Stethoscope

#160 The role of women in pandemics


 

7 May 2020

At the height of COVID-19, when leadership is being tested, having adequate women representatives in management roles is vital, as the impact of the pandemic on women may be even greater than for our male counterparts. 

Pandemics perpetuate gender inequality in multiple domains. Globally, more women suffer job losses because they make-up most of part-time and informal workers and history shows the economic impact can last for years. In the 2014 Ebola outbreak in West Africa, researchers found out that, “Everyone’s income was affected”, but “men’s income returned to what they had made pre-outbreak faster than women”. Moreover, financial difficulties and isolation can place women and children at risk of domestic violence and exploitation. The women facing unsafe home situations are at further risk through inaccessibility to health services as healthcare providers are burdened by the influx of pandemic cases. 

The peril of women’s independence is not limited to developing nations. Over 60 per cent of Australian couples with carer responsibilities are dual-income and COVID-19 public health measures may affect their socio-economic welfare. Lockdown and home schooling may force many couples to face tough decisions about which parent should compromise to meet the increased household obligations. More frequently it’s women who take-up the unpaid primary caregiver roles. In addition to gender norms, couples may believe it makes more economic sense for men to continue working if they are the higher income earner. Again this highlights the impacts of the gender wage gap - Australian women still earn $242.90 per week less than men as of November 2019

In the healthcare setting, women are the forefront of public health as we represent 80 per cent of healthcare and social workers. Women make-up 90 per cent of registered nurses, 43.6 per cent of general practitioners, 36.2 per cent of emergency physicians and 32.4 per cent of physicians, according to Medical Board statistics. The leadership roles, however, are disproportionately held by men. 

Medical school admissions have had gender parity in the last few decades, but women account for only 30 per cent of medical school deans, chief medical officers and medical college board and committee members. In terms of the National Cabinet, 33 per cent of Premiers, 30 per cent of MPs and 60 per cent of Chief Health Officers in Australian states are women. Women are half of the country’s population and in need of adequate representation from leadership driving COVID-19 management, but this is not the case in Australia. 

Gender inequality in employment, social status and income within medicine can be detrimental to the mental health of women practitioners. Women doctors are at significantly higher risk of psychological distress, depression, anxiety and suicide ideation. Furthermore, the increased demand in domestic responsibility and workplace stress, which are exacerbated during the outbreak crisis, can further contribute to poorer mental health for our women doctors. These doctors are also not immune to the risks of domestic violence and unsafe home situations; up to 44.9 per cent of women doctors have experienced intimate partner and family violence

Many medical institutions and leaders claim to commit to gender equity, but more substantial actions are required. It is therefore important for organisations and individuals to be accountable if they allow gender inequity to perpetuate. Improving gender specific discrimination involves remodeling gender roles, legislating policy and protocols to protect gender equality and driving conversation that women’s equality should be a moral obligation for our society. It will take effort from every individual and leader for this to be achieved. 

The integrity of Australia’s healthcare system has been challenged with the exponential rise of COVID-19 patients, but it’s also highlighted an opportunity for change. Strong evidence should be the impetus to ensure adequate levels of women’s representation in public health and policy making to control pandemics. Gender specific impacts of COVID-19, Ebola and Zika have been discussed even at the level of the Lancet. As we slowly push towards the other side of this pandemic together, let us as individuals stay connected, support and look out for one another and especially make sure we look after our women doctors and patients. 
 

Dr Natalie Sae-Rian
Doctor-in-training
AMA Victoria Women in Medicine Committee

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