EIGE-2021 Gender Equality Index 2021 Report: Health

• With a score of 71.6 points – an increase of only 0.2 points since 2018 – this domain signals a setback in annual progress and indicates major ongoing gender equality challenges in the EU labour market. Progress in the subdomain of participation has slowed, and strong gender segregation in the labour market continues. This is demonstrated by the particularly low and almost static score of 61.3 points for the subdomain of segregation and quality in 2019.
• Gender gaps in full-time equivalent (FTE) employment rates remain extremely large in some groups. The biggest gap, of 27 percentage points (p.p.), is between women and men taking unpaid care of children, followed by a 21 p.p. gap between foreign-born women and foreign-born men. Both reflect the negative influence of gender roles and stereotypes on women’s participation in the labour market, and thus on their economic independence and empowerment.
• Not only has COVID-19 revealed gender divisions in the labour market, but its adverse effects on employment prospects have been greater, and are likely to be more prolonged, for women than for men as a result of labour market gender segregation and the highly unequal distribution of unpaid care duties. The pandemic could stall or even erase gender equality gains among groups, including foreign-born women and men, with the risk of further widening divisions in our societies.

• With a score of 82.4 points, the domain of money has slightly improved since the previous edition, and has risen by 3.3 points since 2010. Although access to financial resources is driving overall growth in this domain, a fall of 0.2 points in the economic situation subdomain since 2018 has slowed the overall pace of growth.
• The gender gap in mean equivalised net income has stagnated in the EU since 2014. The gender gap among people aged 16 years or older was 925 purchasing power standard (PPS)^[2] in 2019, although gaps in data hamper assessment of income inequalities among Roma people and undocumented migrants.
• The COVID-19 pandemic is likely to exacerbate the income gap between women and men because of the gender imbalance in paid and unpaid work. More women than men in the EU have lost income because they have had to assume care duties, including home schooling. Without appropriate income support, the feminisation of poverty will accelerate post pandemic.

• With an EU score of 62.7 points, the score for the domain of knowledge has remained static since the 2020 edition of the Gender Equality Index, improving by only 2.9 points overall since 2010. Although educational attainment is increasing among young women and men, more significant progress in this domain is being curbed by persistent gender segregation in higher education and by low participation in lifelong learning.
• The proportions of women and men aged 15 years or older in formal or non-formal education and training remained low in the EU in 2019 – 17 % and 16 %, respectively – despite a small increase since 2010. Participation in adult learning gradually decreases with age, and engaging hard-to-reach groups remains a challenge.
• The closure of schools and childcare services during the pandemic has increased the childcare burden for parents and created new unpaid roles, such as home schooling. Women in the EU have been generally more engaged in supporting their children with online schooling during the pandemic and are more dissatisfied with this type of schooling than their partners.

• Owing to the lack of updated data on time use, the score for the domain of time has not been revised for this edition and relies on information from 2016. With the most recent progress unable to be assessed, this domain’s overall contribution to the Index score in the long term is negative. The score of 64.9 points reveals entrenched gender inequalities in the time women and men spend on paid and unpaid work and in recreation.
• Housework is the most unequally shared of the three most common forms of unpaid care, the other two being childcare and long-term care for older people and people with disabilities and chronic conditions. About 78 % of women in the EU dedicate at least 1 hour per day to housework, compared with 32 % of men. This gender gap of 46 p.p. increases to 62 p.p. among women and men with children.
• The COVID-19 pandemic has had a huge impact on people with care responsibilities, especially women with children. Restrictions have made external care services from professional providers and social networks such as grandparents, friends and neighbours either unavailable or harder to access. Consequently, care has been provided largely from within the family. As Chapter 4, on the domain of knowledge, shows, online schooling has seen parents adopt new forms of unpaid work in their daily routine. Across the EU, increased time spent on unpaid care activities has led to acute work–life tensions, particularly for women.

• The domain of power is progressing the most. Since 2010, its score has increased by 13.1 points; between 2018 and 2019 alone, it increased by 1.9 points. This improvement accounts for almost two thirds of all progress in the Gender Equality Index since 2010.
• Nevertheless, the score of 55.0 points for the power domain is still the lowest of all the domains. Women account for only one in three national parliamentarians. In economic decision-making, women continue to be substantially under-represented in corporate boardrooms – accounting for 30 % of boardroom members in 2021. In large companies, less than 1 in 10 board presidents or chief executive officers (CEOs) are women. Progress in corporate boardrooms has been largely driven by legislative action in seven Member States (BE, DE, EL, FR, IT, AT and PT). In countries without specific gender equality action on decision-making, it will take more than 125 years to reach gender parity.
• The glaring lack of women in decision-making has become far more obvious during the COVID-19 pandemic. This is particularly evident among entities responding to the crisis or designing economic stimulus and recovery measures. Although an overwhelming majority of EU healthcare workers are women, men dominate leadership positions in the sector. By March 2021, only one in four EU health ministers and 4 out of 10 junior/vice ministers were women.

