Health risks and outcomes that disproportionately affect women during the Covid-19 pandemic: A review

In the paper

“Reports from the CDC emphasize healthcare workers’ increased risk of contracting SARS-CoV-2 given the close interaction with high concentrations of patients and visitors amidst shortages of personal protective equipment (PPE) (CDC, 2020a).”

What the sources say

• Not checked yetcites CDC, 2020a

In the paper

“In an effort to mitigate SARS-CoV-2 infection, pregnant people have had their autonomy limited during this pandemic, including visitor restrictions during labor (CDC, 2020b), forced separation of SARS-CoV-2-positive mothers and infants (CDC, 2020b), and the potential for reduced options for anesthesia due to limited resources for respiratory support (Society for Obstetric Anesthesia and Perinat”

What the sources say

• Not checked yetcites CDC, 2020b
• Not checked yetcites Society for Obstetric Anesthesia and Perinatology, 2020

In the paper

“Despite this potential increase in unintended pregnancies and financial strain of the pandemic's economic fall-out, some states are threating to halt abortion services (Ollstein, 2020), inaccurately denoting these procedures as elective and able to be delayed (Smith et al., 2018; Watson, 2018; Bayefsky et al., 2020).”

What the sources say

• Not checked yetcites Ollstein, 2020
• Not checked yetcites Smith et al., 2018 source
• Not checked yetcites Watson, 2018 source

In the paper

“Outside of the pandemic, women on average report more physical and mental unhealthy days per year than men despite utilizing more preventive care services (Centers for Disease Control and Prevention [CDC], 2013).”

What the sources say

• Not checked yetcites CDC, 2013

In the paper

“However, this study was limited by missing data points among its participants including pregnancy status (missing for nearly 75% of participants) and medical comorbidities (missing in close to 80% of cases).”

What the sources say

• Not checked yetcites Ellington et al., 2020

In the paper

“Outside of the healthcare workforce, women, particularly women of color and immigrants, constitute the majority of US domestic workers and caregivers that are paid outside of formal channels (Diaz-Ordaz, 2010). Although these workers play critical roles in the care of children, the sick, and the elderly, many legal protections afforded to formal caregivers (including health insurance, overtime pay”

What the sources say

• Not checked yetcites Diaz-Ordaz, 2010

In the paper

“One-third of US women reported delays or cancellations in sexual and reproductive healthcare, with a higher proportion of reports from Black, Latinx, LGBTQIA, and low-income women. Women in these groups also report more concern about their ability to access sexual and reproductive healthcare services, particularly contraception (Lindberg et al., 2020).”

What the sources say

• Not checked yetcites Lindberg et al., 2020

In the paper

“According to Ellington et al. (2020), pregnant women infected with SARS-CoV-2 are at greater risk for severe illness when compared to non-pregnant women with SARS-CoV-2, including increased risk of hospitalization (aRR = 5.4, 95% CI 5.1–5.6), intensive care unit admission (aRR = 1.5, 95% CI 1.2–1.8) and mechanical ventilation (aRR = 1.7, 95% CI 1.2–2.4).”

What the sources say

• Not checked yetcites Ellington et al., 2020

In the paper

“Gender is a social determinant of health, unique from but entangled with sex differences (Springer et al., 2012; Rich-Edwards et al., 2018)”

What the sources say

• Not checked yetcites Springer et al., 2012 source
• Not checked yetcites Rich-Edwards et al., 2018 source

In the paper

“Due to their personal caregiving responsibilities, working women lose roughly $5000 annually in income from wage penalties and reduced hours (Van Houtven et al., 2013). Conversely, male informal caregivers do not experience any difference in income for these responsibilities (Van Houtven et al., 2013).”

What the sources say

• Not checked yetcites Van Houtven et al., 2013 source

In the paper

“Racial disparities in access to and utilization of healthcare services and provider and institutional bias contribute to these outcomes, all of which may worsen during the health system stress of pandemics (Moaddab et al., 2018; American College of Obstetrics and Gynecologists [ACOG], 2015; Rosenthal and Lobel, 2011).”

