicians are better at diagnosing and treating heart disease and stroke in men. And this is partly because women-specific information is lacking and what is available hasn’t been widely disseminated yet.
Women were left out of our clinical research and two-thirds of participants in clinical trials on heart disease and stroke have been male. And when women are included, a sex and gender analysis is not always done. Many of the tests used to diagnose heart attack were developed and tested on men, and many guidelines for heart disease and stroke still fail to adequately address women’s needs. So, there’s a general lack of awareness amongst healthcare providers and women themselves to understand the unique risk factors that contribute to heart and brain health.
In fact, in 2019, heart disease and stroke claimed a woman’s life in Canada every 16 minutes. It is the leading cause of premature death in women, and women make up just over half of Canada’s population.
Now, when you ask how women are affected differently depending on who they are, this impact happens through various factors, like ethnicity, age, socioeconomic status, even marital status, underlying health conditions, lifestyle, of course, and stress. There’s also little understanding on how women of differing ethnic backgrounds may have varying risk factors and cultural influences that impact their health outcomes.
It’s really critical that we place importance on research in understanding how intersectionality plays a role in women’s risk and health outcomes for heart disease and stroke.
We’re talking about various facets of someone’s identity, right? So, we want to bring in ethnicity, we want to bring in socioeconomic status. Maybe this person has a disability— could be neurotypical, it could be a physical disability. Oftentimes, when folks have a disability, other health conditions can be overlooked because they might tie into that disability.
When folks have various intersecting identities that make them up as a person, if it looks different from, you know, different individuals that they’re typically seeing, then certain things can be missed.
00:08:58 Andrea
What needs to happen to close the gender gaps in care and research for brain and heart health?
00:09:03 Carissa
To date, we’ve seen some progress around research, diagnosis, and treatment to support awareness, but moving forward, we definitely recognize that more needs to be done to ensure that women’s heart and brain health is fully supported.
So, first off, like gender-specific research funding to start an understanding of how heart and brain conditions affect women differently. And also, healthcare provider education— training and resources for healthcare providers to recognize and address the unique symptoms and risk factors and treatment for women.
We also want to raise public awareness campaigns. This is super important for folks to be able to see their likeness in these stories that come out, to know if they’re at risk or not. Obviously, advocating as well, and policy change. So, advocating for policies that promote gender equity in healthcare; research to ensure that women’s needs are adequately being addressed; community engagement initiatives; lifestyle interventions to promote healthy lifestyle habits, like regular exercise, balanced diet, stress management, sleep hygiene.
Heart and Stroke will be working with partners from all sectors and will take an approach that ensures health equity and Indigenous well-being that drives change in three key areas: our research, public awareness, and education, and the healthcare journey. Heart and Stroke is committed to working in partnership to transform the healthcare system to ensure all women receive the care they need when it comes to their heart and brain health.
It is crucial that care for women’s heart and brain health is sex and gender appropriate, equitable, culturally relevant, and, of course, safe.
00:10:23 Andrea
What can listeners do to take action for their heart and brain health today?
00:10:27 Carissa
Start with knowing your risks—that’s the first place to start. Educating yourself and understanding your risks for heart disease and stroke is so important and critical. Only 11% of women in Canada can name one or more women-specific risk factors for heart conditions and stroke. Heart and Stroke recently published a great resource on its website that educates women on their risk factors across their life stages, specifically focusing on the reproductive years, menopause, and post-menopause.
You can read this information on modifiable risk factors like an unhealthy diet, physical activity, and unmodifiable risk factors like family history. You can also find tips for how to have a conversation about risk factors with your healthcare provider, and a self-assessment tool provided as well. To access this information, please visit heartandstroke.ca/women and click on “Women’s risk factors” to learn more.
Other steps, again, around leading a healthier lifestyle are super important. Eight in ten cases of premature heart disease and stroke cases are preventable through healthy lifestyle behaviours, like eating well, so opting for whole foods wherever possible and limiting processed foods when you can; getting moving, so incorporating physical activity into your daily routine, so even walking for 20 minutes a day is a great start; being smoke free if you can—seeking help and support in quitting; if you drink alcohol, limit yourself to smaller amounts, pace yourself, and drink plenty of water in between.
And stress management is super important—practicing mindfulness, activities like yoga, journaling, just spending time being still and doing nothing when you’re feeling overwhelmed. Talking to friends or loved ones, or a healthcare professional, a mental health care professional if you can. And keeping an eye on your blood pressure is really important as well—I know that’s a really critical thing in my life is checking my blood pressure regularly—and most folks can do this at a local pharmacy. If you have the means, you can also purchase an at-home monitor as well.
00:12:15 Andrea
Alright, now what? Check out Heart and Stroke Foundation’s website at heartandstroke.ca/women.
If you want to make sure no woman, girl, Two Spirit, trans, or nonbinary person feels out of options, out of sight, out of time, or out of mind, visit yescountmein.ca today. When you count yourself in, you’ll join over 67,000 people in the Canadian Women’s Foundation’s generous and active community. You’ll get tools and opportunities to advance gender equality. This movement needs you. Visit yescountmein.ca and count yourself in today.
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