Biased Data: COVID-19 Isn’t Gender Neutral
As people around the world face the adverse effects of COVID-19, academic institutions and governments are turning to data to track the scope of the crisis. This Johns Hopkins’ dashboard provides a strong example of using data visualization to inform the greater public with state-of-the-art data analytics. However, the available data is only capturing a partial picture of the crisis. Quantitative evidence like percentages and numbers can seem “impartial” or “objective” when it is often anything but. Data is not collected in a vacuum, but in specific cultural contexts, and researchers may be biased in their data interpretation or collection. If we don’t collect enough types of data, we lose the granularity needed to accurately interpret it and inform future decisions.
One of the most glaring COVID-19 data needs is including whether the person affected was a woman or man — otherwise known as sex-disaggregated data or, more broadly speaking, gender data. By looking at the Johns Hopkins data, you would have no idea that identifying as male means being at an increased risk of dying from COVID-19, since the dashboard does not differentiate between the number of women and men who have died from the virus. That’s not a fault of Johns Hopkins — it’s a problem because countries, including the United States, do not require gender data and therefore do not uniformly collect it. When insufficient gender data is collected, everyone suffers. Correcting that trend now could provide better protection and equity in healthcare going forward.
The lack of gender data extends across the field of medicine, with men making up the vast majority of all participants in medical trials. Women represented just 22 percent of initial small-scale safety trials for drug applications submitted to the Food and Drug Administration in the U.S. These failures to include women in research can result in worse health outcomes. Where we do have gender data, we can act to save more lives. For example, studies tell us that women are more likely to die from a heart attack when treated by a male physician compared to a female physician, as women experience different symptoms during heart attacks (nausea, shortness of breath, and jaw pain) than men, who are more likely to experience chest pain. Sharing this critical information on health gender differences can save lives.
From the currently available gender data, we have found that COVID-19 affects men more severely than women. Being male is as much a risk factor for the novel coronavirus as being old. In a report by the World Health Organization analyzing more than 74,000 cases, 60 percent of COVID-19 patients who died were men. In Italy, that number is even higher at 70 percent. Unfortunately, experts do not know why and only speculate that the reason may be linked to known risk factors which affect men at disproportionately higher rates such as preexisting conditions, alcoholism, and smoking. Without systematic gender data collection, we cannot understand how men and women experience COVID-19 differently or seek out a treatment by investigating those differences.
Challenges with gender data are also found in the treatment and vaccine trials for COVID-19. The National Institute of Allergy and Infectious Disease is running vaccine trials for COVID-19 on 45 adults, but they are not analyzing results by sex due to the small sample size. Even in small samples, analysts need gender data for further analysis of disproportionate effects along the lines of gender.
From emerging news, we are also understanding the gendered impact of the COVID-19 in society at large. Women are more likely to work part-time, work without benefits, and experience lay-offs than men. Internationally, travel restrictions have impacted foreign domestic workers, the majority of them women, in many ways. Workers have been barred from entering the Philippines and Indonesia, for example, leaving them stranded in Southeast Asia without basic protections or access to medical care. School closures also disproportionately affect women, as they often bear the majority of childcare responsibilities. In addition, there have been increased reports of domestic violence globally alongside some hotline eliminations and removals of gender-based violence protections, making survivors increasingly vulnerable (though some countries are rallying to improve protections).
Women also comprise the majority — approximately 67 percent — of medical professionals and first responders. Healthcare workers in general are more likely to contract severe or fatal cases of COVID-19 because they are exposed to a higher viral load without sufficient personal protective equipment (PPE). Additionally, most PPE is designed for the male frame and often does not fit women, which means that they’re more exposed to a higher viral load of the deadly virus.
We learned from Zika and Ebola that if we don’t measure impacts on women and make decisions informed by both men’s and women’s needs, all community members suffer and have worse health outcomes. Intentionally including women in data collection and research studies for COVID-19 is the only way to truly understand the impact of this pandemic. By gathering comprehensive gender data on COVID-19, we may not only capture the full scope of the problem but may also find the solutions to save lives and prevent future crises.
Andrea was a 2014–2015 Global Health Corps fellow at the Inter-American Development Bank in the United States. Today, Andrea is the Deputy Director of Operations at Development Gateway, a technology and data-for-development nonprofit. A native Texan, Andrea specializes in thoughtful design of programs and technical tools to solve tough social challenges around the world. She can be found in her beloved DC neighborhood of Adams Morgan, discussing politics in Spanish and eating tacos. She can be reached by email at andrea.c.ulrich@gmail.com.
Global Health Corps (GHC) is a leadership development organization building the next generation of health equity leaders around the world. All GHC fellows, partners, and supporters are united in a common belief: health is a human right. There is a role for everyone in the movement for health equity. To learn more, visit our website and connect with us on Twitter/Instagram/Facebook.
