Pillars of our Integrated Health Work

Gender Equity

Gender equity is the process of giving women and men the resources that they need to succeed in life. Gender equity recognises the diversity of disadvantage experienced by women and directs resources accordingly in order to reach equality.

Gender inequality in the workplace

As of November 2018, Australia’s national gender pay gap stands at 14.1%, with women in full-time work earning on average $239.80 less per week than men1.

In the SMR, we consistently see gender inequality based on employment type between women and men, with higher rates of women employed on a part-time basis, while a very small percentage of men are employed on a part-time basis. ABS census data from 2016 demonstrated that Mornington Peninsula had the highest gender inequality in the region with 52.6% of women in part-time work compared to only 21.3% of men.

When looking at 2016 census data relating to full-time employment we again see gender inequality. Port Phillip remained the only LGA in the SMR where women employed full-time ranked above the state average, demonstrating the lowest inequality in full-time employment in our region (60% females vs 74% of males). This was followed closely by Stonnington2.

Gender inequality in income

ABS census data from 2016 demonstrated clear gender inequality in the proportion of women and men who earn below the minimum weekly wage (that is, $0 -$649 pw) across the SMR. In our region, the proportion of women earning below the minimum weekly wage was consistently higher than men. There were six LGAs in which the proportion of women earning below the minimum weekly wage exceeded the state average.

Gender inequality and ageing

Across the SMR, the largest proportion of our population is aged between 25 and 44 years with females and males across the region accounting for between 20% and 22% of the population, respectively. Applying a gendered lens, we know that in Victoria women are particularly at risk of violence aged between 15 and 50 years of age3.

The SMR also has a larger proportion of females aged over 65 years (F= 16.6%, M= 14.4%) 4. Older women are increasingly living in poverty due to the accumulative impacts of gender inequality throughout life including lack of superannuation, gender pay gap, unpaid care in the home and a lack of supportive systems 5.

Mothers’ index indicator

The indicators measure a mother’s health, wellbeing of her children, her education, the family’s economic status and SES.

In 2016, SMR ranked 39.8 above the state average of 22.16. However, when we look at ranking per LGA we can see varying degrees of advantage and disadvantage.

Gender inequality in leadership

Gender disparities are consistently seen across Australian workplaces, such as the disparity between men and women in leadership roles. This perpetuates existing stereotypes about the role of women, both at work and in wider society, and exacerbates gender pay inequality7.

In 2016, only three of 10 mayors were female. City of Port Phillip was the only LGA in the SMR with a female CEO. Women were also underrepresented as councillors across all LGA’s8.

Women are also unrepresented in executive, general management and legislator positions across the SMR.

Prevention of Violence against Women

One in three Australian women will experience physical violence and one in five women over the age of 15 will experience sexual violence at some stage in their lifetime9.

Within the SMR there are pockets of disadvantage wherein we see both high and lower rates of violence in varying LGAs. However, looking at SMR as a whole, we continue to see an increase in rates of violence.  Across the SMR, an increase in family violence incidents over the last five years can be seen in a number of LGA’s including Cardinia, Casey, Kingston, Port Phillip and Stonnington 10

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Perceptions of safety

Within the SMR, several LGAs scored quite low when replying to the question “How safe do you feel walking alone in the local area by night?” Casey, Frankston and Greater Dandenong fared worst with most female participants answering that they Did Not Feel safe walking alone at night in the local area. Six out of the 10 municipalities within the SMR scored below the state average in both 2011 and 2015. In contrast, females in the municipalities of Bayside, Port Phillip, Mornington Peninsula and Stonnington scored higher when answering the same question 11.

Perceptions of Safety (2015)FemaleMale
Bayside50.888.3
Cardinia40.877.7
Casey26.370.2
Frankston25.468
Glen Eira45.679.8
Greater Dandenong1953.1
Kingston41.686.6
Mornington Peninsula41.282.3
Port Phillip47.882.2
Stonnington56.285.2
SMR average39.577.3
Victoria average4478.8

Sexual Offences

Sexual offences throughout the SMR have declined from 2018 to 2019 in a number of LGA’s. This is an encouraging sign particularly as the rate of sexual offences across several LGA’s in the SMR had seen some extensive increases between 2017 and 2018. While several LGA’s saw significant shifts in sexual offences in the last two years, Kingston and Frankston saw considerable increases in the sexual offence rate 12.

