A year ago, we could never have predicted how dramatically the COVID-19 pandemic would change our lives. Although the global crisis may have initially seemed like a great leveler, with everyone facing the same threat, in reality, many existing inequalities have been exacerbated. On International Women’s Day, it is important to look at the particular challenges faced by women during the pandemic.

From healthcare workers to people suffering from mental illness, from victims of intimate partner violence to informal carers, women are over-represented in many groups that are already carrying a heavy burden. The pandemic has particularly affected these groups.

This has been a year of unprecedented stress for frontline health workers, as well as informal carers trying to manage without the usual services. The majority of healthcare workers worldwide are women, and women perform three-quarters of all unpaid care work.  As the saying goes, we’re all in the same storm but not in the same boat.

Let’s look at those figures more closely. In a 2019 report, aptly named “Delivered by Women, Led by Men”, the World Health Organization reported that women make up 70% of the global health workforce while only holding 25% of senior roles. Moreover, women hold on average 90 % of jobs in the long-term care sector.

Caring for COVID-19 patients is extremely difficult. Various studies conducted with frontline healthcare workers exposed to the COVID-19 virus report higher rates of depression, anxiety and other stress related symptoms among frontline health workers and also report that female healthcare workers are disproportionately affected.

Informal caregivers have also been hit hard by the measures implemented since the start of the pandemic. As mentioned, the majority of unpaid caregivers worldwide are women. This phenomenon is observed across countries, continents and illnesses. The COVID-19 crisis has amplified the impacts on unpaid care work due to reduced care services and support, both formal through limited care services and informal related to family and social networks.

The organisation I represent, the Women’s Brain Project, focuses on sex and gender differences in brain and mental diseases. We believe that, knowledge and consideration of gender differences and gender-specific needs in caregiving, for example, is highly relevant for shaping effective policies, public health strategies and support services. This is even more essential in the context of the COVID-19 pandemic where a significant impact on informal caregivers’ general well-being and mental health is observed.

More broadly, the pandemic compounds gender differences in mental health.  Various mental illnesses, including anxiety and depression, are found to be more prevalent in women. For instance, women are nearly twice as likely to be diagnosed with depression and anxiety disorders compared to men.

In addition to pre-existing risk factors for mental illness being heightened, people are dealing with new risk factors affecting psychological wellbeing, such as isolation due to lockdown.

Various studies published since the start of the pandemic report an increased prevalence of mental health problems, mainly anxiety and depressive symptoms, as well as an increase in substance abuse. This phenomenon is consistently reported across countries from the United States to Switzerland to South Africa. Indeed, the United Nations has described this increase in mental health disorders as a global phenomenon, reporting that the global rate of depressive symptoms was three times higher in April 2020 when compared to the previous year.

Annemarie Schumacher Dimech, President and co-founder of WBP

On the economic side, COVID-19 has drastically affected sectors with a high proportion of female workers, such as retail, hospitality and tourism. Many women have been left without jobs and income, prompting them to stay in the private sphere of home and perform more domestic responsibilities. This can widen gender gaps in labour force participation, wages, and unpaid care work. Women are already more likely to live in poverty and preliminary findings suggests that women are more likely to lose their jobs than men during the pandemic.

And of course, the widespread closure of schools and childcare facilities has resulted in a sharp increase in care, housework and home-schooling responsibilities, disproportionately shouldered by mothers. Apart from schoolwork, parents must also support children with the psychological effects of this situation. Parents have reported various difficulties that children are experiencing due to the COVID-19 related confinement, such as restlessness and difficulty concentrating. Various studies observe the effects of these challenges. In a US study by Panchal et al. published this year, adults in households with children were more likely to report anxiety and or depressive symptoms when compared to households without children. Moreover, women with children were more likely to report symptoms of anxiety or depression than men with children.

The experience of pregnancy and motherhood has also been affected by the pandemic. Pregnant women and new mothers are going through pregnancy, childbirth and motherhood at a time when they are isolated, and access to informal as well as professional support is limited. Various studies have found an increase in stress, depression and anxiety among pregnant women during the pandemic. This increase in stress and anxiety in the perinatal phase is of great concern since it can contribute to various physical and psychological risks including postpartum depression. An important preventive factor for postpartum depression is screening and early detection of symptoms, which is problematic due to limited social contact during pandemic. Alternative solutions urgently need to be implemented.

Finally, at a time where we are being asked to stay at home as much as possible, women living with abusive partners are more vulnerable than ever. The COVID-19 pandemic has had a significant effect on domestic violence where women are disproportionately affected. The United Nations reports that domestic violence has increased in frequency and severity across countries since the pandemic, with a drastic increase in the number of calls to support services and helplines. Further reports also mention a rise in domestic abuse deaths during lockdown.

 

All the facts are available to us through numerous studies and reports. It would be a tragedy to accept worsening inequalities as an inevitable consequence of this pandemic. In the spirit of ‘build back better’, this knowledge should be the basis for gender-specific measures addressing the needs of vulnerable groups who have been particularly affected by the pandemic. We have an excellent opportunity to introduce transformational policies promoting equity, sex and gender specific strategies and interventions to create a fairer, healthier world. Let’s not squander it.

Dr. phil. Annemarie Schumacher Dimech is President and co-founder of the Women’s Brain Project and heads the palliative care further education programme at the University of Lucerne, Switzerland.

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