Women’s contribution to health underrecognized, undervalued

Ana Langer
Ana Langer co-chaired the Commission on Women and Health.

June 11, 2015 — Fact: Around the world, more and more women are struggling with noncommunicable diseases (NCDs) like cancer, diabetes, and cardiovascular disease.

Fact: Around the world, women who provide health care are routinely underpaid, undervalued, or not paid at all.

Fact: Around the world, poor women in poor countries face significant health inequities.

These issues—and many others—were outlined at the June 5, 2015 launch of a comprehensive new report that sheds light on women’s health status, their value as health care providers, and their centrality to the overall health and success of societies around the world. Several members of the 15-member Commission that produced the report—a partnership between The Lancet, Harvard T.H. Chan School of Public Health’s Women and Health Initiative, and the University of Pennsylvania School of Nursing—outlined its major points at the launch event at Harvard Chan School.

Dean Julio Frenk, who served on the Commission, called the report “a force to inspire the conversation for the post-2015 development agenda.”

Speakers at the launch stressed that issues surrounding women and health affect development on a broad scale. That’s because women are often the linchpins in ensuring the health of their families and their communities, and a healthy population is key to healthy economic development. As Mariam Claeson of The Bill & Melinda Gates Foundation put it, “If the health needs of women and the problem of gender inequality are not addressed, no society or economy will achieve its potential.”

The report assesses the significant extent to which women’s work in the health sector is not financially valued, and offers estimates of what their work is actually worth.

Harvard-affiliated experts who served on the Commission and who spoke at the June 5th event included Frenk; Ana Langer, professor of the practice of public health and director of the Women and Health Initiative and Maternal Health Task Force at Harvard Chan School; and Felicia Knaul, associate professor at Harvard Medical School.

A fragmented view of women’s health

Although thinking about “women and health” has evolved over the past 50 years—from a focus on child health, to population growth, to maternal mortality, and, more recently, to the increase in NCDs among women worldwide—women’s health is still conceived of “in a fragmented way,” Langer said. Emphases on particular diseases (i.e. breast cancer) or stages of life (i.e. the reproductive years) lead to competition for attention, funding, and action. “We at the Commission call for a broader, more comprehensive approach that looks at women’s health throughout the life cycle,” Langer said, and that takes into account factors such as social inequities, economics, politics, and environmental issues that can impact women’s health.

“The challenges are far from over,” Langer said. “There are big inequalities that need to be addressed. Health systems still are failing women.”

Underpaid, undervalued

Women are not fairly compensated for their crucial contributions, according to the report. Most women working in the health care sector are nurses, often underpaid and unable to reach decision-making or leadership positions. And, in most societies, it’s women who provide the lion’s share of home health care for relatives—for which they’re typically uncompensated. “We see this as an invisible subsidy to health systems,” Langer said.

Felicia Knaul at Women and Health event
Felicia Knaul

Knaul conducted an economic analysis to place monetary value on women’s contributions to health care systems and found that those contributions amount to 4.8% of global GDP—about $3.1 trillion. A little less than half of that is unpaid, she said.

Some of the jobs women perform can’t adequately be measured, she added. “What happens when a woman walks hours to get wood or fetch water?” she asked. “That’s counted as domestic work—but it’s important for preventing illness and promoting health.”

Also speaking at the launch were Justine Davies of The Lancet; Afaf Meleis of the University of Pennsylvania School of Nursing, co-chair of the Commission; and Ruth Bonita of the University of Auckland. Responses came from two discussants: Paula Johnson of the Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital and Harvard Medical School; and Jeni Klugman of the Women and Public Policy Program, Harvard Kennedy School.

Learn more

Women’s contributions to health care nearly 5% of global GDP (Harvard Chan School news)

— Karen Feldscher

photo of Ana Langer: Emily Cuccarese

photo of Felicia Knaul: courtesy Harvard Global Equity Initiative