INTRO COMMENTS: Hello. Welcome to Modern Healthcare’s Next Up, a podcast for emerging healthcare leaders. My name is Kadesha Smith and I’ll be your podcast host. My background is digital strategy for hospitals and health systems and I’ll be talking with experts about how the next generation of healthcare leaders can address the industry’s most pressing issues.
This inaugural episode dives into some ways that the COVID-19 pandemic is disproportionately affecting women.
Most of our nation's essential workers, particularly in healthcare, are women who are dealing with burnout, furloughs, pay cuts, mom guilt, homeschooling, mental health risks and increased risk of exposure to COVID-19 even as they are being asked to work more on the front lines and at home.
Modern Healthcare reporter Maria Castelucci’s story on this issue was published on May 25, so please check it out.
We’ll also be exploring this issue at the Women Leaders in healthcare virtual conference on August 13-14, 2020. To learn more go to modernhealthcare.com/womenleaders
In this episode, we’re talking to Dr. Rosemary Morgan, on faculty at Johns Hopkins Bloomberg School of Public Health with a joint position in the School of Nursing, also co-coordinator of the International Gender and COVID-19 Working Group.
Now let’s hear Dr. Morgan’s insight on how healthcare leaders can reduce the toll this pandemic is taking on women.
MODERN HEALTHCARE: Hello Dr Rosemary Morgan. How are you doing?
DR. ROSEMARY MORGAN: I’m good thank you. Thanks so much for having me.
MODERN HEALTHCARE: So, you recently published a study in the Lancet about how the COVID-19 pandemic is specifically affecting women all over the world, especially those who work in the healthcare field. So, I just want to share some key stats before we dive into your insight.
Here’s what we know: We know that women comprise nearly 90% of the healthcare workforce in the United States. We also know that in addition to the environment and responsibilities at work becoming more stressful during COVID-19, there's strong evidence showing that women continue to take all the majority of household responsibilities, such as child care, grocery shopping, cooking and caring for elderly parents. And this is all kind of taking the toll as the pandemic stretches on. So, my first question for you is, if you could nail down a list, what would you say are the top three issues affecting women who work in healthcare, particularly in direct patient care and then have to come home to their families?
DR. ROSEMARY MORGAN: The three issues that I'd like to highlight include:
- Dual responsibilities—so juggling both career and home responsibilities
- Gender bias within personal protective equipment that specifically affects health care workers
- And the lack of women's representation within health system leadership and particular COVID-19 leadership.
Let me start with the first one, which is dual responsibilities. We know that women undertake the majority of household chores and unpaid care work. We have evidence that clearly shows this. This does make it look more difficult to balance both their productive work in the workplace and then working at home and doing childcare responsibilities and household chores. So evidence, for example, shows that the majority of healthcare and caring for elderly parents is still done by women. There was a recent article that looked at the time difference between men and women, and it showed that women perform an average of 241 minutes of unpaid labor, which includes cooking, cleaning, caregiving everyday. But men only spent 145 minutes per day on domestic work. And with the current situation with COVID-19, there's an extra burden as schools and nurseries close and as elderly and vulnerable relatives may need more help with errands, and that responsibility is falling on women.
There was an interesting survey published that the New York Times published recently that reported that nearly half of men say that they do most of the homeschooling for example. While only 3% of women agreed with this. So, while fathers of children under 12 report spending more time on it than their spouse, only 3% of women said their spouse was doing more. And 80% of mothers said that they sent more time on it. And you can just imagine the psychological burden and stress that this dual responsibility is putting on women.
The second major issue is in regards to gender bias within personal protective equipment, which for short is PPE. You mentioned previously the percentage of the workforce in the United States that is made up of women is 90%. Worldwide that statistic is around 75%. And while we need more data to really understand why, data from Spain, for example, shows that 72% of female healthcare workers have been infected, while only 28% of male healthcare workers.
