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The Female Frontline: How Healthcare Is Affected by the "She-cession"

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The COVID-19 pandemic has caused many essential healthcare workers—primarily women—to leave the workforce. This has brought up gender equality issues in the workplace, and many employers are taking action.

The COVID-19 pandemic has had a significant impact on healthcare jobs. While the coronavirus rapidly spread throughout the U.S., the demand for healthcare workers dramatically increased. Unfortunately, as the need was heightened, many institutions found themselves struggling to retain female employees, who represent nearly 70% of the global healthcare workforce.[1] In fact, according to a National Women’s Law Center Analysis, four times as many women as men dropped out of the labor force in September of 2020.[2]

Vice President Kamala Harris said in a video call with women’s advocacy groups and lawmakers that the 2.5 million women who have left the workforce constitutes a “national emergency” that must be addressed. “In one year,” she said, “the pandemic has put decades of the progress we have collectively made for women workers at risk.”[3]

Why did this happen? What are employers doing to combat it? And what implications does this have for the future?

 

Why Women Left Their Healthcare Jobs

The coronavirus has increased family responsibilities and the need for unpaid care—burdens which are disproportionately carried by women.

Schools shifted to virtual learning, and day care centers became restricted by child-staff ratios, making childcare inaccessible to many families. One in four women who reported becoming unemployed during the COVID-19 crisis said it was because of lack of child care—double the rate of men.[4] An analysis by Colorado State and Yale researchers estimates that 35% of medical assistants care for children between the ages of 3-12, and many don’t have another family member in their household to provide child care when schools close.[5] Black, Latina, or women between the ages of 20-24 have been particularly affected by the economic “she-cession”, highlighting equity issues within the workforce.2

Although there’s been a rise in telehealth, many frontline healthcare professions such as medical assistants and patient care technicians must perform their tasks in-person. For these professionals, working remotely is rarely an option, and trying to schedule their work around remote learning and limited childcare options gave many no choice but to leave their job.

The sudden absence of women in the workforce is felt more strongly in the healthcare field, and especially among frontline healthcare professions. Nearly 87% of healthcare support occupations are held by women, according to BLS data.[6]

As schools begin to reopen and restrictions are lifted, the economy has regained some of the jobs lost … but the healthcare sector is still struggling. In January 2021, the overall unemployment rate improved, but the healthcare industry saw 30,000 job losses in the month—most notably in nursing care facilities and home healthcare services.[7] This could be attributed to the fact that healthcare is a female-dominated industry.

“Of the female-dominated industries in our area, the ones that are having a slower recovery are the ones that don’t allow for work from home or remote work opportunities. It creates a unique challenge for those employers to find ways to create policies and work environments that accommodate that workforce in particular,” says Jessica Palm, Vice President, Marketing & PR, Kansas City Area Development Council.

How Healthcare Employers Are Responding

The COVID-19 pandemic has put a spotlight on gender equity issues in the workplace. Companies in all industries—especially female-dominated sectors like healthcare—are making changes to try to retain current and recruit new female talent.

“COVID has really shined a light on where we had gaps as a society and as a country, and we’re seeing a lot of employers and communities step up in a variety of different ways to support talent in their region,” Palm says.  

Healthcare will be forever changed by the pandemic. The changes many employers are making are not just band aid fixes, but long-term solutions that hope to make the workplace a better environment for women now and well into the future. Below are some examples of the efforts healthcare institutions are making in response to the “she-cession”.

Embracing telehealth as a new way to work

The pandemic made telehealth a new normal—a change that is likely here to stay. According to the CDC, there was a 154% increase in telehealth visits during the last week of March 2020, compared with the same period in 2019.[8]

The ability to work remotely became necessary in many roles, and that flexibility is essential to working parents who must care for their children at home. Many healthcare positions must be in-person, but for those that can be remote, telehealth empowers healthcare institutions to offer flexible options in a way they haven’t before.

Healthcare institutions that have embraced telehealth as a path forward have the potential to attract more women to the workforce and can also expand care—especially to women. Before the pandemic, telemedicine was gaining traction with working mothers who, while juggling work and childcare, found it challenging to go to in-person appointments. In 2019, the users of telehealth platform Doctor on Demand were 65% female, and approximately two-thirds of the physician’s on staff were also women.[9] Virtual medicine can benefit women as both employees and as patients.

Working toward gender equality in leadership

Gender equality in healthcare was already a hot topic before the pandemic, and the issue has only been exacerbated by the loss of workers due to the coronavirus. Pre-pandemic, about 80% of healthcare jobs were held by women, yet fewer than 20% hold key leadership positions and a mere 4% of healthcare companies are women-led.[10] Representation of women in healthcare leadership positions particularly declines for women of color, likely because, as one report suggests, factors that exist for women in general are amplified for women of color.[11] 

These discrepancies are highlighted by the fact that women are now leaving the workforce at a higher rate than men. Working toward gender equality takes time and cultural change, but some companies are stepping up and committing to making them.

