Gender pay gap narrowing in Canada’s health sector. Will COVID reverse that progress?

Gender pay gaps in the Canadian health sector are narrowing, but employment loss during the COVID-19 pandemic affected women more than men, according to a new report.

A global analysis by the World Health Organization (WHO) and International Labour Organization (ILO) released on Wednesday shows that in Canada, the wage divide between men and women working in the health and care sector almost halved over the last decade to 4.7 per cent in 2019 from 8.5 per cent in 2000.

This means, on average, earnings for female workers were 4.7 per cent lower than their male counterparts.

In contrast, the pay gap in the United States remained almost the same and increased in several European countries, such as Czechia, Estonia and Hungary, over the last decade.

“It’s disappointing that we aren’t at pay equity yet, especially as a country that does have pay equity legislation,” said Morgan Hoffarth, past president of the Registered Nurses Association of Ontario.

The COVID-19 pandemic, that has pushed many health-care workers to the brink, saw average hourly wages growing faster for Canadian women in the health and care field. This narrowed the gender gap in monthly earnings to 14 per cent in December 2020 from 19 per cent in January 2019.

However, these were only marginal improvements, the WHO and ILO said, given the crucial role front-line workers have played to fight COVID-19.

And health-care workers, who are predominantly women, say they are not adequately being compensated for their work.

“People who work in health care are not adequately compensated for the work that they do at work and the work that they continue to do outside of work and outside of their paid time as well,” said Hoffarth, who is a registered nurse in Ontario.

In Canada, the federal government passed the Pay Equity Act in December 2018, which requires federally regulated employers to establish and periodically update a pay equity plan.

Meanwhile, in Ontario, the controversial Bill 124 that was passed in 2019 and limits wage increases to a maximum of one per cent total compensation per year for public employees, has been opposed by health-care workers.

“When we look at the actual policies that affect women’s pay and women’s livelihoods and women’s safety in health care, I don’t really see the policies that are supporting health-care workers and particularly women through the pandemic,” said Michelle Cohen, a family doctor in Brighton, Ont., and an expert on equity in health care.

Globally, women health-care workers face a larger pay gap compared to other economic sectors, earning an average of 24 per cent less than their male colleagues do, the report found.

“Historically, earnings in highly feminized sectors such as health and care have been lower because these are sectors that were considered to have a low value added attached to them,” Michelle McIsaac, a WHO economist and co-author of the report, told Global News.

Cohen said there needs to be a better valuation of care work and work that gets dumped into the “women’s work category.”

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Despite some progress in Canada, the latest WHO/ILO report paints a grim picture for women in the health-care sector, according to its findings, as women continue to face gender-based inequalities.

An analysis published in the Canadian Medical Association Journal in August 2020 suggested that female doctors are underrepresented in top-earning medical specialties and paid less for equivalent work because of structural inequities that follow them throughout their career.

Using publicly available data, Canadian researchers found that women account for less than 35 per cent of doctors in the 10 specialties with the highest incomes, including radiology, ophthalmology and cardiology.

While past economic crises may have served to reduce gender inequalities in the labour market, the current pandemic, in the long run, could reverse any progress made towards achieving gender equality, the study authors warned. 

This is because while employment in the health and care sector had recovered by December 2020, the recovery was greater for men than for women, the report said.

Health-care workers across Canada are currently grappling with emergency rooms flooded with patients amid a summer surge of illnesses.

Meanwhile, hospitals continue to struggle with staff shortages and COVID-19 burnout, with many health-care workers leaving the medical field.

“Women have suffered the impact of the pandemic particularly because most workers in the health and care sector are women,” said McIsaac.

Since women have a greater representation at the low end of the pay scale, the loss of employment at the low end during the periods with the strictest public health measures may have impacted them more than men who are less represented at the low end of the pay scale in the health and care sector, she added.

There are also concerns about the long-term impact this will have with the health-care profession becoming less and less attractive.

“We’re seeing health-care workers burn out and leave the field … and … that’s going to be primarily women,” said Cohen.

As the pandemic continues with parts of the country now in a seventh COVID-19 wave, Cohen said there needs to be better job security, adequate PPE and paid sick leave to better support health-care workers in the country.

In Canada, health-care is 75 per cent funded by the province and 25 per cent by the federal government.

“I think we really need to look at the funding model and make sure that we are regularly reviewing the salary and the wages of individuals working in health care and making sure that they are matching with the cost of inflation,” said Hoffarth.

McIsaac also said more needs to be done to reduce pay gaps in Canada and around the world, by providing help to young mothers, or women in reproductive years, to balance work with family; and by promoting laws that equalize women and men in the labour market, such as parental leave for women and men.

There also needs to be political commitment, she said, to make sure that the gender pay gap in the health and care sector is addressed through increasing investment and improving the working conditions of all workers in the industry, including pay scales that show the value the sector brings to society.