Women’s health was dramatically impacted by COVID-19. Health economist Jane Sarasohn-Kahn shares how the pandemic changed all aspects of women’s health—and how we must improve it.

By Jane Sarasohn-Kahn, MA, MHSA

In July 2021, the Centers for Disease Control and Prevention (CDC) announced sobering news about the declining life expectancy in the United States. Overall, Americans lost 1.5 years of life expectancy at birth in 2020 due to a handful of factors, such as COVID-19, unintentional injuries (such as premature deaths due to drug overdoses), homicide and diabetes.

Among all the demographic groups studied, women did better, in the context of this study, than men. For example, women’s life expectancy declined 1.2 years—from 81.4 years in 2019 to 80.2 years in 2020. Men’s life expectancy, however, declined by 1.8 years between 2019 and 2020—from 76.3 years in 2019 to 74.5 years in 2020.

This slight advantage of women’s longevity compared to men’s obscures other data that paint a more comprehensive picture of women’s health eroding in the pandemic across many dimensions: physical health, financial, mental and behavioral.

Women’s Longevity Cut Short Due to COVID-19

The CDC’s report indicates that COVID-19 was the primary factor for the change in life expectancy in women between 2019 and 2020,  accounting for nearly 80% of women’s declining longevity. For comparison, unintentional injuries (such as drug overdoses) diminished women’s life expectancy by nearly 7% and diabetes by 2.7%. (On the upside, improvements in cancer outcomes enhanced women’s life lengths by nearly 35%).

Women’s Access to Healthcare Services in the Pandemic

Women were more likely than men to have gone without healthcare during the COVID-19 pandemic, according to research from the Kaiser Family Foundation. Furthermore, women who had economic and medical challenges before the coronavirus had worsening health conditions because of skipping medical services in 2020.

“These gaps in care could translate into higher numbers of women experiencing severe health issues after the health emergency from the pandemic resolves,” the KFF warns in its report.

This is especially concerning given that COVID-19 may have entered a “fourth wave” of cases spiking due to the so-called Delta variant in the middle of summer 2021. (As the coronavirus continues to mutate, the CDC continues to track the evolving public health situation in terms of variants such as interest, concern and high consequence.)

 Women in the ‘She-Cession’: The Financial Toxicity of COVID-19

 “Women are bearing the brunt of the recession,” Wunderman Thompson called out in The Future 100: 2021 forecast.

During the pandemic, women in the U.S. were 1.8 times more like to lose a job than men, according to an April 2020 report from the Bureau of Labor Statistics. In December 2020, all of the jobs lost were occupied by women, an observation made by the National Women’s Law Center (NWLC). The NWLC calculated that this was the first time since 1948 that the female unemployment rate hit double-digits.

By the start of 2021, it became clear that the pandemic had exerted an even bigger toll on women’s employment as the virus continued to thrive through the winter months and well into 2021.

It is important to note that a year before, in December 2019, women held more payroll jobs than men for the first time in ten years. The pandemic has erased many years’ worth of women’s job gains.

The effects from COVID-19 on the women’s microeconomy are likely to be persistent, according to research on the impact of the pandemic on gender equality published by the National Bureau of Economic Research. “Closures of schools and daycare centers have massively increased childcare needs, which has a particularly large impact on working mothers,” the study noted.

The Impact of Working From Home

On gender equality at the work front, a study from Qualtrics and the theBoardlist observed that men were promoted at work more than women during the pandemic. Furthermore, 26% of men with kids at home received a pay raise while working remotely compared to only 13% of women. And 29% of men with children at home took on additional leadership responsibilities working from home while only 13% of women with kids at home said the same.

Overall, women found working from home to be more detrimental to their professional lives than men did, according to the Qualtrics/theBoardlist survey.

These study findings represent a new meme that has emerged in mass media looking at the impacts of people working from home or feeling under-valued in their jobs during their long pandemic journeys: that is “The Great Resignation.” As NPR interpreted growing numbers of people not returning to work in 2021, “remote work changed hearts and minds.”

Mental and Behavioral Health Eroded in the Pandemic

Stress levels increased significantly due to COVID-19, according to CVS Health’s Health Care Insights Study 2021. CVS Health discovered that more women than men recognized mental health and behavioral health impacts a year into the pandemic:

  • 40% of women felt greater anxiety during the pandemic compared with 32% of men
  • 38% of women felt more stress versus 31% of men
  • 32% of women self-diagnosed depression vs. 26% of men, and
  • 33% of women felt isolated and lonely compared to 25% of men.

