April 28 was World Health Day. To mark that day, Lucie Pépin rose from her seat in the Senate to ask her colleagues not to forget the receptionists, technicians, orderlies, records managers, cooks and janitors – those people behind the doctors and nurses – who make our health care system work but are so often overlooked. She said these “hidden” workers are mostly immigrant women from visible minorities, poorly paid, non-unionized and without benefits.
Where did Pépin get this information? From a report called "Hidden Health Care Work and Women", available on the Canadian Women’s Health Network and based on research by York sociologist Pat Armstrong, Carleton University Professor Hugh Armstrong, and York grad Krista Scott-Dixon (BA Hons. ’95, MA ’98, PhD ’02).
Pat Armstrong specializes in women in the labour force and her research often attracts media attention. Her report last year on violence against workers in long-term care received enormous coverage. “That’s had an impact,” she says. Government policy-makers as well as long-term care providers are reading it. When Pépin spoke about invisible health care workers to Senate, she was sharing knowledge – which is exactly what Armstrong means to do.
Armstrong holds a Canadian Health Services Research Foundation/Canadian Institutes of Health Research Chair in Health Services and Nursing Research. Part of her mandate is knowledge transfer. Another is to ensure that gender analysis is a part of health services and 
policy research. This year has been a banner year for achieving both. She’s published five – yes, five – books:
- Women’s Health: Intersections of Policy, Research and Practice (Canadian Scholars’ Press, 2008) is an edited collection of articles by senior provincial and federal policy makers, scholars and practitioners. The book, which she edited, grew out of an intensive one-week graduate diploma course in health policy and management Armstrong delivered for the Ontario Training Centre in Health Services & Policy Research.
- Critical to Care: The Invisible Women in Health Services (University of Toronto Press, 2008) grew out of the report on "Hidden Health Care Work and Women" Pépin mentioned.
- About Canada: Health Care (2008), the first in Fernwood
Publishing’s About Canada series, was written with husband Hugh, about how Canada’s health care system developed and what it’s become. - They Deserve Better: The Long-Term Care Experience in Canada and Scandinavia (Canadian Centre for Policy Alternatives, 2008) is based on comparative research that identifies different – and better – ways of delivering long-term care.
- A Place to Call Home: Long-Term Care in Canada (Fernwood Publishing, 2009) is a collection of papers presented at annual workshops of the Women and Health Care Reform Group, which Armstrong chairs.
Impact is difficult to measure. “It’s always a hard thread to follow,” says Armstrong. But she hopes her research is having an influence on public- and private-sector decision makers in health care. She has appeared before the Romanow Commission on the Future of Health Care in Canada. She expects the Ontario Ombuds Report to contain recommendations on long-term health care, learned from attendance at a workshop she organized last summer. The Women and Health Care Reform Group has produced popular easy-to-read pieces on home care, maternity care, long-term care, privatization, timely access to care and other topics. The Ontario government has consulted her about health care reform. “So you do see some impact. But it’s not like stopping a particular drug. It’s a very long process to get governments and practitioners to think about gender.”
Meanwhile, Armstrong is spending the summer drafting an application for funding for a major seven-year collaborative research project on promising practices in long-term care. Researchers from the United States, United Kingdom, Scandinavia, Germany and Canada would study long-term care practices in each other’s countries and figure out what works best.
She also has another book percolating on how working women are affected by the current economic recession, a return to the focus of her graduate theses.
And she keeps an eagle eye on the Conservatives. In March she wrote an op-ed piece in the Ottawa Citizen calling on Stephen Harper to drop proposed legislation that would erode pay equity for women.
“Women’s work is never done,” says Armstrong.
By Martha Tancock, YFile contributing writer