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Sexual and Reproductive Health

For the first time at a state level, the link between PVAW and SRH has been formally made. Family and gender-based violence can create barriers to women’s right to safely access appropriate SRH care services including timely access to contraception and fertility services13.

The strategy also identifies that ‘sexual and reproductive health is critically influenced by sex and gender norms, roles, expectations and power dynamics14. Societal norms place responsibility for contraception on women. This means that young women are more likely to believe that they hold responsibility for condom use and managing any risks associated with sex15. In addition, women often face stigma attached to casual sexual practices, whereas for men this behaviour is normalised and accepted. This stigma can have implications for women accessing SRH services16.

Gendered response

WHISE recognises that women have been disproportionately affected by poorer sexual and reproductive health.

As the report “Common Threads” reveals, “while SRH involves biological difference between the sexes, it is also influenced by social interactions such as gender relations, power differentials and economic and cultural factors”17.

Reproductive access and rights

Through a mapping of SRH services in the region, WHISE has found that women lacked information and access to contraception.

Have you identified an increase or decrease in the following needs from your clients of the past year?

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Service provision

WHISE has identified a number of issues of unmet service provision or requiring attention. 59% of organisations who responded to WHISE 2018 Service Mapping research stated that they were unable to appropriately provide SRH services for specific unmet needs.

Some of their concerns included:
  • Their inability to provide culturally appropriate SRH information
  • A lack of female GPs, or women’s health clinics
  • Long waiting lists for IUD insertion
  • A lack of easily accessible youth friendly sexual health practitioners
These practitioners and service providers further outlined various reasons for their inability to adequately respond to specific needs in their service provision. These included:
  • Inadequate or no funding for certain aspects of SRH
  • Inability to adequately refer clients to more specialised services
  • Lack of consistently available health practitioners
  • Lack of appropriately qualified and experienced health practitioners

Contraceptive use across the SMR

Contraceptive implant

Within the SMR, we can see that uptake rates for the contraceptive Implant are consistently low. Data from the Women’s Health Atlas18 reveal that several LGA’s have rates below the state average, while the LGA’s of Cardinia, Casey, Frankston, and Bayside, to a lesser degree, have higher rates of contraceptive implant use.

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Contraceptive IUD

Intra Uterine Device (IUD) insertion is variable throughout the SMR. Greater Dandenong has the lowest rate in the SMR, as the chart below reveals.  We can see that this has been the case from 2016 to 2018.  On an encouraging note the uptake of the contraceptive IUD across the SMR has also steadily been increasing from 2016 to 2018.19

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STI rates: shifting attitudes

Throughout Australia, high levels of STIs continue to occur. There is often misinformation or misunderstanding about the impact or health consequences of STIs. Throughout the SMR, high rates of STIs were identified, in line with national trends. In particular, high rates of Chlamydia, Gonorrhoea, and Hepatitis B were found present amongst a number of municipalities in the SMR.

Chlamydia

The SMR has some of the highest rates of Chlamydia found in Victoria (see below)20. Within the SMR, six out of the 10 LGAs have rates higher than the State average for Chlamydia. Chlamydia has been steadily rising since 2010 despite a small drop in 2012. While the rates of Chlamydia in men are also high in comparison to the State average, women maintain higher rates in all 10 LGAs in the SMR21

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Hepatitis B

Greater Dandenong, Stonnington and Port Phillip have higher rates of Hepatitis B than the State average. Greater Dandenong has the highest rate of Hepatitis B in the SMR22.

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Gonorrhoea

Port Phillip and Stonnington have rates of Gonorrhoea almost eight times higher than the state average. These rates are most likely due to the historically high rates of LGTBIQA+ individuals living in those two municipalities23.

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Cervical Screening Participation

Low participation in Pap Screening is found in Cardinia, Casey, Frankston and Greater Dandenong. These four municipalities are below the state average of 60% participation with Frankston having only 54% participation rate

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HPV vaccination

Several LGAs have low HPV immunisation rates for 14 year-old females (see below). As research has revealed, “the HPV vaccine has significantly lowered the risk of HPV-related cancers for thousands of women around the world”24.

