Column: America’s health care depends on women

Meghan Fitzgerald, DrPH, RN, is an adjunct associate professor and private equity investor at Columbia University Mailman School of Public Health. She has decades of experience in healthcare, from frontline patient care to advising prominent healthcare companies. Here, she explains why the U.S. healthcare system won’t bounce back without making deliberate improvements for women.

Despite ongoing challenges from COVID-19, the U.S. has returned to nearly full employment in less than two years, with an unemployment rate of 3.9%, April 2020 was 14.8%. This is much faster than the recovery after the 2007-2009 global financial crisis. However, this success story ignores the current lack of women in the workforce, whose labor force participation rate has reached a 33-year low. Women make up 60% of all people who have lost their jobs due to the coronavirus.

This dynamic can quickly get serious when we’re talking about our fragile healthcare system, which is being hit by an Omicron surge, pent-up demand, inconsistent policies, and catastrophic labor turnover. Growth in health care jobs for women stalls in 2021 before turning negative. Women hold 76% of all healthcare jobs (89% of home health aides are women and 91% of nurses are women) So it’s fair to say that the recovery of our American healthcare system depends on a viable female-led workforce.

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In health care, women-led areas, including outpatient care facilities and home care, have been hit hardest by staffing shortages.

Our health care system cannot take sick leave.

In order to create a viable plan, we must address three major challenges that working women face in healthcare.

Lack of appropriate paid time off

Women in health care are more likely to serve as caregivers for family members, whether children or adults, than their male counterparts.

Although 73% of Americans support paid family leave, A “build back for a better economic recovery plan” including care relief is still being debated. Meanwhile, programs to help families during the pandemic have expired, such as the Families First Coronavirus Response Act and child tax credit payments.

While partisan politics continues to drive the process, healthcare employers and employees are being forced to get “creative.” That means extending shifts, using overtime and relying on personnel agencies — none of which is sustainable for workers, patients, or a system that can withstand future crises.

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Lack of flexible work options

Essentially, a lot of healthcare work has to be done in person. For example, 97% of patients receiving home care require assistance with bathing. Nonetheless, the use of remote patient monitoring can triage scarce resources, and telemedicine can amplify the value of employees. Employers should seek inspiration from their innovative peers around flexible shifts, respite care, job sharing and rotation. The top priority is to improve employee mental health, function and retention. All frontline workers should be given access to mental health screenings and resources without fear or stigma.

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lack of vocational training

Healthcare support roles are expected to experience the fastest job growth over the next decade. However, research shows that for many, a four-year degree is out of reach, with 44% of women citing affordability and 38% citing parenting as a barrier. Healthcare can’t wait. The government must fund trade, vocational and certificate degrees to create a new workforce starting in high school.

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The pandemic has mobilized a generation of young people who want to work in health care but need access to an affordable degree to do so. Those who start with a trade degree have the opportunity to gain experience before climbing the healthcare ladder and then earn a degree and training.

Epidemics in history are remembered for their impact, not just the severity of the disease. Once the pandemic subsides, disruptions during the pandemic often give way to economic opportunities. However, history finds periods of socio-political conflict due to delayed and uneven economic recovery. Given that 76% of full-time health care jobs are held by women, and that female workforce participation has been hit hard during the pandemic, we need to focus on remediating and reversing these problems.