The Gender Pay Gap, Care Economy, and Mental Health

Leanna M.W. Lui, HBSc


November 24, 2021

According to an analysis by the Pew Research Center and a report by the National Women's Law Center, women were earning approximately $0.83-$0.84 for every $1.00 compared with their male counterparts in 2020. Accordingly, women would need to work an additional 42 days to receive compensation for earnings by men during that year. Moreover, these gaps also exist with respect to race inequalities. For example, Black and Latina women who are working full-time were reported to earn approximately $0.64 and $0.57, respectively, for every $1.00 compared with their white, non-Hispanic male counterparts. Striking, isn't it?

The gender pay gap also affects physicians. A 2021 Medscape survey found that male physicians earn 35% more than female physicians. The biggest gap seems to be between male and female specialists, with men earning $376,000 and women $283,000.

Gender Inequality and COVID-19

In addition to workplace responsibilities, women are also more likely to take on unpaid positions in the informal care economy — examples of these tasks include cleaning, grocery shopping, and childcare. In fact, the COVID-19 pandemic has increased the burden of unpaid care work among women, which often incurs a significant impact on their participation in the paid economy.

A study in the United States evaluating the impact of gender inequality during COVID-19 suggested that the rise in unemployment among women during this time may be related to decreased occupational flexibility. Accordingly, the closure of schools and caregiving facilities has translated into increased responsibilities as the informal caregiver, and a decreased ability to fulfill work obligations. Consequently, women may be overwhelmed and unable to maintain their employment status, are limited in their work opportunities, and/or are furloughed or passed over for promotions.

Gendered Pay Gaps Affect Mental Health

A study by Platt and colleagues investigated the relationship between gendered wage gaps and gendered disparities in depression and anxiety disorders. Researchers found that females with a lower income compared with their matched male counterparts were more likely to experience depression and generalized anxiety disorders (ie, they were 2.4 times more likely to experience depression and 4 times more likely to experience anxiety), while women who earned more than men did not report a significant difference in depression and researchers reported reduced gaps in the prevalence of anxiety disorders. As such, it has been suggested that wage gap inequalities are a contributing factor to gendered mental health disparities. 

Reduced pay is not only a signifier of reduced returns on human capital. In fact, it may also have implications for their role in the care economy (eg, greater time allocation as a result of reduced return), result in a higher likelihood for relocation as it relates to their partner's work, overqualification for a position, inflexible work schedules, and reduced work autonomy, et cetera.

Wage inequalities may also act as a proxy for workplace inequalities such as promotions, prestigious projects, limited upward mobility, and internalized negative workplace experiences, all of which may contribute to increased sleep loss, stress, and related mental health stressors. 

One might say, "A few cents, so what?" In addition to income itself, there's a broader theme at play, which is gender discrimination and inequality. We should encourage conversations around the gender pay gap and develop strategies to combat this economic and social disparity. 

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About Leanna Lui
Leanna M.W. Lui, HBSc, completed an HBSc global health specialist degree at the University of Toronto, where she is now an MSc candidate. Her interests include mood disorders, health economics, public health, and applications of artificial intelligence. In her spare time, she is a fencer with the University of Toronto Varsity Fencing team and the Canadian Fencing Federation.


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