What the sources say

• Not checked yetcites Moaddab et al., 2018 source
• Not checked yetcites ACOG, 2015
• Not checked yetcites Rosenthal and Lobel, 2011

In the paper

“Women also have worse outcomes for prevalent health conditions including asthma (CDC, 2013), diabetes (Roche and Wang, 2013), and myocardial infarctions (Mehta et al., 2016).”

What the sources say

• Not checked yetcites CDC, 2013
• Not checked yetcites Roche and Wang, 2013
• Not checked yetcites Mehta et al., 2016 source

In the paper

“although PPE is often marketed as “unisex,” findings show that they are manufactured according to traditional male proportions (Trades Union Congress, 2017). This has led to some women wearing ill-fitting PPE, potentially compromising their degree of protection (Pugh, 2020).”

What the sources say

• Not checked yetcites Trades Union Congress, 2017
• Not checked yetcites Pugh, 2020

In the paper

“Additionally, there have been increased cesarean section rates among SARS-CoV-2 positive patients, which are often performed before term, increasing the risk of complications for both the mother and neonate (Della Gatta et al., 2020; Matar et al., 2020).”

What the sources say

• Not checked yetcites Della Gatta et al., 2020 source
• Not checked yetcites Matar et al., 2020

In the paper

“With increased job loss due to the pandemic (Nicola et al., 2020), many women are forced to work part-time in multiple healthcare facilities without paid sick leave, thereby increasing their risk of SARS-CoV-2 exposure and transmission to others (Pichler et al., 2020).”

What the sources say

• Not checked yetcites Nicola et al., 2020 source
• Not checked yetcites Pichler et al., 2020

In the paper

“Consequently, it is likely that women are experiencing more caregiver burden during the pandemic while being isolated from the social supports needed to reduce this burden.”

In the paper

“Despite the decreased desire to become pregnant, women have experienced logistical and political threats to contraception and abortion access during the Covid-19 pandemic.”

In the paper

“Outside of disease outbreaks, female caregivers are more likely to experience a specific stress termed “caregiver burden,” the multidimensional toll that caregivers experience to their social, emotional, spiritual, financial, and physical wellbeing (Adelman et al., 2014). Perceived lack of agency in choosing the role, financial stress, and social isolation are associated with higher caregiver”

What the sources say

• Not checked yetcites Adelman et al., 2014 source

In the paper

“The increased risk of certain negative health outcomes and reduced healthcare access experienced by many women are typically exacerbated during pandemics.”

In the paper

“More broadly, differences in screening, testing, and indications for hospitalization for SARS-CoV-2 among pregnant and non-pregnant people may cloud the reported conclusions, and it is unclear if the increased risks seen among pregnant people are from obstetric or SARS-CoV-2 related complications (Ellington et al., 2020).”

What the sources say

• Not checked yetcites Ellington et al., 2020

In the paper

“A multinational survey found that women without social support are more vulnerable to negative mental health outcomes than men without social connections, due to women's greater reliance on social support (Dalgard et al., 2006).”

What the sources say

• Not checked yetcites Dalgard et al., 2006 source

In the paper

“Incidents of IPV and gender-based violence (GBV) increased globally during the Ebola (2014) and Zika (2016) outbreaks (Davies and Bennett, 2016) and are escalating during Covid-19 (North, 2020).”

What the sources say

• Not checked yetcites Davies and Bennett, 2016
• Not checked yetcites North, 2020

In the paper

“Beyond its direct implications for physical and mental health, IPV is a social determinant of health and is associated with higher morbidity and mortality for co-occurring diseases (Miller and Mccaw, 2019).”

What the sources say

• Not checked yetcites Miller and Mccaw, 2019 source

In the paper

“The Covid-19 pandemic also presents a perfect storm for female informal caregivers to experience increased burden, as mentioned above, which has demonstrated negative outcomes such as poor self-care, depression, and anxiety (Adelman et al., 2014).”

What the sources say

• Not checked yetcites Adelman et al., 2014 source

In the paper

“This, coupled with the mental and economic strains of the pandemic, is likely initiating and exacerbating IPV and GBV (Van Gelder et al., 2020).”

