A quick gender critical overview
the impact of covid19 On HEALTHCARE WORKERS
Here at the Feminist Directory we think that it is important to observe the world through a gender lens. Data shows that the COVID19 pandemic has disproportionately affected many sectors which are female dominated such as Healthcare, Early Education etc.
The pandemic has also led to a rise in unpaid care work which is disproportionately falling to women. We have researched how this combination of factors is affecting women’s mental health, physical health, economic stability and professional lives.
At the Feminist Directory we think that it is important to observe the world through a gender lens. Data shows that the COVID19 pandemic has disproportionately affected many sectors which are female dominated such as Healthcare, Early Education etc.
The pandemic has also led to a rise in unpaid care work which is disproportionately falling to women. We have researched how this combination of factors is affecting women’s mental health, physical health, economic stability and professional lives.
In this video we will explore the impact of Covid 19 on Healthcare workers around the world. We will have a particular focus on the gendered implications of the virus and review ways in which the pandemic has and will affect the careers of women in the sector.
We acknowledge that many individuals will be shaped by intersectional experiences but for the sake of this video we will explore from a gender perspective.
For the sake of specific exploration we will use the UK and Australia as two places of focus.
The Impact of Covid19
UN:
In some countries, COVID-19 infections among female health workers are twice that of their male counterparts. Governments should ensure that all care-sector professionals, and health-care and long-term care workers in particular, have adequate protection against transmission.
CNBC:
Roughly 70% of the global health-care workforce is made up of women, according to an analysis of 104 countries conducted by the World Health Organization. In the Hubei province of China, where the virus originated, more than 90% of health-care workers are women.
Women Health Care Workers are at the front line of COVID-19
Youtube vid intro video: (USA focus) Women Health Care Workers Are At The Front Lines of COVID-19 | NowThis
General Climate Pre-Covid
What did the sector look like prior to Covid19? The Healthcare sector has an expectation of 24/7 availability and intensely demanding work environment. It has long been criticised for a lack of support for women workers – particularly those with home care responsibilities.
Women are underrepresented in senior and decision making roles in most national and global health settings (Target 5.5).6 This is due to gendered norms regarding women’s and men’s work (Target 5.4) and structural bias and sexism in the health sector both nationally and globally. This in turn limits women’s input into decision-making in health. The concentration of women in lower paid jobs also hampers their economic empowerment and job security and increases their work burden, given their dual responsibility for paid care and unpaid care (for their families and communities).
UN Spotlight on gender, COVID-19 and the SDGs: Will the pandemic derail hard-won progress on gender equality?
The UN and the WHO have voiced concern that in times of crisis, such as a global pandemic, existing inequalities are magnified and the effects are accelerated. This is an area where gender disparity and equality is likely to be set back and de-prioritised.
Pay Gap – Pre-Covid vs Covid
UN: Globally, women make up 70 per cent of health care workers, but they are underrepresented in senior and decision making roles in most national and global health settings.
The absence of women in senior medical leadership roles leads to both a professional and financial glass ceiling. Women are largely lacking in representation at the top of the medical pay scale.
According to the Journal of Hospital Medicine:
The gender pay gap in medicine has been consistently demonstrated among many specialties. The reasons for this inequity are multifactorial, and the COVID-19 pandemic has the potential to further widen this gap. With the unequal burden of unpaid care provided by women and their higher prevalence as frontline workers, they are at greater risk of needing to take unpaid leave to care for a sick family member or themselves. Similarly, without hazard pay, those with direct clinical responsibilities bear the risk of illness for themselves and their families without adequate compensation.
Collateral Damage: How COVID-19 Is adversely impacting women physicians
So Where Has COVID Had an Effect on the Sector?
Before the magnifying glass of the COVID-19 pandemic caused physicians to look more closely at many aspects of their profession, there was awareness of the general culture of overwork that affect all physicians and the expectation by some that women physicians would make adjustments in their professional roles to accommodate their personal roles. These professional adjustments were made, including part-time status, despite the known limitations on professional progression, career advancement, and economic potential. These adjustments further propagate gender inequities and the persistent compensation gap women physicians experience.
Linda Brubaker MD – JAMA Network (Women Physicians and the Covid-19 Pandemic)
There is hope that by using a gender lense to observe the effects of the Covid19 pandemic, the sector can push back against inequalities and use this time as an opportunity to reassess structural imbalances. One such area where change must occur is within the career progression of women. The lack of women represented in the higher echelons of the sector has broad consequences.
The paucity of women at high-level leadership positions in institutions across the United States, including university-based, community, public, and private institutions, means that there is a lack of female representation when institutional policy is being discussed and decided. This lack of representation may lead to policies and procedures that negatively affect female hospitalists or, at best, fail to consider the needs of or support female physicians.