In Italy it was 66% of female healthcare workers, compared to 34% of male. And in the United States, the CDC published data on the characteristics of healthcare personnel with COVID-19. This was between February and April, so the numbers might have changed by now because every day they're changing. But in that time period, of those who were infected, 73% were women. So, of healthcare workers that were infected in the United States, 73% were women and 55% had come into contact with COVID at their work.
And so why? Why is this, is the question we’re asking. And one of the reasons has to do with the fact that medical technology equipment has historically been built for the male body. This is all personal protective equipment, too, so seat belts in cars and construction workers and police.
Personal protective equipment has been designed for the male body. So, many more women health care workers are failing those tests—called fit tests for personal protective equipment like masks. The evidence is anecdotal now because we haven’t had major studies, but if we know this from other sectors about personal protective equipment, we can suppose that this is also happening in the health workforce.
We’re seeing on Twitter that many healthcare workers, female women healthcare workers, discussing or stating that they are failing their fit test. So, not only do we not have PPE in some instances, but it's not even fitting healthcare workers adequately, which I just think is a major issue that needs to be addressed.
MODERN HEALTHCARE: Absolutely.
DR. ROSEMARY MORGAN: And the third issue is the lack of women representation within leadership. We discussed about the percentage of women in the health workforce. Worldwide it’s 75%, right. But women only make up 25% of the global health or health workforce decision-making roles, or leadership roles, which is a huge discrepancy.
And if you look at the coronavirus or the COVID-19 decision making body, the White House Task Force at the beginning originally was over 90% men. And only 20% of the WHO emergency committee on COVID-19 are women. There’s a great group called Operation 50/50, which is ran by women in global health that is really looking at these numbers.
And we have to ask, what are the implications of this? If we’re lacking women representation—and I'm not even talking about other aspects of diversity, like race or ethnicity, or anything else—what are the implications of this? We do know that more diverse decision-making bodies are more effective. There was evidence in the business sector to show that. But we also know that if someone is not represented on a decision-making body, the needs of that particular group are less likely to be seen as important and met. We know that women have specific needs. So, if these task forces are all made up of men, what does that mean for those needs.
MODERN HEALTHCARE: Absolutely. So, the next question I then have is how can healthcare leadership best support their female frontline workers, especially in the areas of finances when people are making decisions about layoffs and furloughs and emotional health. You talked about the buren of homeschooling plus caring for an elderly parent plus still having to work. Then there's exposure risk. How can Healthcare leaders best support these frontline workers, especially those who are women and have to go home.
DR. ROSEMARY MORGAN: When we think about the impact of COVID-19, it is important to think about the long-term impact. Women have historically, in past pandemics with Ebola and Zika for example, women have been more negatively affected in the long-term for economic reasons. We saw with ebola, for example, that while both men and women were laid off or stopped working, men returned to the workforce much more quickly than women did. We're expecting to see similar evidence with COVID-19.
And we also know that women are earning less money than men. You know there's a huge pay discrepancy. So careful consideration does need to be given in regards to the implications of layoffs and furloughs and pay cuts for women and and for men and for different groups of men and women. There's different implications for women of color, for example versus, Caucasian women.
And I would recommend looking into different social protection strategies. There's a lot of literature coming out of the economic sector about this. Just to briefly give you some ideas: These measures include social assistance, like family and childcare grants, and social insurance like unemployment insurance, social protection measures may also support specifically low-income and vulnerable workers.
And these are being more introduced, including paid sick leave, for example, waivers on rent and utility payments. So, these are all considered social protection measures. Providing childcare support is another big one, especially for women on the frontline that are health workers. To help balance their paid work and unpaid work, childcare would really help and support that. Also, thinking about increasing men's contributions on to unpaid care and domestic work through paid paternity leave, for example, and equal parental leave is another measure.
With emotional health, things like flexible working hours, mental health support is also extremely important. Thinking about healthcare workers who have to isolate from their families.
And exposure risk. The need for adequate personal protective equipment is so important and personal protective equipment that fits different shapes and bodies. We know that healthcare workers come in all shapes and forms. We shouldn't have only have protective personal equipment that's designed for one particular type of body.
