Gender Equality Index 2021: Health

Despite an intensifying vaccine roll-out, at the time of writing the COVID-19 pandemic is still not under control in the EU. Though the full effects of the pandemic on people’s health are not clear, they are likely to be far-reaching. By July 2021, COVID-19 had claimed more than 730 000 lives and infected 33 million people. This represents 7 % of the EU population.

The burden of infection and death has been unevenly spread across countries and population groups. The greatest numbers of cases are reported in the largest countries, such as Germany, Spain, Italy and Poland^[1]. However, the highest shares of cases by population are in less populated countries – Czechia, Luxembourg, Slovenia and Slovakia – with rates ranging from 11 % in Luxembourg to 16 % in Czechia.

Section 9.2.2. explores the specific ways in which women and men are affected by COVID-19 in terms of infection and health outcomes. It also examines some of the gendered consequences of the pandemic restrictions on health, including mental health and exposure to gender-based violence.

Among the pandemic’s more obvious effects on public health is a drop in life expectancy. In 2020, life expectancy in most EU countries was lower than in 2019. Preliminary data shows that life expectancy fell slightly more for men than for women, except in Spain. The largest decreases were for men in Poland and Lithuania (– 1.5 years) and in Romania (– 1.4 years), and for women and men in Spain (– 1.6 years and – 1.4 years, respectively)^[2]. The drop in men’s life expectancy, while possibly temporary, is related to higher numbers of COVID-19 fatalities and higher rates of excess mortality among men in most EU countries (see Section 9.2.2.).

The pandemic has also been linked to a decline in the number of births registered in late 2020 and early 2021, especially in the countries most affected by the outbreak^[3]. Data from the Short-Term Fertility Fluctuations points to a drop of 10 % in Hungary in January 2021, 13 % in France and 17 % in Estonia^[4]. The highest fall (of 20 %) – a real ‘baby crash’ – was in Spain (Tomas Sobotka et al., 2021). The combination of significant health risks, psychological distress and, economic uncertainty – including large-scale job losses – and much more unpaid care work for women during the pandemic have been put forward as possible reasons for couples delaying or forgoing having children (Voicu and Bădoi, 2021).

As Section 9.2.1 on SRH discusses, provision of and access to these services have varied greatly across the EU and over time. This could also have been a factor, especially for couples and individuals needing to conceive with medical assistance. With populations ageing across Europe, and Member States in southern and central Europe particularly affected by low birth rates, the fall in registered births during the pandemic is expected to exacerbate ongoing demographic challenges.