Collateral Damage: How COVID-19 Is Adversely Impacting Women Physicians: J. Hosp. Med. 2020 August;15(8):507-509. Published Online First July 20, 2020 | 10.12788/jhm.3470
Gender Split: Unpaid Care Work
A recent study by the Boston Consulting Group in May 2020 is flagged in the UN report below. It reported “in France, Germany, Italy, the United Kingdom and the United States found that working women on average do 15 hours more a week of unpaid care and domestic work compared to men.”
The Mayo Clinic has been measuring the unpaid workload of men and women for thirteen years within the healthcare sector.
We studied sex differences among married physicians in time spent on household activities (eg, cleaning and cooking) and child care (eg, bathing and homework) from 2003 through 2016 using the American Time Use Survey, a detailed time use survey administered by the US Census. Overall, we found that female physicians with children spent 100.2 minutes (95% CI, 67.0-133.3 minutes) more per day on household activities and child care than did male physicians, a finding that was qualitatively similar after adjustment for work hours outside the home of both spouses.
https://www.mayoclinicproceedings.org/article/S0025-6196(18)30147-2/fulltext
General Climate Covid
This table shows the gender difference in contraction of Covid19 by healthcare workers. The healthcare sector is heavily female dominated which has placed women on the front lines to deal with the pandemic. The UN has calculated the occupational risk for women. According to the UN, in some countries, COVID-19 infections among female health workers are twice the amount of their male counterparts.
The occupational risk score is based on three job attributes: contact with others, physical proximity to others and exposure to disease and infection. The findings demonstrate that the three occupations with the highest COVID-19 occupational risk are health professionals, health associate professionals and personal care workers. These are highly feminized occupations, in which women account for at least seven in every ten workers.
Table:
General Climate: Covid UK
The NHS and the Health and Care Women Leaders Network (HCWLN) have surveyed the effects of Covid19 on the female workforce in the health sector. The NHS workforce is predominantly female (77 per cent). Here are some key findings of the HCWLN, delivered by the NHS Confederation :
– Almost three-quarters of the respondents reported that their job had a greater negative impact than usual on their emotional wellbeing as a result of the pandemic. More than half had suffered a negative impact on their physical health. It is obvious that the level of pressure and expectation of self-sacrifice created by the pandemic is not sustainable.
– Twenty one percent said they did not have access to the PPE they needed. A respondent said that staff were wearing gowns in size XL, when most required a small or medium fit. Whilst we recognise the issue of sizing is not always unique to gender, it is more relevant to those who are of a smaller frame. It is inevitable there is a physical impact on those wearing PPE that is too big for them.
– An increase in unpaid working hours with an average of 7.14 additional hours per week. One respondent noted : “there are not enough hours to do my job in the time I’m given, which means I’ve had to do a lot more in my own time and unpaid, which has had a negative impact on my family.”
Impact on Women Workers
Pregnant Health Workers
Health workers on the frontlines are putting themselves at risk both physically and mentally in order to prioritise the care of their patients. Pregnant women are deemed to be ‘high risk’ and are generally instructed to shield. Those who are pregnant and working on the front lines have been forced to reconsider their work. There have been reports in the UK of pregnant healthcare workers in intensive care after contracting the virus.
A study of COVID-19 by pregnancy status found pregnant women were more likely to be hospitalized (32 percent), compared to non-pregnant women (6 percent). In light of these findings, governments are emphasizing prevention and calling for pregnant women and their families to take precautions. UN Spotlight on gender, COVID-19 and the SDGs: Will the pandemic derail hard-won progress on gender equality? : https://data.unwomen.org/sites/default/files/documents/Publications/Spotlight-Gender-COVID-19-SDGs.pdf
As the pandemic has progressed and the negative impacts on pregnancy are well documented, there have been moe precautions that have been put in place.
Existing guidance from UNISON reads:
Where risks can’t be removed and suitable alternative work can’t be offered then you should be suspended on full paid leave for as long as necessary to protect the health and safety of you and your unborn child. If you are in your third trimester (more than 28 weeks pregnant), or have an underlying health condition – such as heart or lung disease – you must not be deployed in roles where you are working with patients/public. You should be supported to work from home where possible.
Mental Health
In addition to the physical risk, there is a huge mental toll on health workers. Prior to the onslaught of Covid19, health workers were already under an immense level of stress – there is a large amount of burn out in the field – and this has been exacerbated by the pandemic. There are gender implications within this, women are more likely to suffer anxiety as a result of Covid19, especially due to the fact that women are carrying the main burden of housework and parenting.
