Pandemics – diseases that spread throughout populations – highlight and exacerbate social inequalities.  Who is most exposed to pathogens and who is able to avoid exposure? Who makes the decisions regarding allocation of care resources? Who gets care and who doesn’t when resources cannot keep up with need? And who tends the sick, and with what support?

Gender status and norms figure powerfully into how these issues play out. At this point in the COVID-19 story, gender patterns have received little attention beyond occasional mentions that men in China were slightly more likely than women to become seriously ill from coronavirus. Whether this difference has to do with lifestyle (for example, men are more likely to smoke and to work in mines, either of which can cause respiratory weakness) or with better resilience in women due to genetic factors is not yet known.

Here in the United States, women are at particular risk during during the COVID-19 pandemic.  Reasons for increased risk have to do with disparities in employment and income, caregiving responsibilities, and life expectancy.

• Public health experts believe that the highest likelihood of viral transmission is within households. Women make up the vast majority of family caregivers — tending children as well as disabled and elderly relatives. As a consequence, women are most likely to be in frequent contact with bodily fluids of household members.

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• Health care facilities are a particularly high-risk environment for viral transmission. Far more women than men work in health care, especially in roles involving frequent patient contact, for example, as nurses and medical assistants.
• Women are especially likely to juggle (poorly) paid work in health care facilities with (unpaid) work caring for family members.

• Older people are at substantially higher risk of becoming very sick or dying from the virus. Elderly women greatly outnumber elderly men, especially in nursing homes. Like prisons and other total institutions, nursing homes are pressure cookers for the spread of disease in that large numbers of vulnerable people live in close quarters, breathing the same air, eating from the same dishes, using the same bathrooms.

• Women are more likely than men to be poor. Women earn lower wages and are especially like to be “at-will” employees and therefore less able to miss work. As a consequence, women have less money to purchase supplies needed to prevent or manage infection.
• Instructions to remain at home or shelter in place put women and children at particular risk from domestic abuse. During crises intimate partner violence tends to increase. During this particular crisis, there may be even few options than normal for escaping an abusive situation.

Crises like the coronavirus pandemic can shine light on existing social problems, and point the way to solutions. Three-quarters of Americans live paycheck to paycheck. Many cannot afford timely health care or risk missing a day’s work — given the absence of universal health care and universal paid medical and family leave in the United States. Women in particular bear the brunt of these policies. Perhaps while COVID-19 forces us to change business as usual, we’ll find the national will to move towards universal health care and paid family leave — and true gender equality.

Susan Sered, a medical sociologist at Suffolk University, is working on a more detailed gender analysis of the COVID-19 pandemic.