Even though we have just elected our first woman Vice President, women have yet to get a fair shake in the workplace. Or in the world, really. But here I’m going to focus on the workplace.
I’m a physician who has been studying gender in the medical workforce for over a decade. I frequently speak about gender bias, sexual harassment, the motherhood penalty, microaggressions, and other factors that are holding women back in the medical field. I thus had a fairly solid sense of what was happening for women, particularly women physicians, prior to the COVID-19 pandemic. For instance, although women have made up at least 45% of medical school classes since the late 1990s, we are still in the minority of leadership positions (only 18% of Deans are women nationally).
Still, the degree to which this pandemic has worsened the disparity, in medicine and in other professions, has shocked even me.
After shelter-in-place orders went into effect in the spring, schools quickly transitioned to remote learning. Colleges sent students home. Everyone who could work from home did.
What happened next was predictable--and reports as early as the summer supported our suspicions. As 500 Women Scientists warned in May, as things shut down women were made responsible for the bulk of the additional childcare and housework, and productivity was immediately affected.
Dr. Gretchen Goldman was one of many women who shared her story on social media. After being interviewed on CNN, she posted a photo of what her life looked like on camera and what it actually was in reality--toys strewn about, her computer propped on a chair that itself was on top of a table. “I want to be clear that parents are being put in an impossible situation now and it will derail entire careers, especially for moms,” she wrote.
The monthly jobs reports point to the intersectional nature of these disparities. In September, 1.1 million people left the workforce. 865,000 of those people were women, and almost half of those women were Black or Latina. One in nine Black and Latina women were unemployed, a 57% higher rate than that among white women.
The data, unfortunately, support her assertion. Since the pandemic, women’s jobs have been almost twice as vulnerable as those of men, and women spend twice as much time caregiving as do men. Not surprisingly, women performed three-fourths of the unpaid care work before the pandemic, and this asymmetrical burden is growing.
The monthly jobs reports point to the intersectional nature of these disparities. In September, 1.1 million people left the workforce. 865,000 of those people were women, and almost half of those women were Black or Latina. One in nine Black and Latina women were unemployed, a 57% higher rate than that among white women. The more recent December 2020 jobs report shows that while men gained 16,000 jobs while women lost 156,000. Further analyses show that white women actually gained jobs while Black and Latina women made up the majority of the losses. (It’s important to highlight that Black and Latinx communities are also disproportionately likely to become sick with or die from COVID-19)
The pandemic in many ways affects healthcare more than any other sector. Not only has it affected how we work, but it has affected our own health as well. Women are 70% of healthcare workers globally, and they are 73% of the healthcare workers who have been infected with SARS-CoV-2. There are concerns about the impact of COVID-19 on pregnancy, with some hypothesizing that it may cause placental issues due to its effect on blood clotting. Personal protective equipment (PPE), when we have enough of it, may not have been designed to actually properly fit women.
When we look beyond the impact of COVID-19 on health and domestic responsibilities, it is likely that, once the dust has settled, the virus will have asymmetrically negatively impacted academic productivity. Pre-print servers, which are a way for researchers to share data quickly, especially during the COVID-19 pandemic, give us a snapshot of academic productivity. Studies that have looked at manuscripts posted to pre-print servers this year, in an effort to quickly disseminate research, have shown that men’s increased use of these servers outpaces that of women. And, comparing publications focused on COVID in 13 medical journals to all publications in the same journals in 2019, researchers found that women’s authorship was down 19%.
If I’ve painted a grim picture, it’s because the situation really is dire. Ten months into the pandemic (in the United States), we have no government support to help us, as individuals or organizations, meet these challenges. It is on us to put together creative solutions to keep women in the workforce. What might that look like?
Aside from issues in the workplace, there is reason to be concerned for higher rates of domestic violence since so many of us are spending more time than ever at home. While how much domestic violence may have increased with shelter-in-place or “lockdown” orders is unclear, a 20% increase, based on volumes to call centers, seems to be a conservative estimate. In one study, researchers looked at the injuries that people had when they sought care in the emergency department and found that these injuries were more severe than what might have previously brought people to the hospital. Another study estimated that the rate of femicide had doubled in the UK.
If I’ve painted a grim picture, it’s because the situation really is dire. Ten months into the pandemic (in the United States), we have no government support to help us, as individuals or organizations, meet these challenges. It is on us to put together creative solutions to keep women in the workforce. What might that look like? Here are four suggestions for healthcare organizations:
For healthcare workers, we need to start by making sure that we have enough PPE that fits people with all different sizes and shapes of faces.
The sacrifices asked of healthcare workers deserve remuneration. Hazard pay and medical school debt forgiveness won’t repay the families of healthcare workers who have died, but as those at the Brookings Institute have argued, it would be the right thing to do.
Healthcare organizations should consider providing housing for healthcare workers assigned to high-risk units so they don’t have the added stress of possibly infecting their family on top of what is already very challenging work.
Healthcare organizations should be more aware of the fact that not every healthcare worker may feel comfortable or safe taking care of patients with COVID-19. Some may have their own health issues that place them at increased risk of developing severe symptoms (for example, immunosuppression, advanced age, respiratory illness, etc), or they may care for someone who is at increased risk. We need to be creative with how people can contribute aside from direct patient care that may endanger their own lives. Perhaps they can take on more administrative or teaching roles or only care for non-COVID patients.
And three suggestions for all organizations:
Acknowledge that the pandemic has challenged our mental health in new and very difficult ways. Yoga, resilience, and mindfulness are not going to solve the mental health crisis we are in. If we are to empower employees to continue to do their best work, we need to validate their struggles and provide resources that will actually help. That could be more time off, free therapy, childcare (provided safely, perhaps in small pods), adjustment of productivity targets, etc.
Adjust productivity targets and performance reviews to be realistic and practical. We are no longer living in the pre-COVID world. Pretending we are is damaging to morale and, ultimately, engagement and productivity. Showing employees humanity and giving them grace now not only is the right thing to do. It will also pay off in spades in the future.
Even though the protests of the summer have faded, racism remains a destructive force in our society. No strategy to support women will be effective unless it embraces the importance of intersectionality.
It’s worth noting that these strategies would likely benefit all employees, not just those who have childcare or other caregiving responsibilities. We can do better for our workforce. Why not start now?