Further evidence of the pandemic’s impact on women’s mental health was found in the Kaiser Family Foundation study cited above, finding that seven in 10 U.S. women said worry or stress related to COVID-19 affected their mental health—21% reported a “major” impact on mental health and 51% reported a “moderate” impact.

The American Psychological Association (APA) has been tracking stress in America for many years prior to the emergence of COVID-19 in the U.S. In 2020, the APA conducted several consumer surveys into Americans’ stress, finding that parents of children felt particularly acute pangs of anxiety and stress in the first year of the pandemic: “COVID-19 stress is taking a toll on U.S. parents,” the APA suggested.

In the APA study, parents with children under 18 years of age were much more likely to have a high stress level compared with adults without children. Parents reported stressors related to education, basic needs, access to healthcare services and missing out on major milestones such as children’s graduations, sporting events or cultural events typically held at their local schools.

These stressors contributed to some women’s negative behavioral health impacts. Nielsen noted an overall increase of 243% of online alcohol purchases in April 2020, as drinking shifted from “off-premises” in bars and restaurants to the home. A RAND Corporation study published in JAMA observed that heavy drinking among women rose by 41% during the pandemic shutdown as of mid-June 2020. “Heavy drinking” was defined in the study as four or more drinks consumed within a couple of hours.

“The alcohol spike seen among women, younger adults, and non-Hispanic white individuals highlights the need for primary care providers, behavioral health providers, and family members to be aware of the risks of increased alcohol use and heavy drinking during the pandemic,” the RAND study recommended.

Reimagining ‘Infrastructure’ in the Care-Heavy Economy

One aspect of women’s health warmed up in the age of COVID: investments in digital health products and services targeted to “femtech” got a sort of wake-up call. Digital women’s health investments are expected to reach $522 million by the end of 2021, largely driven by the need to improve women’s health outcomes and reduce costs.

HealthXL recently curated a women’s digital health update, noting that, “When we look into the digital health space, women are 75% more likely to use digital tools to track their health, and even when health insurance companies fail them, women are willing to use contraceptive and fertility apps, subscription birth control, and other tools to meet their needs.”

COVID-19 exposed the challenges women face. During the pandemic, many new products and services grew out of the pandemic as necessity was truly a mother of invention, Frost & Sullivan’s global healthcare and life sciences leader Reenita Das alluded to in a recent report.

Ever the realist, Das wrote, “Femtech still continues to be the stepchild for digital health.”

Speaking of stepchild, we come full-circle on women’s health and well-being to get real about what the private sector can and cannot do. That speaks to re-imagining what “infrastructure” is post-pandemic and in the digitally transforming world at work and at home.

In his Build Back Better Framework for infrastructure investment, President Biden speaks of supporting women’s employment and strengthening family economic security. “Despite the progress our nation has made over the last four months, there remain two million fewer women in the workforce than there were before the pandemic struck—taking a toll on our economy and on millions of families across the country,” the Framework’s website details.

“When women are better off,
we’re all better off.”

The healthcare economy overlaps with the larger macro-economy and women’s financial wellness. As the pandemic persists in either its fourth wave or as an endemic part of our American life, women’s ability to get back to work and back on-track for financial health will also bolster or diminish their physical and mental health and well-being.

Compared with 36 other developed countries, the U.S. falls in 35th place with respect to public spending on early childhood education and childcare investments. Women carried the burden of unpaid caregiving in 2020, the National Partnership for Women & Families calculated.

Gina Raimondo is the current Secretary of Commerce. Her background has been in business and economic development. In her recent speech to the Manassas Women’s Roundtable, Raimondo said, “Women are the backbone of our economy. And our economy cannot fully recover unless women can fully participate. Over 2 million women left the workforce during the pandemic … this mass exodus is a national emergency, and it demands a national solution.”

That national emergency applies to women’s minds, bodies, spirits and pocketbooks. As we seek to build healthcare back better, industry stakeholders should be mindful that addressing only the medical and physical aspects of women’s health won’t be enough to achieve optimal outcomes, lower costs, and realize resilient population health and buoyant economic growth in America.

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