The Mayo Clinic has added more women to leadership and Board of Trustees positions. Cincinnati Children’s created the Center for Diverse Leadership in Pediatrics to advance leadership and career development opportunities for diverse leaders. UnityPoint Health partnered with local grocery stores in some regions to have individual food orders delivered to employees on-site during the pandemic, recognizing that women disproportionately took on more home responsibilities.[12]

COVID made things that already existed more visible, and this [gender inequality in the workplace] is one of those issues,” says Sheri Gonzales, Vice President and Director of KC Rising, a Kansas City-based regional economic development initiative. Gonzales points to needs such as quality childcare, quality education, and increased flexibility that especially help support working women.

Establishing family-friendly policies

Strong family policies can help ensure that employees do not have to choose between career and family while also helping businesses and the economy overall. Providing paid family and medical leave is proven to improve the labor force participation, earnings, and economic security of all workers, especially women.[13] Businesses often have the false belief that providing paid leave will be costly, but research indicates that there are no added costs; in fact, some employers report cost savings.[14] 

Family-friendly policies extend beyond maternity leave. A major issue that has been highlighted by the pandemic is the need for childcare assistance. Some major hospitals and healthcare organizations offer on-site childcare that employees can use during their shifts. As schools went virtual, employers began to offer proctored learning environments for school-aged children to attend their remote classes while their parents worked. One Fortune 500 healthcare company took it a step further and supplemented childcare costs for every single employee in their system. These childcare benefits are a huge attraction for working mothers, making it more feasible for them to re-enter the workforce. 

COVID-19 has been a catalyst for change. While the environment they once knew has evolved to something hardly recognizable, the evolution has indeed had a positive impact. As employers acknowledge and combat the “she-cession” sparked by the pandemic, there’s promise that former, current, and future female frontline workers can expect a more flexible and family-friendly work environment.

 

Sources: 

[1] WHO, & Boniol, M. et al (2019, March). Gender equity in the health workforce: Analysis of 104 countries. https://www.who.int/hrh/resources/gender_equity-health_workforce_analysis/en/

[2] Ewing-Nelson, C. (2020, Oct). Four Times More Women Than Men Dropped Out of the Labor Force in September. National Women’s Law Center. http://nwlc.org/resources/four-times-more-women-than-men-dropped-out-of-the-labor-force-in-september/

[3] Rogers, K. (2021, February 18). 2.5 Million Women Left the Work Force During the Pandemic. Harris Sees a ‘National Emergency.’ The New York Times. https://www.nytimes.com/2021/02/18/us/politics/women-pandemic-harris.html

[4] Modestino, A. S. (2020, July 29). Coronavirus child-care crisis will set women back a generation. Washington Post. https://www.washingtonpost.com/us-policy/2020/07/29/childcare-remote-learning-women-employment/

[5] Bayham, J., & Fenichel, E. P. (2020). Impact of school closures for COVID-19 on the US health-care workforce and net mortality: a modelling study. The Lancet Public Health, 5(5), e271–e278. https://doi.org/10.1016/s2468-2667(20)30082-7

[6] Bureau of Labor Statistics, “Table 1: Employed and Experienced Unemployed Persons by Detailed Occupation, Sex, Race, and Hispanic or Latino Ethnicity, Annual Average 2019,” Current Population Survey (unpublished data) (2020).

[7] U.S. Bureau of Labor Statistics. (2021, February 5). Employment Situation Summary [Press release]. https://www.bls.gov/news.release/empsit.nr0.htm

[8] Centers for Disease Control and Prevention. (2020, October). Trends in the Use of Telehealth During the Emergence of the COVID-19 Pandemic — United States, January–March 2020 (69(43);1595-1599). https://www.cdc.gov/mmwr/volumes/69/wr/mm6943a3.htm

[9] Farr, C. (2019, June 30). Telemedicine apps are thriving because working moms love the convenience of their smartphones. CNBC. https://www.cnbc.com/2019/06/30/telemedicine-apps-like-american-well-are-thriving-because-of-moms.html

[10] Kacik, A. (2019, May 22). Few women reach healthcare leadership roles. Modern Healthcare. https://www.modernhealthcare.com/operations/few-women-reach-healthcare-leadership-roles

[11] Berlin, G., Darino, L., Greenfield, M., & Starikova, I. (2020, March 1). Women in the healthcare industry. McKinsey & Company. https://www.mckinsey.com/industries/healthcare-systems-and-services/our-insights/women-in-the-healthcare-industry

[12] Gooch, K. (2020, August 12). How Forbes’ best employers in healthcare are improving their workplaces for women. Becker’s Hospital Review. https://www.beckershospitalreview.com/hospital-management-administration/how-forbes-best-employers-in-healthcare-are-improving-their-workplaces-for-women.html

[13] Boesch, D. (2021, February 5). Quick Facts on Paid Family and Medical Leave. Center for American Progress. https://www.americanprogress.org/issues/women/news/2021/02/05/495504/quick-facts-paid-family-medical-leave/

[14] Appelbaum, E., & Milkman, R. (2011). Leaves That Pay: Employer and Worker Experiences with Paid Family Leave in California. Center for Economic and Policy Research. https://www.cepr.net/documents/publications/paid-family-leave-1-2011.pdf

 

 

 

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