By Molly Hartzog, Health Communications Specialist IV
The role of women in public health is long and complicated. Women make up 76% of the overall healthcare workforce, and in recent years, more than half of matriculants to US medical schools.[i,ii] However, this achievement largely only applies to white women, as Black women in healthcare are concentrated in the lowest wage, highest risk, most laborious positions, and comprised only 9.6% of women matriculants in medical school for the 2022-2023 year.[ii,iii] Just 6% of women matriculants identified as Hispanic, Latino, or of Spanish origin.[ii] At Karna, our gender diversity is consistent with what’s generally seen in the public health industry: 73% of our employees are female. Of our female employees, 60% are non-White (fall into one of the following races: Hispanic/Latino, two or more races, African American, or Asian).
There’s historical precedent to the disproportionate representation of women in healthcare: At the turn of the century, as germ theory and microbiology worked its way into public consciousness, much of the work and worry of fighting germs fell into realms traditionally considered “women’s work”: childcare, cooking, and housekeeping. The domestic science movement—led by woman professionals, including home economists, nurses, and social workers—sought to educate housewives and mothers of the early 20th century in household microbiology. This movement framed our current practices in handwashing, cleanliness, and food storage as noble activities of good manners and good housekeeping (yes, Good Housekeeping began as one important educational outlet for the domestic science movement). While having an inarguably profound impact on public health, the domestic science movement was a double-edged sword. It provided more avenues for women to pursue financial independence, fueling expansion in the fields of social work, nursing, and home economics; at the same time, the movement was largely only accessible to white, college-educated, middle-class women, fueling their prejudicial superiority against “dirty” and “unhygienic” indigenous and Black people.[iv]
We see similar gender dynamics and negative effects in the COVID-19 pandemic. Caregiving responsibilities fell disproportionately on mothers: 1 in 10 mothers reported quitting a job due to the pandemic, and over half of them identifying daycare or school closure as the reason. Almost half of working mothers reported taking unpaid sick leave due to daycare or school closures. Over half of mothers of children under 18 reported negative mental health impacts due to the pandemic compared to just over 1/3 of fathers. 1 in 5 mothers reported the mental health impact as “major.”[v] Women are more likely than men to wear masks, more likely to take on COVID-19-related caretaking responsibilities, and mothers are more likely to have a negative mental health impact due to the pandemic than fathers.[vi] Compound these factors with the disproportionate impact of COVID-19 disease on communities of color and the gendered racism faced by women of color, specifically, you have an incredibly precarious situation.
As we wrap up Women’s History Month, let’s celebrate the women leading us through the pandemic—the moms, caretakers, housekeepers, nurses, doctors, scientists, and public health professionals. At the same time, let’s reflect on how to minimize the burdens we put on women caretakers, improve their mental health, and promote more women of color in safer, higher-paying healthcare positions.
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[i] https://www.census.gov/library/stories/2019/08/your-health-care-in-womens-hands.html
[ii] https://www.aamc.org/media/6026/download?attachment
[iii] https://www.healthaffairs.org/doi/10.1377/hlthaff.2021.01400
[iv] Tomes, Nancy. (1998). The Gospel of Germs: Men, Women, and the Microbe in American Life. Cambridge: Harvard UP.
[vi] https://news.gallup.com/poll/310400/new-april-guidelines-boost-perceived-efficacy-face-masks.aspx