What the sources say

• Not checked yetcites Van Gelder et al., 2020

In the paper

“These issues will both contribute to the development of mental health disorders and limit access to mental health resources for women during and after the pandemic.”

In the paper

“Previous work suggests that gendered differences in mental health disorders outside of the disease outbreaks exist largely due to structurally imposed strains on women (Afifi, 2007), with disproportionate impacts on Black, Latinx, Native, and immigrant populations, partially due to discrimination (American Psychiatric Association, 2007; Greenwood et al., 2017).”

What the sources say

• Not checked yetcites Afifi, 2007
• Not checked yetcites American Psychiatric Association, 2007
• Not checked yetcites Greenwood et al., 2017 source

In the paper

“Despite greater utilization of mental health resources, women in the US are twice as likely to have unmet needs for mental health services as men, often because of inadequate insurance coverage and stigma associated with seeking care (US Department of Health and Human Services, 2010).”

What the sources say

• Not checked yetcites US Department of Health and Human Services, 2010

In the paper

“Despite the challenges in access to family planning in a pandemic, medication abortion facilitated by telemedicine is prohibited in eighteen US states (Guttmacher Institute, 2020). Even if pregnant people obtain prescriptions for medication abortions, mifepristone—one of the drugs used—is subject to Risk Evaluation and Mitigation Strategy (REMS) restrictions (Mifeprex REMS Study Group, 2017). The”

What the sources say

• Not checked yetcites Guttmacher Institute, 2020
• Not checked yetcites Mifeprex REMS Study Group, 2017

In the paper

“Continued restrictions on abortion will inevitably increase the number of pregnant people needing obstetric care during and in the aftermath of this pandemic, burdening an already under-resourced healthcare system.”

In the paper

“Women are underrepresented in drug development trials; many researchers fail to design studies with adequate samples of women, and even fewer analyze results according to gender and sex (Liu and Mager, 2016; Nowogrodzki, 2017).”

What the sources say

• Not checked yetcites Liu and Mager, 2016
• Not checked yetcites Nowogrodzki, 2017 source

In the paper

“Together, these circumstances represent dangerous, often tragic, public health emergencies that disproportionately affect women.”

In the paper

“While these risk factors can affect the mental health of all populations during the Covid-19 pandemic, there is likely a differential impact on women.”

In the paper

“Gender roles tend to be reinforced during times of disease outbreak (Smith, 2019; Davies and Bennett, 2016). This likely increases feelings of stress, dissatisfaction, and lack of autonomy among women as they try to reconcile their self-identity with their imposed roles.”

What the sources say

• Not checked yetcites Smith, 2019 source
• Not checked yetcites Davies and Bennett, 2016

In the paper

“The pandemic will have immediate and long-term effects on women's health, highlighting the importance of gender analysis in its planning and response.”

In the paper

“Gender blindness leads to health interventions that may be less effective for women at best and directly harmful to their wellbeing at worst—outcomes demonstrated in previous disease outbreaks (Smith, 2019; Davies and Bennett, 2016).”

What the sources say

• Not checked yetcites Smith, 2019 source
• Not checked yetcites Davies and Bennett, 2016

In the paper

“Additionally, the current body of knowledge overwhelmingly focuses on differences among genders that are detrimental to women.”

In the paper

“During disease outbreaks, “gender blindness”—the systemic failure to acknowledge gender differences in health—pervades and hinders response efforts (Smith, 2019).”

What the sources say

• Not checked yetcites Smith, 2019 source

In the paper

“There may be aspects of women's experiences during the Covid-19 pandemic and other disease outbreaks that are beneficial to women's health, but our discussion of those topics is limited by the negativity bias of reporting in the literature.”

In the paper

“Much of the literature cited here regarding gender and disease outbreaks come from the SARS, Ebola, and Zika outbreaks.”

In the paper

“Furthermore, we recognize that gender is often framed through a lens of ethnocentrism, classism, and heteronormativity, which limits our description of the literature.”