Sex-disaggregated data matters: tracking the impact of COVID-19 on the health of women and men

Sarah Hawkes,Athena Pantazis,Sonja Tanaka,Kakoli Borkotoky,Ravi Verma,Sylvia Kiwuwa-Muyingo,Kent Buse,Abhishek Gautam,Sneha Sharma,Anna Purdie

doi:10.1007/s40888-021-00254-4

Abstract

Sex and gender matter to health outcomes, but despite repeated commitments to sex-disaggregate data in health policies and programmes, a persistent and substantial absence of such data remains especially in lower-income countries. This represents a missed opportunity for monitoring and identifying gender-responsive, evidence-informed solutions to address a key driver of the pandemic. In this paper we review the availability of national sex-disaggregated surveillance data on COVID-19 and examine trends on the testing-to-outcome pathway. We further analyse the availability of data according to the economic status of the country and investigate the determinants of sex differences, including the national gender inequality status (according to a global index) in each country. Results are drawn from 18 months of global data collection from over 200 countries. We find differences in COVID-19 prevention behaviours and illness outcomes by sex, with lower uptake of vaccination and testing plus an elevated risk of severe disease and death among men. Supporting and maintaining the collection, collation, interpretation and presentation of sex-disaggregated data requires commitment and resources at subnational, national and global levels, but provides an opportunity for identifying and taking gender-responsive action on health inequities. As a first step the global health community should recognise, value and support the importance of sex-disaggregated data for identifying and tackling an inequitable pandemic.

Highlights

COVID-19 has served to both illustrate and, in some cases, exacerbate existing inequities in health and wellbeing
Pearson correlations were computed to assess the relationship between the gender disparities in COVID-19 mortality and country income level, Gender Inequality Index (GII), female labor force participation and the percent of population living in an urban area
Men are more likely to be hospitalised (M:F = 1.21:1; n = 28 countries), more likely to be admitted to intensive care is more than double that of women’s

Summary

Introduction

COVID-19 has served to both illustrate and, in some cases, exacerbate existing inequities in health and wellbeing. Exposure to the virus itself, as well as access to and provision of health services (both preventative and curative), have highlighted the social, occupational, structural, commercial and political drivers of the pandemic and its impact across communities and countries. Intersecting across all these drivers, sex and gender play important, and frequently overlooked, roles in determining the differential health impacts of COVID-19 on people and populations.

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