Medical care is a huge and booming sector of most economies — largely thanks to women who today produce the majority of the world´s healthcare. Reducing gender bias and investing in women will produce more health and healthier economies.
In no profession is the entry of women more evident than in medicine. Only a few decades ago, female faces were almost nowhere to be found in medical-school classrooms. Today, women are the majority of medical students. In the United States, only 10 percent of practicing doctors were women in 1980, today the figure is 30 percent. Within a few years, a patient will be as likely to be treated by doctor who is a woman as one who is a man.
But, will physicians who are women have the same opportunities to specialize and enjoy equal earnings to their counterparts who are men? Unlikely.
Policies to make employment in the health sector more gender friendly are few and far between. Globally, nurses continue to fight gender discrimination. Long working hours and little tolerance for absences constitute huge barriers to women working in the medical profession. In Mexico, underemployment and unemployment is especially common among women doctors — a huge waste of scare resources.
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In 2015, along with colleagues from around the world, I published research in The Lancet, a leading medical journal, on the global value of women’s contributions to healthcare.
The findings show a surprisingly high figure: $3.1 trillion, equal to 4.8 percent of world GDP.
Let’s put this number in context: It is almost one-third of the entire Chinese economy and three times the Mexican economy. And, our estimate is conservative — the figure could be 20 percent to 30 percent higher.
About half of the $3.1 trillion corresponds to paid work in the health sector — by women who are doctors, nurses or social workers, or who work in the pharmaceutical, medical-care device or health-insurance industries, for example.
The other half of women’s global contributions to healthcare — valued at $1.5 trillion, or about 10 percent of the entire U.S. economy — are the many unpaid hours caring for children, other family members who fall ill or the elderly.
In the United States, total contributions by women to health are valued at 6.3 percent of GDP, and about 45 percent corresponds to unpaid work in the home. In Canada, the total is 6.1 percent, but only 30 percent is unpaid. In Cuba, Peru and China, unpaid home-based work constitutes more than 70 percent of women´s contributions to health.
Home-based healthcare is an important subsidy to healthcare worldwide that is not recognized, valued or remunerated. It generates more healthcare for all, but what does it do to women?
Unpaid work in the home is unregulated, and there is no professional training. Who teaches a teenage girl living in a small pueblo in Bolivia to care for her diabetic grandmother? Or a woman in South Florida how to lift her heavy, wheelchair-bound father-in-law?
Further, research in Mexico shows that after accounting for women´s time in paid work, caregiving and other domestic chores, only six hours remain in a day. That means no time for relaxation if women hope to get an almost-decent night’s sleep.
For men, however, half of the hours in a week are for rest and relaxation.
This is unfair. It embodies gender bias. It is bad for women’s health and wellbeing. Since women are the majority producers of health, overworking us also negatively affects healthcare outcomes and the economy.
Is the solution multi-tasking? I am sitting across from my 11-year old, writing this article and trying to help her buy stickers for her computer. She is cogently explaining to me why I am doing a bad job at both activities. She is right. I encourage her to buy more stickers while I finish writing. Given my compromised situation, she expands her purchase and with my AMEX spends $30 on eight stickers. Conclusion: Mass multi-tasking not a good solution.
While I know that regulations and incentives do not necessarily change attitudes like machismo, it’s a good place to start. Yet, few countries have laws and institutions to promote the participation of men in the home through paternity or long-term care leave.
Healthy health sectors produce healthier, stronger economies. Healthy, fairly remunerated women who can work and also enjoy their families and lives are key to producing health. How can this win-win be achieved? By striving for equality of opportunity for men and women to take part in —and yes, even enjoy — care-giving in the home.
Felicia Knaul is a professor in the Department of Public Health Sciences at the University of Miami’s Miller School of Medicine and director of the Miami Institute for the Americas.