For more than a year, the COVID-19 pandemic has upended lives around the world as scientists scramble to understand SARS-CoV2—how it invades cells, how it affects the body and how to stop its spread.
But the unprecedented public health crisis—and ongoing physical distancing, isolation and travel restrictions—has also had significant economic consequences. Just as certain groups have been disproportionately affected by COVID-19, some are also more vulnerable to the social and financial fallout of the pandemic.
The coronavirus has touched virtually every corner of the globe, sparing no one. But research reveals that women are bearing the brunt of the economic hardship that has resulted from layoffs, lost income and lingering financial insecurity.
Why women are more vulnerable
Women tend to earn less and have fewer savings, according to the United Nations (UN). Around the world, women have limited access to social protections, yet they are more likely to shoulder the responsibility of unpaid, domestic duties, which is more likely to force them out of the labor market. Moreover, women account for most single-parent households, the UN reports.
Job losses, shrinking economies and weakened social protections have left women around the world with fewer safeguards to help them make ends meet—from a single mother in South Sudan to a domestic worker in Guatemala to a small business owner in the United States.
In early 2020, women held the majority of jobs in the U.S. for the first time in nearly 10 years. As of December 2019, 50.04% of jobs were held by women, according to the Bureau of Labor Statistics.
One year later, employers slashed 140,000 jobs. A closer analysis of these numbers reveals a stark gender gap. Women accounted for all of those job losses, losing 156,000 jobs, while men gained 16,000.
Overall, women had 5.4 million fewer jobs at the end of 2020 than they did before the pandemic began. Meanwhile, men lost 4.4 million jobs during that same time period.
In the U.S., women are more likely than men to work in non-essential service sectors, such as leisure and hospitality, education, and health services—all of which require personal contact and have been among the hardest hit by the pandemic. Jobs in these sectors also tend to be part-time positions, offering less compensation and fewer opportunities. They are also more likely to employ low-income women and women of color.
Economic Gender Gap Tied to Health and Well-Being
Working women have been more vulnerable to layoffs during the pandemic with less financial security to help them weather the storm. Meanwhile, more women than men have also assumed greater responsibility for unpaid domestic and family duties due to school and daycare closures.
The compounded effects of financial insecurity, heightened caregiving responsibilities and a mass traumatic event like COVID-19 have put more women at risk for health behavior changes.
Sharecare and Boston University School of Public Health (BUSPH) examined how women managed financial hardships associated with the pandemic. More than 90,000 women were surveyed from March 20 to April 10, 2020 with the goal of assessing whether COVID-19 financial stressors were associated with health risk behavior changes, such as smoking, vaping or drinking more, exercising or sleeping less and/or following a less healthy diet.
“There is an inexorable link between income and health,” says senior researcher and dean of BUSPH, Sandro Galea. “We wanted to see how pandemic-induced stressors have shifted health risk behaviors, especially for the most vulnerable—those with the fewest resources to begin with.”
More than one-third of women surveyed experienced financial stressors including decreases in pay, job loss, or difficulty paying bills. Financial stress was also associated with higher odds of health risk behavior changes, with the most socioeconomically vulnerable women at the highest risk for long-term health effects.
Financial Stress Linked to Poor Sleep and Substance Abuse
Among the most notable health risk behavior changes among the women surveyed: poor sleep and substance abuse.
Roughly one-third of the women polled who reported likelihood of having trouble paying bills also reported sleeping fewer hours since the pandemic began, according to the Sharecare CWBI/BUSPH survey. By comparison, only 21% of the women who reported not having trouble paying bills reported sleeping less.
The short and long-term health effects of sleep loss shouldn’t be underestimated. Initially, poor sleep can affect decision-making skills, mood and short term, a lack of adequate sleep can affect judgment and mood. Those who are sleep deprived, may have difficulty learning, reacting, forming new memories and concentrating.
In 2019 alone, more than 36,000 people died in motor vehicle traffic crashes. The U.S. Department of Transportation points out that 1 to 4% of all highway accidents are the result of poor decision-making tied to lack of sleep.
Over time, sleep loss also increases the risk for chronic health issues, including obesity, diabetes and heart disease.
The Sharecare CWBI/BUSPH survey also found that women experiencing financial stress were drinking more alcohol. These women were also smoking or vaping more, compared to those who were not experiencing the same level of financial strain.
The survey showed that 16% of women with a decrease in pay reported drinking more alcohol since the start of the pandemic, compared to 13% among women who did not report a decline in their income.
In August 2018, a comprehensive review of existing research published in The Lancet concluded that alcohol intake is tied to a greater risk for injuries and certain diseases, including several forms of cancer. Moreover, as people’s alcohol consumption increases, so do their odds of developing a range of other health issues, from high blood pressure to lung or liver disease.
Similarly, the CWBI/BUSPH survey found that almost three times as many women who reported difficulty paying their bills (6%) also reported an increase in smoking or vaping during the pandemic, compared to those who did not report difficulty paying bills (2%).
The multitude of health risks from smoking and vaping are well-established. Ironically, the financial and psychological toll of the pandemic, which may be contributing to higher rates of smoking among women, may also be increasing their risk for COVID-19.
Smoking and/or vaping are risk factors for severe coronavirus infection. Smoking weakens the immune system, increases the risk for respiratory infections and heart disease—all of which make people more vulnerable to the effects of the disease.
Building a Resilient Post-COVID-19 Future
As of March, 2021, schools across the nation have re-opened, 39 million people in the U.S. have been fully vaccinated, and the employment-population ratio for women has increased to 54.1 percent, compared to 65.4 percent for men.
Progress has been made but the work of building a more resilient and healthier post-COVID-19 world continues.
The year-long social and economic fallout may have long-term consequences for health, particularly among the most socioeconomically vulnerable, if individual risk factors and social inequities are not addressed.
Substance Use Disorder Resources
It’s critical for those with substance use disorders to gain access to prevention, treatment and recovery services. The following resources can help people locate resources in their local area:
- SAMHSA: Behavioral Health Treatment Services Locator
- SAMHSA’s National Helpline: 1-800-662-4357, which provides 24-hour free, confidential treatment referral routing service for individuals with mental and/or substance use disorders.
- Mental Health America Crisis Line: 1-800-273-TALK
- Alcoholics Anonymous