Women’s health worsened in 2021, says global survey

For women around the world, the second year of the Covid-19 pandemic has brought more health challenges than the first.

In 2020, medical technology company Hologic launched a global survey in partnership with Gallup to assess the extent to which women’s health needs were being met.

Countries were scored based on women’s responses to questions in five categories: general health, preventive care, mental health, safety, and basic needs such as food and shelter.

The overall score for the Global Women’s Health Index in 2021 was just 53 out of 100, one point lower than in 2020. No country scored more than 70 points in 2021, with Taiwan, Latvia, Austria and Denmark in the top spots. Three countries scored less than 40 points: Afghanistan, Congo and Venezuela.

“The economic and psychological burden of the pandemic will weigh on many families for some time, and we know it has particularly affected women,” said Gertraud Stadler, director of the Institute of Gender in Medicine at Charite hospital in Berlin.

Women were more stressed, worried, sad and angry in 2021 than at any other time in the last decade, according to a Gallup poll that included rankings from the Global Women’s Health Index.

Women were also more likely than men to say they didn’t have enough money to buy food in 2021, a share that rose from 34% of women in 2020 to 37% in 2021.

“Overall, the data is concerning and we understand that we need women to be healthy to fully engage and be empowered. It is clear that the time has come for us to work together and start finding solutions and improving women’s health care.”

“The world is failing women”

According to Hologic and Gallup, the top five areas evaluated in the Global Women’s Health Index can explain most of the variation in a woman’s life expectancy at birth.

For example, they found that women who said they had seen a healthcare provider in the past year had an average life expectancy of two years longer than those who did not.

Preventive care is an area where the United States scored better in 2021 than it did in 2020. It ranked second in this dimension on the Global Women’s Health Index, behind only Latvia.

“It was a small improvement, but we have to be happy about it,” Harvey said. “Overall, though, the world is failing women in preventive care.”

About 1.5 billion women did not have access to preventive care last year, she said. And globally, less than 1 in 8 women have been screened for cancer at any time in the past year, according to the survey.

While the remedy for this flaw may seem simpler, experts say it actually reflects the multiple layers of challenges women face.

Women “are always the last to take care of ourselves. We are the primary doctors in our families,” said Katie Schubert, president and executive director of the Society for Women’s Health Research, a US-based activist group that was not involved in the new study. “It goes back to a lot of these different burdens that women are taking on, both from the perspective of being a caregiver but also being a part of their community.”

In the US, for example, Schubert says, women are more likely to go to a health appointment for their children than for themselves. And the share of women who don’t show up for a key doctor’s appointment six weeks after giving birth is “quite impressive,”

said Dr. Susan Harvey, vice president of worldwide medical affairs at Hologic and former director of breast imaging at the Johns Hopkins School of Medicine.

Maternal health needs attention

Despite some improvement, the United States remains an exception in women’s overall health—in part because of maternal health, an area that experts agree deserves more attention around the world.

Opinions on health and safety among women in the United States dropped in the 2021 Global Women’s Health Index, as did measures of individual health, including pain and general health problems.

A safety-related question asked women to assess whether pregnant women where they live receive high-quality health care.

A study published in June found that maternal mortality in the US increased in the first year of the pandemic, especially among Hispanic and black women. And new data from the US Centers for Disease Control and Prevention found that more than 4 out of 5 pregnancy-related deaths were preventable.

Rich nations generally scored better than low-income nations on the Global Women’s Health Index. In fact, the gap in scores between high- and low-income countries has nearly doubled from 2020 to 2021, with an average gap of more than 20 points. But life expectancy in the US was lower than average, despite health care spending well above average.

In some ways, the wider gender disparities in health care are already well known around the world. For example, women seeking medical help for a heart attack in many countries take longer to get a correct diagnosis, are treated less consistently and are less likely to attend cardiac rehabilitation, Stadler said.

“All of this combines with worse outcomes and higher mortality in women than in men,” she said.

Raising women, lifting society

Experts agree that improving women’s health will uplift society as a whole.

“Often women have the role of health managers in their families and communities. And they are taking on a large part of the care work, so children, partners, parents benefit from women’s health as well,” Stadler said. And the effects are far-reaching. “Without this fundamental health and well-being of women, we will not be able to advance any of the goals related to economic stability or equity in socioeconomic development,” Schubert said.

“That really stands on the shoulders of a healthy environment, a healthy person and healthy outcomes.” But gender equality – in health and in other aspects of life – is still far from reality. Schubert noted that Covid-19 vaccine trials did not include pregnant women.

“My hope is that we can better prepare to be more inclusive and comprehensive in our biomedical research, regardless of whether we are dealing with a pandemic or some other public health emergency,” she said. But the pace of change has been “excruciatingly slow”.

Much of what is measured in the Global Women’s Health Index is in line with the goals identified by the United Nations in its Sustainable Development Goals. And a report published by UN Women and the UN Department of Economic and Social Affairs this month found that, at the current pace of progress, gender equality will not be achieved until 2030, as originally intended with the Sustainable Development Goals. Instead, it will take centuries.

“It is critical that we come together now to invest in women and girls to recover and accelerate progress,” said Sima Bahous, Executive Director of UN Women, of the report.

“The data shows undeniable regressions in their lives exacerbated by global crises – in income, security, education and health. The longer it takes to reverse this trend, the more it will cost us all.” But there is some hope. “My hope is that we come out of the pandemic stronger,” Stadler said. “The pandemic has drawn more people’s attention to the importance of preventive behaviors.

People have learned a lot about the importance of joint action to protect each other.”