Where are the women? Gender inequalities in COVID-19 research authorship.
TL;DR: Investigating whether gender differences existed in authorship of COVID-19 research since the onset of the pandemic found that women’s representation in research generally and specifically in the study of CO VID-19 may be disproportionately affected by lockdown measures.
Abstract: ### Summary box
Despite some progress over the last decade, gender inequalities persist in academic and research settings. Previous studies have shown that women have a lesser share of authorship positions overall and are less likely than men to be first or last author, the most relevant positions to career progression.1 The gap between total authorships for women and men has been stable in recent years, but has grown for senior authorships.2
With lockdowns enforced across the globe due to the COVID-19 pandemic, many researchers are now working from home and face competing demands from parenting, homeschooling and other caring duties. These roles are predominantly assumed by women, especially in countries with high gender inequality. Women’s representation in research generally, and specifically in the study of COVID-19, may be disproportionately affected by lockdown measures. Under-representation of female researchers tends to create under-representation of issues that are relevant to women in research — in our current situation this may create important gaps in our understanding of COVID-19.
Therefore, we investigated whether gender differences existed in authorship of COVID-19 research since the onset of the pandemic. …
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219 citations
TL;DR: While the manifestation of inequity in each country or region is bound up in the local-to-global interface of historical, economical, social and political forces, COVID-19 disproportionately affects the world’s marginalised.
Abstract: ### Summary box
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has grinded the world economy to a halt and upended health systems across the globe, contributing to disruptions in routine health services and skyrocketing rates of death.1 Against this backdrop, the pandemic highlights with renewed clarity the way structural violence operates both within and between countries. Defined as the discriminatory social arrangement that, when encoded into laws, policies and norms, unduly privileges some social groups while harming others, this concept broadens our thinking about drivers of disease.2 While the manifestation of inequity in each country or region is bound up in the local-to-global interface of historical, economical, social and political forces, COVID-19 disproportionately affects the world’s marginalised, from Black, Indigenous and People of Color (BIPOC) communities in North America to migrant workers in Singapore. …
172 citations
TL;DR: Actionable items from these data include mitigation of burnout and depression through increasing PPE access and provision of wellness programs, with a particular focus on high-risk groups.
Abstract: Background To better understand how the COVID-19 pandemic has affected surgical trainees' and early-career surgeons' professional and personal experiences, a survey of the membership of the American College of Surgeons (ACS) Resident and Associate Society (RAS) and Young Fellows Association (YFA) was performed. Study Design An anonymous online survey was disseminated to members of RAS and YFA. Descriptive analyses were performed and factors associated with depression and burnout were examined with univariate and multivariable stepwise logistic regression. Results Of the RAS/YFA membership of 21,385, there were 1,160 respondents. The majority of respondents (96%) reported the COVID-19 pandemic having a negative impact on their clinical experience, with 84% of residents reporting a > 50% reduction in operative volume and inability to meet minimum case requirements. Respondents also reported negative impacts on personal wellness. Nearly one-third reported inadequate access to personal protective equipment, and depression and burnout were pervasive (≥21% of respondents reported yes to every screening symptom). On multivariable analysis, female sex (odds ratio [OR] 1.54 for depression, OR 1.47 for burnout) and lack of wellness resources (OR 1.55 for depression, OR 1.44 for burnout) predicted depression and burnout. Access to adequate personal protective equipment was protective against burnout (OR 0.52). Conclusions These data demonstrate a significant impact of the COVID-19 pandemic on the lives of residents and early-career surgeons. Actionable items from these data include mitigation of burnout and depression through increasing personal protective equipment access and provision of wellness programs, with a particular focus on high-risk groups.
91 citations
TL;DR: The authors found that during the early months of the COVID-19 pandemic, there was an unusually high submission rate of scholarly articles, which may have penalized the scientific productivity of women.
Abstract: During the early months of the COVID-19 pandemic, there was an unusually high submission rate of scholarly articles. Given that most academics were forced to work from home, the competing demands for familial duties may have penalized the scientific productivity of women. To test this hypothesis, we looked at submitted manuscripts and peer review activities for all Elsevier journals between February and May 2018-2020, including data on over 5 million authors and referees. Results showed that during the first wave of the pandemic, women submitted proportionally fewer manuscripts than men. This deficit was especially pronounced among more junior cohorts of women academics. The rate of the peer-review invitation acceptance showed a less pronounced gender pattern with women taking on a greater service responsibility for journals, except for health & medicine, the field where the impact of COVID-19 research has been more prominent. Our findings suggest that the first wave of the pandemic has created potentially cumulative advantages for men.
86 citations
TL;DR: In this article, the authors highlight twelve issues for reflection, which can help us better prepared for future pandemics, including digital divide, health inequality, gender inequality, economic disadvantage, family well-being, impact on holistic wellbeing, economic development versus saving lives, consumption versus environmental protection, individual rights versus collective rights, international collaboration versus conflict, prevention of negative well being, and promotion of positive wellbeing.
Abstract: COVID-19 has severely affected the world since December 2020. Because of its sudden onset and highly contagious nature, the world has responded in a "crisis management" manner. With effective vaccines almost available, it is appropriate at this time to have some reflections about COVID-19 in relation to the quality of life issues. In this paper, we highlight twelve issues for reflection, which can help us better prepared for future pandemics. These include: digital divide, health inequality, gender inequality, economic disadvantage, family well-being, impact on holistic well-being, economic development versus saving lives, consumption versus environmental protection, individual rights versus collective rights, international collaboration versus conflict, prevention of negative well-being, and promotion of positive well-being.
85 citations
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TL;DR: Several mechanisms through which the pandemic response is likely to affect health are summarised: economic effects, social isolation, family relationships, health related behaviours, disruption to essential services, disrupted education, transport and green space, social disorder, and psychosocial effects.
