WOMEN in the health and care sector face a larger gender pay gap than in other economic sectors, earning on average of 24% less than peers who are men, according to a joint report by the International Labor Organization and the World Health Organization.

The report finds a raw gender pay gap of approximately 20 percentage points which jumps to 24 percentage points when accounting for factors such as age, education and working time. This highlights that women are underpaid for their labour market attributes when compared with men.

Much of the wage gap is unexplained, perhaps due to discrimination towards women, who account for 67% of health and care workers worldwide.

The report also finds that wages in the health and care sector tend to be lower overall compared with other economic sectors. This is consistent with the finding that wages often are lower in economic sectors where women are predominant.

The report finds that, even with the COVID-19 pandemic and the crucial role played by health and care workers, there were only marginal improvements in pay equality between 2019 and 2020. It also finds a wide variation in gender pay gaps in different countries, suggesting that pay gaps in the sector are not inevitable and that more can be done to close these gaps.

Within countries, gender pay gaps tend to be wider in higher pay categories, where men are over-represented. Women are over-represented in the lower pay categories.

Mothers working in the health and care sector appear to suffer additional penalties. During a woman’s reproductive years, employment and gender pay gaps in the sector significantly increase. These gaps then persist throughout the rest of a woman’s working life.

The report observes that a more equitable sharing of family duties between men and women could, in many instances, lead to women making different occupational choices.

The analysis also looks at the factors that are driving the sector’s gender pay gaps. Differences in age, education, working time and the difference in the participation of men and women in the public or private sectors only address part of the problem. The reasons why women are less paid than men with similar labour market profiles in the health and care sector across the world remains, to a large extent, unexplained by labour market factors, the report says.

Moderate drinking linked to brain changes and cognitive decline

Consumption of seven or more units of alcohol per week is associated with higher iron levels in the brain, according to a study of 20 965 people published in PLOS Medicine. Iron accumulation in the brain has been linked with Alzheimer’s and Parkinson’s diseases and is a potential mechanism for alcohol-related cognitive decline. The participants from the UK Biobank reported their own alcohol consumption, and their brains were scanned using magnetic resonance imaging (MRI). Almost 7000 also had their livers imaged using MRI to assess levels of systemic iron. All individuals completed a series of simple tests to assess cognitive and motor function. Participants’ mean age was 55 years and 48.6% were female. Although 2.7% classed themselves as non-drinkers, the average intake was around 18 units per week, which translates to about 7.5 cans of beer or six large glasses of wine. The team found that alcohol consumption above seven units per week was associated with markers of higher iron in the basal ganglia, a group of brain regions associated with control of motor movements, procedural learning, eye movement, cognition, emotion and more. Iron accumulation in some brain regions was associated with worse cognitive function. Although drinking was self-reported and could be underestimated, this was considered the only feasible method to establish such a large cohort’s intake. A limitation of the work is that MRI-derived measures are indirect representations of brain iron and could conflate other brain changes observed with alcohol consumption with changes in iron levels.

PCOS in mothers linked to increased risk of health problems in their children

Children born to mothers with polycystic ovary syndrome (PCOS) have an increased risk of developing infections, allergies and other childhood illnesses by the age of 13 years, according to a study published in Human Reproduction. The study looked at 1 038 375 children born in Quebec, Canada, between 2006 and 2020. Of these, 7160 children were born to mothers with PCOS. The researchers found that children of mothers with PCOS were 32% more likely to be admitted to hospital with a variety of health problems than children of mothers without PCOS. They were 31% more likely to be admitted for infectious diseases and 47% more likely to be admitted for allergy-related problems, such as asthma. The risk of hospitalisation was increased for problems relating to metabolism (up by 59%), the gut (72%), central nervous system (74%) and ears (34%); it was also increased for respiratory problems, such as pneumonia (32%) and mental and behavioural problems (68%). There was no link with cancer, and there was little difference between boys and girls in the association of PCOS with hospitalisation. The researchers adjusted their findings to take account of factors that could affect the results, such as mothers’ other health problems, age, parity, alcohol and tobacco use, and socio-economic deprivation. They found that the associations between maternal PCOS and the health of offspring were not explained by fertility treatments, multiple births, preterm births or the mothers’ other health problems. As this is an observational study, it is unable to show that PCOS causes health problems in children, only that it is associated with them, and it cannot show what mechanisms may be involved.