LGACoverage Dose 1Coverage Dose 2Coverage Dose 3
Cardinia82.2%78.3%68.6%
Casey89.0%84.3%75.8%
Greater Dandenong82.4%80.7%75.3%
All SMR LGA’s88.9%85.6%79.1%
Victoria90%87%81.1%

HIV

Port Phillip and Stonnington have a HIV rate five (5) times higher than the state average; particularly amongst its male population (see below). These two LGAs have a high LGBTIQ+ population as well as a transient community of travellers.

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Syphillis

In Victoria, notifications for “infectious syphilis (defined as infection less than two years duration including primary, secondary and early latent presentations) reached a record high in 2018”.  The increase of syphilis seen in women is particularly concerning as Syphilis “during pregnancy can cause congenital syphilis which may result in serious birth defects and stillbirth”25.  Since 2004, “congenital syphilis re-emerged in Victoria, with two cases notified in 2017 and two cases in 2018. Two cases resulted in fetal death” 26.

The rise in syphilis rates can also be seen in the rates within in the SMR.  As the chart below shows, rising rates amongst several LGA’s within the SMR can be seen in 2018 and 2019. Between the years 2015 and 2018, an increase in the syphilis rate was seen in all LGA’s bar the LGA’s of Bayside and Glen Eira, where the rate fell marginally.  Latest statistical data indicate that Port Phillip and Stonnington continue to have the highest syphilis rates in the SMR followed by Glen Eira.

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Sexual and Reproductive Health Literacy

The link between the ability to make choices about SRH and literacy is significant. An informed choice cannot be made without having access to “comprehensive and reliable sexual and reproductive health information. Information needs to be transparent and accessible, particularly for disadvantaged women”27.

Access to a wide range of information in a variety of languages may not exist or be limited to only specific languages. Competency and confidence in seeking out SRH information may also be challenging for some women. For other women, cultural barriers may exist preventing them from fully accessing information and support. These challenges may limit women’s ability to make the most appropriate choices for themselves.

It is noteworthy to remember that health literacy encompasses more than just ‘educating’ or empowering individuals but that it is also about ensuring health providers and organisations are able to appropriately communicate and disseminate information with individuals from a range of settings.

Notes:

