by Chiara Daina
The Observatory on gender equity in healthcare leadership, in its second annual report, shows that public health leaders are almost all male
It still seems anachronistic today to have to talk about inequalities in access to the job market that depend on being a woman or a man. But unfortunately it’s the reality. When considering career progression and senior roles in public health, the evidence is overwhelming. Although women represent almost 70% of those employed in the NHS structures (equal to around 450 thousand professionals) – with an increase of five percentage points since 2010 -, men are much more often in director positions (out of ten managers over six are male). In order for the wind to change, it is essential to first learn to recognize the phenomenon and define it ever more clearly, to increase social awareness, break the logic of “it has always been done this way” and try to shake the status quo.
So let’s start with the numbers. Among doctors, according to the latest data from the Ministry of Health, referring to 2021, women are more than half (51.3%) but just 8.5% are at the head of a facility, compared to 20.8 % some men. In more detail, among the directors of complex units, 19% are women, while among those of simple units, 37%. This photograph is limited, however, to a mere numerical count of the women employed overall in public health and of those at the top. If, however, we wanted to evaluate the impact in terms of equity of gender representation in top roles to understand whether women who enter the world of healthcare have the same chances as men of becoming leaders, the reasoning to be followed is different. The tool that allows you to scientifically calculate the equality between women and men in leadership positions was developed by the team of the Observatory on gender equity of leadership in healthcare, born in 2022 from the partnership between the Luiss university business school of Rome and Women leaders in healthcare (Leads), an association committed to promoting the culture of gender equality in the highest levels of healthcare careers through conferences, working groups, research and coaching. This is an index called “Gender leader index in health” (Glih), which measures the relationship between the gender distribution in top positions and that among all employees. The indicator ranges from 0 (neither of the two genders is represented) to 1 (exclusive representation of only men or only women): if it is less than 0.5 it means that women are undersized in leadership compared to men, while if it is above 0.5, female bosses are over-represented. To be clear, if women doctors make up 51.3% of the total, perfect equality of representation would be achieved if 51.3% of facility directors were also female. Which is not the case.
The Observatory, in its second annual report, calculates a gender equity index of leadership in public health (which includes doctors, veterinarians, healthcare, administrative and technical professionals) which in 2021 stands at 0.20, a value in slight increase compared to 0.19 in 2020 and 0.17 ten years earlier. “The trend is slowly and steadily growing but we are still very far from the goal of equity. It means that today in the public sector there are seven male managers for every hundred employees and less than two if they are women. To achieve equal representation, at this rate, it will take around 150 years” comments Marina D’Artibale, co-director of the Observatory and founding member of Leads.
The situation is much more balanced in drug and medical device manufacturing companies. Even in the pharmaceutical sector, considering both the intermediate managerial level (that of managers) and the highest level (that of managers), the Glih index calculated by the Observatory rises from 0.50 in 2020 to 0.51 in 2021 showing for the first time an overtaking of women. Specifically, the predominance of female leaders is recorded among managers (0.53), while at management level male leadership still prevails (0.41), even if based on the Observatory’s forecasts in the next five years we could reach to an equal representation of the two genders. Finally, in the medical device sector, the disproportion of male leaders is confirmed although the index, between 2020 and 2021, has moved towards greater equity: from 0.29 to 0.30.
Among the functions of the Observatory on gender equity of leadership in healthcare there is also the collection of virtuous projects, which concern for example the conciliation between work and private life. D’Artibale, together with the other co-director Maria Isabella Leone, responsible for the Luiss MBA area, explain why the Observatory is an innovative tool and a driving force for the change that is needed: “It is the first permanent observatory that every year it maps gender equity in top roles in the healthcare sector. Through a comparison of the phenomenon between public and private it intends to promote the contamination of good practices in the various regions. It produces data that represents an important awareness tool available to all administrators of local health authorities, hospitals, pharmaceutical and device companies, to encourage them to direct their efforts towards greater equality in career opportunities. And it stimulates a debate on gender equity that is not ideological but based on numbers and research evidence.”
March 14, 2024
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