Fluvoxamine and colchicine ruled out for treatment of mild COVID-19

The antidepressant drug fluvoxamine and the gout drug colchicine are not recommended for patients with mild or moderate COVID-19 because there is currently insufficient evidence that they improve important outcomes for patients, and both drugs carry potential harms, say a WHO Guideline Development Group panel of international experts published in The BMJ. No recommendation was made for either drug in patients with severe or critical illness, given limited or no data. Fluvoxamine and colchicine are commonly used, inexpensive drugs that have received considerable interest as potential COVID-19 treatments during the pandemic. However, the recommendations against their use reflect ongoing uncertainty about how the drugs produce an effect in the body, and evidence of little or no effect on survival and other important measures, such as risk of hospital admission and need for mechanical ventilation. There is also a lack of reliable data on COVID-19-related serious harms associated with these drugs. The WHO’s advice against the use of fluvoxamine except in clinical trials was informed by data from three randomised controlled trials involving over 2000 patients, and their strong advice against colchicine was based on data from seven randomised controlled trials involving 16 484 patients.

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5 thoughts on “Women in health earn a quarter less than men

  1. Kay says:

    Max says “It has for decades been illegal to pay women and men differently for the same work.”

    In the modern economy income levels are not fixed and frequently are negotiable, especially for senior roles. There is evidence to show that females are often offered lower salaries than males for similar roles. Maybe females are less likely to negotiate a higher income than males but this is still a gender based pay gap. Likewise there is evidence of bias in selection for both training programs and senior roles in medicine.

    Females in General Practice tend to have a different cohort of patients to male GPs and this can impact on income. One GP practice charged a higher fee for their female doctors as they consulted less patients per hour and the practice was strongly criticised by the general public and in the media for doing this.

    So it is not as simple as Max makes out with that statement. The disparity is more complex than the number of hours worked or time taken for parenting or choice of specialty.

  2. Anonymous says:

    I once worked as the only female GP, full time, in a middle sized group practice.
    Patients were routinely advised to come to me for Paps and other ‘women’s work’ Smears and tears.
    It wasn’t uncommon for me to find 5 Paps booked into the one session.
    So although equal pay for equal work, this skews into poorly remunerated Level C/ long consults.
    And a great deal of unremunerated follow up.
    Reflects in the bottom line.
    I left GP in favour of a level playing field as salaried MO in ED. And have this transition to thank for a more comfortable retirement.

  3. C says:

    agree with Max.
    if someone chooses to work part time rather than full time, or chooses General Practice or Psychiatry instead of Orthopaedics or Cardiology, or takes a year or 2 off because of children, of course they will be earning less.
    it is not workplace discrimination.

  4. Randal Williams says:

    The article on gender pay gaps in health is misleading and disappointing, and suspicious of a political agenda. Payment for equivalent work in medicine and nursing is the same for both genders and has been for decades. If women are paid less , could it be that they choose to work less hours, do less overtime or work in lower paid/less demanding areas of health care ? We have to accept the biological reality that women have the babies , and are likely to take time off or work less hours as a result. I fully support their ability to make these choices. It is not “discrimination” but simply the reality of biology and what women want to do in their work and family lives. I agree with ‘Max’ that “choices in work and domestic arrangements do not represent discrimination.”

  5. Max says:

    The title is correct, the text not: there is no gender pay gap, there is an earnings gap.

    It has for decades been illegal to pay women and men differently for the same work.

    The statement ‘…much of the wage gap is unexplained, perhaps due to discrimination towards women’ is gratuitous, tendentious, and utterly unsupported by any data within the article.

    Choices in work and domestic arrangements do not represent discrimination.

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