The gender gap and health care: tackling the problem at its roots

This article was exclusively written for The European Sting by Ms. Feriel Arezki, a 5th year medical student from Bejaia, Algeria. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

According to the Organization for Economic Co-operation and Development, health data: Statistics and Indicators, the female-to male ratio among trainee medical specialists was higher than 1 throughout the study period. After completion of specialist training, the proportion of women with temporary contracts more than doubled that of men. Less than 50% of women achieved permanent positions compared with 70% of men. For permanent non-hierarchical and hierarchical positions, the female-to-male ratio gradually decreased from 0.5 to below 0.2. Although more than 50% of trainee specialists were women, the number of female consultants remained 25% lower than that of men. In 2008, the final year of the study, the percentage of women who had achieved the grade of senior consultant was one-third that of men (29.5% of men vs 10.9% of women).

The significant differences in medical positions held by men and women illustrate the ‘leaky pipeline phenomenon’, consisting of a disproportionately low number of women achieving leading medical positions.

Albert Einstein reportedly said that if he had an hour to solve a problem, he’d spend 55 minutes thinking about the problem and five minutes thinking about solutions.

Thus, to tackle inequalities in health care, we need to start with understanding of where it comes from. What is its origin?

Human societies weren’t always male-dominated. The switch came when we became farmers – and that suggests ways to roll back towards a more equal system.

According to one school of thought, things changed around 12,000 years ago. With the advent of agriculture and homesteading, people began settling down. They acquired resources to defend, and power shifted to the physically stronger males. Fathers, sons, uncles and grandfathers began living near each other, property was passed down the male line, and female autonomy was eroded. As a result, the argument goes, patriarchy emerged.

If patriarchy originated in sedentary social structures that formalised male ownership and inheritance, then laws that give women the right to own property in their own name, for instance, can help.

But such laws exist in many 21st century societies – so why does the patriarchy persist? Ultimately, real change will only come when societies embody the values espoused by the laws.

We need to point out that patriarchy does not affect women exclusively, men too need to be freed from it. According to the World Health Organization, Western men are three to four times as likely to kill themselves as women. A recent study of suicide prevention in Ireland illustrates this. Men who were deemed to be at high risk of suicide reported that seeking help could be construed as a threat to masculinity, including “a loss of power, control and autonomy”.

In conclusion, patriarchy is the least noticed yet the most significant structure of social inequality. Therefore, my five minutes solutions reflection would suggest that equality will be reached by continuing efforts to implement reforms and strategies to overcome the systemic barriers that women health care providers are facing. The laws are the first step, the internalised values come later.

References

Organization for Economic Co-operation and Development. Health data: Statistics and Indicators for 24 countries 2009; [consulted on 23/7/2021]. Available at: http://stats.oecd.org/index.aspx?DataSetCode=HEALTH_STAT.

NewScientist The origins of sexism: How men came to rule 12,000 years ago; [consulted on 23/7/2021]. Available at: https://www.newscientist.com/article/mg23831740-400-the-origins-of-sexism-how-men-came-to-rule-12000-years-ago/#ixzz71cLcJeB3

About the author

Feriel Arezki is a 5th year medical student from Bejaia, Algeria. Currently, she is working as National Officer on Sexual and Reproductive Health and Rights including HIV and AIDS within the IFMSA. She has a deep interest in medical research, gender equity, policy making and digital health.