Abstract: Countries worldwide have implemented strict controls on movement in response to the covid-19 pandemic. The aim is to cut transmission by reducing close contact (box 1), but the measures have profound consequences. Several sectors are seeing steep reductions in business, and there has been panic buying in shops. Social, economic, and health consequences are inevitable.
Box 1
### Social distancing measuresRETURN TO TEXT
The health benefits of social distancing measures are obvious, with a slower spread of infection reducing the risk that health services will be overwhelmed. But they may also prolong the pandemic and the restrictions adopted to mitigate it.1 Policy makers need to balance these considerations while paying attention to broader effects on health and health equity.
Several groups may be particularly vulnerable to the effects of both the pandemic and the social distancing measures (box 2). Table 1 summarises several mechanisms through which the pandemic response is likely to affect health: economic effects, social isolation, family relationships, health related behaviours, disruption to essential services, disrupted education, transport and green space, social disorder, and psychosocial effects. Figure 1 shows the complexity of the pathways through which these effects may arise. Below we expand on the first three mechanisms, using Scotland as an example. The appendix on bmj.com provides further details of mechanisms, effects, and mitigation measures.
Box 2
### Groups at particular risk from responses to covid-19RETURN TO TEXT
729 citations
TL;DR: The representation of women among first authors of original research in high impact general medical journals was significantly higher in 2014 than 20 years ago, but it has plateaued in recent years and has declined in some journals.
Abstract: Objective To examine changes in representation of women among first authors of original research published in high impact general medical journals from 1994 to 2014 and investigate differences between journals. Design Observational study. Study sample All original research articles published in Annals of Internal Medicine , Archives of Internal Medicine, The BMJ, JAMA, The Lancet, and the New England Journal of Medicine (NEJM) for one issue every alternate month from February 1994 to June 2014. Main exposures Time and journal of publication. Main outcome measures Prevalence of female first authorship and its adjusted association with time of publication and journal, assessed using a multivariable logistic regression model that accounted for number of authors, study type and specialty/topic, continent where the study was conducted, and the interactions between journal and time of publication, study type, and continent. Estimates from this model were used to calculate adjusted odds ratios against the mean across the six journals, with 95% confidence intervals and P values to describe the associations of interest. Results The gender of the first author was determined for 3758 of the 3860 articles considered; 1273 (34%) were women. After adjustment, female first authorship increased significantly from 27% in 1994 to 37% in 2014 (P NEJM seemed to follow a different pattern, with female first authorship decreasing; it also seemed to decline in recent years in The BMJ but started substantially higher (approximately 40%), and The BMJ had the highest total proportion of female first authors. Compared with the mean across all six journals, first authors were significantly less likely to be female in the NEJM (adjusted odds ratio 0.68, 95% confidence interval 0.53 to 0.89) and significantly more likely to be female in The BMJ (1.30, 1.01 to 1.66) over the study period. Conclusions The representation of women among first authors of original research in high impact general medical journals was significantly higher in 2014 than 20 years ago, but it has plateaued in recent years and has declined in some journals. These results, along with the significant differences seen between journals, suggest that underrepresentation of research by women in high impact journals is still an important concern. The underlying causes need to be investigated to help to identify practices and strategies to increase women’s influence on and contributions to the evidence that will determine future healthcare policies and standards of clinical practice.
350 citations
TL;DR: I’m curious what lockdown will reveal about the ‘maternal wall’ that can block faculty advancement.
Abstract: I’m curious what lockdown will reveal about the ‘maternal wall’ that can block faculty advancement. I’m curious what lockdown will reveal about the ‘maternal wall’ that can block faculty advancement.
200 citations
TL;DR: These findings corroborate discussions of how women’s participation in medical science links to research outcomes, and show the mutual benefits of promoting both the scientific advancement of women and the integration of gender and sex analysis into medical research.
Abstract: Gender and sex analysis is increasingly recognized as a key factor in creating better medical research and health care
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. Using a sample of more than 1.5 million medical research papers, our study examined the potential link between women’s participation in medical science and attention to gender-related and sex-related factors in disease-specific research. Adjusting for variations across countries, disease topics and medical research areas, we compared the participation of women authors in studies that do and do not involve gender and sex analysis. Overall, our results show a robust positive correlation between women’s authorship and the likelihood of a study including gender and sex analysis. These findings corroborate discussions of how women’s participation in medical science links to research outcomes, and show the mutual benefits of promoting both the scientific advancement of women and the integration of gender and sex analysis into medical research. Nielsen and colleagues’ analysis of a large database of medical research papers shows a correlation between women’s authorship and the likelihood of a study including gender and sex analysis.
151 citations
TL;DR: A rapid analysis of 24 countries’ Covid-19 task force compositions addressed the questions of how far have policy makers and politicians consulted those who have experience and expertise on the secondary effects of lockdowns, social isolation measures and movement restrictions, particularly in certain population subgroups.
Abstract: ### Summary box
As SARS-COV-2 (severe acute respiratory syndrome coronavirus 2) ravages the globe, heads of state are making swift decisions to put large swathes of the world’s population under mass isolation in the race to heed off Covid-19’s lethality, particularly in certain population subgroups. How are these decisions—that affect each and every one of us, some groups disproportionately and regardless of Covid-19 status—made? How far have policy makers and politicians consulted those who have experience and expertise on the secondary effects of lockdowns, social isolation measures and movement restrictions?
We attempted to address these questions with a rapid analysis of 24 countries’ Covid-19 task force compositions. The countries were selected to represent a range of geographies and income levels. As far as possible, we focused on governance bodies set up or activated to give scientific, or evidence-based, advice to …
112 citations