This post was co-authored by Jena Doom, Ph.D., and Greta Hoffman, BA
The COVID-19 pandemic has increased the rates of anxiety and depression around the world. During the first nine months of the pandemic, rates of depression and anxiety among Americans were six times higher than they were in 2019 (Coley & Baum, 2021). From the beginning, health care workers (eg, physicians, nurses, community health workers) have been on the frontlines of this pandemic, experiencing both physical and psychological burdens. Numerous studies have reported that health care workers are at greater risk for burnout, mental exhaustion, insomnia, anxiety, depression, and PTSD symptoms (eg, Talevi et al., 2020).
Health care workers who work directly with COVID-19 patients not only have a greater risk of exposure to the virus but are also more likely to experience psychological distress due to witnessing repeated deaths and patients with severe illnesses. They have to comfort patients when their families are not allowed to visit. In addition, some health care workers chose to move out of their homes to protect their families, removing them from their own support system. These negative experiences often impact men and women differently.
Woman health care worker experiencing distress
Source: Cedric Fauntleroy/Pexels
Women make up almost 70 percent of the health care sector, and research shows that health care workers who are women are at greater risk of mental health problems during the COVID-19 pandemic compared to men (Wenham et al., 2021; López-Atanes et al., 2021). A study looking at the mental health of Italian health care workers during the COVID-19 pandemic found that women had greater symptoms of depression and PTSD than men did (Di Tella et al., 2020). A similar study in Spain revealed that women health care workers were at risk for higher psychological distress compared to their male counterparts (López-Atanes et al., 2021). In Wuhan, China, researchers found that women health care workers had greater anxiety than their male counterparts (Liu et al., 2021).
Specific Challenges for Women Health Care Workers
Many factors may be contributing to the higher rates of mental health problems for women health care workers. Women health care workers have more difficulty finding access to personal protective equipment (PPE), and the PPE that is available is shaped for the male body. This ill-fitting equipment may also increase the risk of COVID-19 exposure among women health care workers (Hoernke et al., 2021).
Additionally, pregnant or nursing women health care workers are, in many cases, not receiving the additional PPE and resources that they need in a hospital during a pandemic. For example, some pregnant health care workers had to continue directly seeing patients despite the increased risk of complications due to COVID-19, and many nursing rooms were not regularly or properly cleaned during the pandemic (Wenham et al., 2021).
Past psychiatric history is a risk factor for experiencing greater psychological distress from the pandemic, which is concerning for women given high rates of baseline mental health problems. One reason that a history of mental illness may be a risk factor is that health care workers may not have adequate mental health support, even after experiencing previous mental health problems.
A study in Brazil highlighted how racial inequality contributed to greater psychological distress in women health care workers. In that study, Black women reported having less access to PPE and training, as well as experiencing more workplace harassment compared to White women (Wenham et al., 2021). In addition, racist and xenophobic violence against Asian Americans increased during the pandemic, creating a greater threat to the safety of Asian American women who were health care workers (Gover, 2020). Women are also more likely to suffer economic impacts from COVID-19 (Wenham et al., 2020).
At the beginning of the pandemic, during stay-at-home orders, gender-based violence escalated (Dlamini, 2021). Calls to domestic violence hotlines increased by a shocking 27 percent just in Brazil in 2020 (Bastos et al., 2020). These poor home environments may contribute to mental health difficulties in women health care workers.
The discrepancy in wages between men and women in health care can also threaten mental health. When women are paid less than their male counterparts, they are significantly more likely to experience depression or anxiety (Platt et al., 2016). Women health care workers are also more likely to experience negative side effects from having to work schedules that are more irregular in comparison to their male counterparts, which can lead to higher levels of burnout and more mental, physical, and occupational stress.
Women are also underrepresented in leadership positions in national and global health care organizations, despite women making up the majority of the health care sector. This lack of representation may lead those in leadership to overlook how the pandemic is impacting men and women differently in public health policy decision-making (Leung et al., 2020).
Potential Policy and Public Health Solutions
Policymakers and public health officials would benefit from viewing the COVID-19 pandemic through a gender lens to understand how the disease affects individuals differently. This gender lens could help reveal larger gender inequalities in order to identify the most effective policy and public health responses. With women making up the majority of the health care sector, it is important to focus research on their experiences to reduce the rising mental health problems in women health care workers. By first acknowledging that women are more likely to have psychological distress from the COVID-19 pandemic compared to men, extra mental health resources and other targeted interventions can be provided to these health care workers.
There is no easy solution to address the gender inequities in health care. However, there are steps that we can take to improve women health care workers’ experiences and mental health during the pandemic:
- Have regular training in gender sensitivity and bias focused on the health care environment.
- Provide sufficient mental health resources that are accessible to all health care workers, with resources specific to women.
- Offer resources for victims and survivors of domestic violence.
- Provide PPE that adequately fits women, and give extra support to pregnant and nursing health care workers.
- Reduce the gender pay gap within health care by increasing pay transparency and implementing fair scheduling practices.
- Increase women leadership in the health care and public health community.