• The domain of health, although having the highest score of all six domains, at 87.8 points, has made minimal progress since 2010, increasing by just 1.1 points. No progress has been recorded since the 2020 Index. The subdomains of health status and access to health services have made marginal headway since 2010, increasing by 1.7 and 2.0 points, respectively. Despite a lack of updated data, the greatest gender inequalities are found in health behaviour, with an EU score of 74.8 points.
• Access to health services in the EU is still not universal. More than 3 % of women and nearly 3 % of men report unmet needs for medical examinations. The groups most likely to report unmet medical examination need are women and  men with disabilities (7 % and 6 % respectively), lone parents (5 %) and specific groups of women, such as those with a low level of education and those older than 65 years (4 % each).
• While the full effects of the pandemic on people’s health remain unclear, they are likely to be far-reaching. As of July 2021, COVID-19 has claimed the lives of more than 730 000 people in the EU, with another 33 million infections registered^[3], which combined account for 7 % of the EU population^[4]. However, the burden of infection and death has been unevenly distributed across countries and population groups. Life expectancy fell in most EU countries in 2020 compared with 2019. Preliminary data shows that it decreased slightly more for men than for women in all EU Member States except Spain. The largest life expectancy falls were among men in Poland, Lithuania (both – 1.5  years) and Romania (– 1.4 years) and among women and men in Spain (– 1.6 years and – 1.4 years, respectively)^[5]. The greater decline in life expectancy among men can be attributed to the fact that, in most EU countries, COVID-19 fatality rates are higher among men , resulting in excess mortality rates being higher among men than among women (see Section 9.2.2).
• The pandemic is also linked to a fall in the number of registered births in late 2020 and early 2021, especially in countries most affected by COVID-19^[6]. This fall is expected to exacerbate demographic challenges posed by declining birth rates in ageing societies across the EU, with Member States in southern and central Europe particularly affected.

• Regular updates to the domain of violence are a challenge because of the dearth of prevalence data. Although not comparable to the European Union Agency for Fundamental Rights’ (FRA’s) survey on violence against women (2014), the Fundamental Rights Survey (2021) data provides more recent insights. It shows that 8 % of women in the EU experienced physical violence (excluding sexual violence) in the 5 years before the survey, and 5 % of women experienced physical violence in the 12 months preceding the survey. Incidents were most likely to take place in women’s own homes (37 %) and to be perpetrated by a family member or a relative (32 %), most often a man.
• While an average of 39 % of women in the EU experienced harassment in the 5 years preceding the survey, some groups of women are much more likely to be affected. These include women who self-identify as lesbian, bisexual or ‘other’ (57 %), women not citizens of the countries in which they live (51 %), women with disabilities (48 %) and women with a tertiary-level education (49 %). The daily use of social media is also accompanied by rampant online harassment and abuse against women (13 %). Among women and girls aged 16–29 years, the prevalence of online harassment is 25 % (FRA, 2021).
• Restrictive measures to tackle COVID-19 have resulted in a surge of intimate partner violence against women. The risk of violence is especially high among already disadvantaged groups, including older women, women and girls with disabilities, migrant women, homeless women and victims of trafficking. The European Institute for Gender Equality (EIGE) reports a sharp increase in demand for victim support services, which are already struggling to continue operations, reach victims, find new support methods and deal with added strain on staff (EIGE, 2021a).

[1] The Gender Equality Index 2021 is calculated for the 27 EU Member States (EU-27).

[2] See the Domain of money chapter.

[3] European Centre for Disease Prevention and Control (ECDC) COVID-19 surveillance update, https://www.ecdc.europa.eu/en/cases-2019-ncov-eueea, accessed 7 July 2021.

[4] Authors’ elaboration based on ECDC daily data, https://www.ecdc.europa.eu/en/cases-2019-ncov-eueea, as of 19 May 2021, based on 2020 data for population.

[5] Authors’ elaboration based on Eurostat data ‘Life expectancy by age and sex’, https://ec.europa.eu/eurostat/databrowser/view/demo_mlexpec/default/tabl..., accessed 8 April 2021.

[6] Compared with the same months of the previous year.