  1. Workplace Gender Equality Agency, 2018, ‘Australia’s Pay Gap Statistics’, Feb. 2019[]
  2. Australian Bureau of Statistics (ABS), 2018, ‘2016 Census Community Profiles. Online. https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/communityprofile/LGA22310?opendocument[]
  3. Crime Statistics Agency, 2017 ‘Family incidents’, Webpage: https://www.crimestatistics.vic.gov.au/crime-statistics/latest-crime-data/family-incidents-4[]
  4. Australian Bureau of Statistics, 2018. 2016 Census Community Profiles[]
  5. Women’s Health Victoria, 2019. Victorian Women’s Health Atlas, Online[]
  6. Save the Children, 2016, ‘State of Australia’s Mothers Report’ https://www.savethechildren.org.au/__data/assets/pdf_file/0007/143863/SOAM_report_2016.pdf[]
  7. Women’s Health Victoria, Women’s Health Atlas,
    https://victorianwomenshealthatlas.net.au/#!/atlas/Gender%20Equality/D/Chief%20Executives,%20General%20Managers%20And%20Legislators/D_11/2016%20%25%20Proportion%20that%20are%20female%20or%20male/139/F/state/all/false[]
  8. Municipal Association of Victoria, 2016, ‘Women In Local Government’ http://www.mav.asn.au/about-local-government/women-in-local-government/Pages/default.aspx[]
  9. Our Watch, Australia’s National Research Organisation for Women’s Safety (ANROWS) and VicHealth, 2015,’Change the story: A shared framework for the primary prevention of violence against women and their children in Australia’, https://www.ourwatch.org.au/getmedia/0aa0109b-6b03-43f2-85fe-a9f5ec92ae4e/Change-the-story-framework-prevent-violence-women-children-AA-new.pdf.aspx.[]
  10. Crimes Statistics Agency, 2019. Family Incidents, Online. https://www.crimestatistics.vic.gov.au/crime-statisticslatest-crime-data/family-incidents-0[]
  11. Women’s Health Victoria, 2019. Women’s Health Atlas https://victorianwomenshealthatlas.net.au/#!/atlas/Violence%20Against%20Women/V/Perceptions%20Of%20Safety/V_01/2015%20%25%20People%20who%20feel%20safe%20when%20walking%20alone%20at%20night/143/F/state/all/false[]
  12. Crime Statistics Agency, 2019 https://www.crimestatistics.vic.gov.au/crime-statisticslatest-crime-data/recorded-criminal-incidents-1[]
  13. Miller et al, 2010 ‘Pregnancy coercion, intimate partner violence and unintended pregnancy’, Contraception, vol. 81, pp. 316-322[]
  14. Department of Health and Human Services, 2017, ‘Women’s Sexual and Reproductive Health: Key Priorities 2017 – 2020’, State of Victoria, Melbourne[]
  15. Youth Affairs Council of Victoria (YACVic) and Victorian Rural Youth Services, 2013, ‘Young people and sexual health in rural and regional Victoria’, p.10[]
  16. Bishop EC, 2012, ‘Examining the raunch culture thesis through young Australian women’s interpretations of contradictory discourses’, Journal of Youth Studie, vol. 15, pp. 821-840[]
  17. Hach M. 2012. Common Threads: The sexual and reproductive health experiences of immigrant and refugee women in Australia. MCWH: Melbourne://www.mcwh.com.au/downloads/publications/MCWH_CommonThreads_Report_WEB.pdf[]
  18. Women’s Health Victoria, Women’s Health Atlas, https://victorianwomenshealthatlas.net.au/#!/atlas/Sexual%20and%20Reproductive%20Health/SRH/Contraceptive%20Implant%20(MBS%2014206)/SRH_09/2018%20Rate%20(per%201,000)/221/F/metropolitan/all/false?layerName=Port%20Phillip&layerCode=358[]
  19. Women’s Health Victoria, Women’s Health Atlas, https://victorianwomenshealthatlas.net.au/#!/atlas/Sexual%20and%20Reproductive%20Health/SRH/Contraceptive%20IUD%20(MBS%2035503)/SRH_10/2018%20Rate%20(per%201,000)/229/F/metropolitan/all/false?layerName=Port%20Phillip&layerCode=358[]
  20. Victorian Notifiable Infectious Diseases Surveillance database, DH http://ideas.health.vic.gov.au/surveillance.asp []
  21. Women’s Health Victoria, Women’s Health Atlas, https://victorianwomenshealthatlas.net.au/#!/atlas/Sexual%20and%20Reproductive%20Health/SRH/Chlamydia/SRH_02/2018%20Rate%20(per%2010,000)/207/F/metropolitan/all/false?layerName=Glen%20Eira&layerCode=322[]
  22. Women’s Health Victoria, Women’s Health Atlas, https://victorianwomenshealthatlas.net.au/#!/atlas/Sexual%20and%20Reproductive%20Health/SRH/Hepatitis%20B/SRH_04/2017%20Rate%20(per%2010,000)/163/F/metropolitan/all/false[]
  23. https://victorianwomenshealthatlas.net.au/#!/atlas/Sexual%20and%20Reproductive%20Health/SRH/Gonorrhoea/SRH_03/2017%20Rate%20(per%2010,000)/159/F/metropolitan/all/false[]
  24. https://www.cancercouncil.com.au/blog/australian-success-story-hpv-vaccine/[]
  25. health.vic, 2019 Syphillis cases continue to rise in Victoria. https://www2.health.vic.gov.au/about/news-and-events/healthalerts/rising-syphilis-cases-august-2018[]
  26. Health.vic, 2019 Syphillis cases continue to rise in Victoria. https://www2.health.vic.gov.au/about/news-and-events/healthalerts/rising-syphilis-cases-august-2018[]
  27. The Women’s Health Network. Women and Sexual and reproductive Health position paper (2012) http://awhn.org.au/wp-content/uploads/2015/03/94_AWHNWomenSexualReproductiveHealthPositionPaper2012.pdf[]