Putting their money where their heart is

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By Michelle Landsberg

AH, FOGEYDOM. ONCE upon a time, Valentine's Day meant red cinnamon hearts and those cut-out paper valentines with dreadful Grade 4 puns. Now, Valentine's Day just brings our annual scolding from the Heart and Stroke Foundation.

This year's Heart and Stroke valentine thwonked into my consciousness with all the airy charm of a concrete balloon. "Women fail,'' said the headlines. Unfit and ignorant of the menace of heart disease, which is an equal opportunity killer. Worse still: we're too stressed, too busy working and caring for our families and two-thirds of us are at an "unacceptable weight."

"It's the leaders within the women's movement we're trying to influence,"said Dr. Anthony Graham of St. Michael's Hospital.

Feminists, according to Graham, are so powerful that we could give heart health the same high profile as breast cancer, consistently rated as women's top concern even though it kills fewer than heart attacks do.

(Hey. Just a thought: if Heart and Stroke thinks all this overwork and stress is so bad for women, how about lobbying for daycare, elder care, home care and equal pay for work of equal value?) More seriously, I'd like to tell the Heart and Stroke a thing or two about its annual tongue-lashing of women. Insulting us is not the very best way to engage us in higher awareness of a serious health risk. And by the way, breast cancer awareness is not a feminist conspiracy against cardiologists. The reasons for women's fear ought to be obvious. Breast cancer is specifically a women's disease, it was hugely underfunded until women's groups started to agitate, it hits women at a much younger age than heart disease and, at that younger age, it's more dangerous. Demographically speaking, doesn't it make sense that the "boomer" generation (overstressed, as you fellas point out) worries most and lobbies hardest against the disease that threatens it most imminently? For your future information, most women do not respond well to framing this discussion as a competition between two serious diseases. You're right that women have to get serious, sooner, about heart health. As political activists know, however, the best way to stir people to action is to offer them a strong alternative. If women knew that there was support and help available to prevent heart disease, they'd line up for it - which is just what they do at Women's College Hospital, home of Canada's very first Women's Cardiovascular Health Initiative and Women's Cardiac Rehabilitation program. Thanks to a $400,000 grant from Canada Trust, Women's College was able to set up an appealingly sleek and attractive small gym. A team of hospital staff, headed by cardiologists Dr. Len Sternberg and Dr. Vera Chiamvimonvat, kinesiologist Karen Unsworth (the only full-time staffer), as well as the nutritionist, clinical care nurse and other specialists, offer individual attention out of their own volunteer commitment.

Results are impressive. In co-ed rehab programs for heart attack patients, only 15 per cent of patients who attend are women - and of those, only 5 per cent stay in the program, with 15 to 20 per cent improvement in heart function at the end.

The Women's College record: 80 per cent in the all-women classes stay in for the whole six months, improving their heart function by 52 per cent.

Most of the "graduates" express greatly increased confidence, optimism and well-being. Why the difference? You can't fake it. A glitzy new "Women's Centre" sign in an otherwise indifferent institution just doesn't do the trick. The understanding has to be deep, permanent and evolving, springing from a whole culture that understands women's needs.

At the Women's College program, the practitioners have learned, by listening, what the patients feel. Older women, it seems, are intimidated by the competitive atmosphere of male-dominated gyms. They're embarrassed by co-ed gym work, partly because they're weaker to begin with and so need a more gradual program. They enjoy the emotional support of small groups of other women. They're poorer then men, and therefore can't afford costly gyms and have less access to cars or taxis. Domestic responsibilities can keep them away. Above all, female cardiac patients can be dragged down by a depression intensified by guilt. The program has worked out helpful responses to all these concerns. The rewards - in prevented illness and restored health - are great.

I asked the Heart and Stroke Foundation how much research money it targeted for women's heart health, since the disease is so different in women. The answer: $2 million out of a total of $23 million in research grants (although, the foundation hastened to point out, any general research might benefit women as well as men).

I confess, Heart and Stroke did get my attention this year with its rather negative approach. Next year, maybe they'll brush up their courtship skills and woo us with a prettier valentine - say, great big grants for researchers in women's health, at female-friendly institutions. Now that's the way to a woman's heart.

Michele Landsberg's article first appeared on Valentine's Day in the Toronto Star, where she is a columnist.