JAMA Network notes :
Physician burnout and suicide are a grim reality in health care with the physician suicide rate two-fold that of the general public and the highest among any US profession.1 In fact, a 2019 survey of more than 15 000 physicians revealed that, among physicians with depression, more than 20% thought about suicide and nearly 40% did not seek help.2
UN notes:
The pressure of balancing work and family life is taking a severe toll on women’s well-being. In a recent IPSOS poll, 32 percent of women reported suffering from anxiety as a result of COVID-19, in comparison to 24 percent of men. These findings were mirrored in the United Kingdom in a poll by Fawcett Society, Women’s Budget Group, Queen Mary University and the London School of Economics.
Mental Health – AUS spotlight
Women are well documented to be carrying a ‘triple load’ during the pandemic of Covid19. This includes the brunt of care work, paid work and the mental labour of worry. Data from a survey conducted by the Monash Alfred Psychiatry research centre indicates that women in Australia are experiencing higher levels of depression, anxiety and stress than men in response to the COVID-19 pandemic.
The Alfred Hospital in Australia has seen a huge spike in their referral rate as a result of the pandemic – the service recorded 56 new referrals in one week in April, compared with an average of two new referrals per week, representing a 2800% increase in demand.
The Australian government has recently announced a $20 million injection of funds into mental health and suicide prevention research, acknowledging that disruptions to usual routines due to COVID-19 are increasing risk. However, it is notable that where mental health research is funded specific to one gender, it is most often designated for males. Today’s analysis explains why lopsided funding is misplaced; women experience worse overall mental health compared to men, and they are also disproportionately negatively impacted by COVID-19 and its policy responses.
Mental Health: Dr Lorna Breen
The increase in women seeking support for their mental health combined with the pressures already felt within the health care systems could be a disaster for women in particular, who work in the healthcare system. Governments must ensure that the necessary mental health support is available for frontline workers, many of whom are traumatised. The recent suicide of US Doctor, Dr Lorna Breen serves a stark reminder that broader support is not being met. COVID-19–associated traumatic experiences will have lasting adverse effects on many physicians. Being called a “health care hero” is not a sufficient remedy for this distress, regardless of physician gender.
Dr Lorna Breen – New York Times
The elder Dr. Breen said his daughter had contracted the coronavirus but had gone back to work after recuperating for about a week and a half. The hospital sent her home again, before her family intervened to bring her to Charlottesville… when he last spoke with her, she seemed detached, and he could tell something was wrong. She had described to him an onslaught of patients who were dying before they could even be taken out of ambulances. “She was truly in the trenches of the front line,” he said…Doctors are accustomed to responding to all sorts of grisly tragedies but rarely do they have to worry about getting sick themselves, or about infecting their colleagues, friends and family members. And rarely do they have to treat their own co-workers. https://www.nytimes.com/2020/04/27/nyregion/new-york-city-doctor-suicide-coronavirus.html
Positives
The pandemic has put immense strain globally on healthcare professionals, particularly women who are carrying the lions share of additional unpaid work. However, there have been positive experiences that are worth noting :
-increased collaboration in teams and compassion from senior staff.
-innovation in remote care
-flexible working
-reports of strong managerial and leadership support in clinical settings
-increase d building team and individual resilience;
-The findings also give voice and shape to the needs of the female workforce, and we hope this will begin to drive real and lasting change. (Covid19 and the Female Health and Care Workforce, NHS confed)
Further Reading
Women Physicians and the COVID-19 Pandemic https://jamanetwork.com/journals/jama/fullarticle/2769140#:~:text=As%20a%20group%2C%20women%20physicians,home%20and%20family%20care%20activities.&text=The%20COVID%2D19%20pandemic%20has%20disrupted%20common%20activities%2C%20such%20as,practices%2C%20shopping%2C%20and%20leisure.
UN Spotlight on gender, COVID-19 and the SDGs: Will the pandemic derail hard-won progress on gender equality?
CCSA Report: How COVID-19 is changing the world: a statistical perspective below:
https://unstats.un.org/unsd/ccsa/documents/covid19-report-ccsa.pdf
COVID-19 and the female health and care workforce
https://www.nhsconfed.org/resources/2020/08/covid19-and-the-female-health-and-care-workforce
How women could be uniquely impacted by the coronavirus
https://www.cnbc.com/2020/03/18/how-the-coronavirus-could-impact-women-in-health-care.html
Sex Differences in Time Spent on Household Activities and Care of Children Among US Physicians, 2003-2016
https://www.mayoclinicproceedings.org/article/S0025-6196(18)30147-2/fulltext
The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30047-X/fulltext
COVID-19 and mental health impacts: Women are at greater risk
Covid19 and the Female Health and Care Workforce, NHS confed
Top E.R. Doctor Who Treated Virus Patients Dies by Suicide
https://www.nytimes.com/2020/04/27/nyregion/new-york-city-doctor-suicide-coronavirus.html