MODERN HEALTHCARE: As healthcare leaders are considering these different issues, what question would you like to see them ask more, especially if their leadership is not representing women well?
DR. ROSEMARY MORGAN: Well, there's so many questions, but you know, how can leadership be more representative of women? How could you increase voices of women and have more diverse representation in your leadership bodies to know that you will create more effective strategies by doing so.
Also, you know, as healthcare workers, women healthcare workers particularly, their roles as unpaid carers you know become further entrench—schools may stay closed for a lot longer, then open and close again; we don’t know. We might be entering a global economic crisis, there’s also this risk that efforts we’ve had in the past to invest in and promote gender parity in leadership and pay — these might be jeopardized or undermined. Often with pandemics, people want to respond to immediate, immediate needs, and that's totally understandable. But remember there's a difference between short-term impacts on long-term: health impacts, social impacts, and economic impacts. We need to look at the larger picture. It's not a zero-sum game. Just because we're looking and talking about one group doesn't mean the other group is not important.
MODERN HEALTHCARE: Absolutely. And I just want to underline, italicize, highlight a point that you've already made — the importance of actually talking to this audience that you're making decisions for, asking them for their own insight and for their own experience and using that as part of the decision-making process. I think that's an excellent point.
DR. ROSEMARY MORGAN: Talk to the people on the ground. What are they going through? Both formally and informally, collecting data and coming up with evidence-based solutions..
MODERN HEALTHCARE: We have time for one more question. Your study in the Lancet was published in March. Fast forward two months to today when we're talking. Do you see any silver linings that have emerged since then from your research that you think will help address this gender-based disparity in how COVID-19 is affecting healthcare workers.
DR. ROSEMARY MORGAN: There’s always a silver lining. There’s always an opportunity to come out of things, but only if appropriate and adequate responses are taken. People are able to find different ways of working. You know, to make accommodations for those who need it, including women and maybe people with disabilities, for example. Working from home, telemedicine... There's a different way of working. And we also hope that this is forcing families to think about how domestic labor is distributed in the home and can changes be made there? And in the future, if employers say that something can’t be done—whether it's remote working, the use of appropriate forms at technology, maye more flexible working arrangements which we know benefit women more. People can look back on this time and say, you know we did it during COVID-19, why can't we also do it now? So, you know, my hope—our hope—with the Gender and COVI-19 Working Group and with my colleagues researching this affects at other universities— is that you know this might put an end to excuses for more accommodative working arrangements and really provide an opportunity for us to build back better and build systems and structures that taken account of gender inequities and respond to them accordingly.
MODERN HEALTHCARE: Thank you so much, Dr. Morgan, for sharing this Insight we look forward to talking with you again about this issue, hopefully talking in much more positive terms about all the progress that's been made.
DR. ROSEMARY MORGAN: Thank you so much for having me. It’s been a pleasure.
OUTRO COMMENTS: Thanks again, Dr. Morgan. She's a public health professor at Johns Hopkins and co-coordinator of the International Gender and COVID-19 working group. The issues brought up in this episode of Next Up will be front-and-center during Modern Healthcare's Women Leaders in Healthcare Conference. This virtual event will be held on August 13 and 14, and it aims to offer new learnings, new opportunities to connect with other women, and new solutions to some of the gender-based disparities in healthcare leadership. To register visit modernhealthcare.com/womenleaders.
Again, I’m your host, Kadesha Smith, CEO of CareContent. Our agency helps health systems reach their growth goals through digital strategy and content.
I invite you to go to modernhealthcare.com to read Maria Castelucci’s May 25 report outlining some of the measures health systems have taken to help women and all employees deal with the personal and professional toll of COVID-19.
Look for more episodes of Next Up at modernhealthcare.com/podcasts or subscribe at Apple podcasts, Google podcasts or your preferred podcatcher. Thanks again for listening.
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