The COVID-19 pandemic in Aragon highlighted the differences in healthcare between men and women

The Aragon Health Services Research Group (GRISSA), from the University of Zaragoza and the IIS Aragón, has studied 390.000 cases of COVID-19 between March 2020 and 2022, revealing that men were hospitalized more frequently than women.

The pandemic caused by the COVID-19 virus highlighted differences in healthcare between men and women in Aragon. «The women entered in hospitals and Intensive Care Units with less frequent that men and their stays were shorter". This is clear from the study carried out by the Health Services Research Group of Aragon (GRISSA), after analyzing 390.000 COVID-19 cases confirmed in Aragon for two years of study, between the months of March 2020 and 2022. The conclusion of the work is clear and the six researchers who have participated in this study They are blunt:

«There are differences in the healthcare provided to men and women. These differences were reduced throughout the pandemic, but persisted even after considering factors such as the age of the patients, their socioeconomic level, the existence of other pathologies or the place of residence»

Underlying this statement are several issues noted in the study: the greatest 'institutionalization' (in residences) of women, mainly due to their greater longevity, the highest incidence of dementia and depression, In some cases, loneliness and its situation most socioeconomically disadvantaged. Added to this are other realities also known in the use of health services, such as role of women as caregivers, which often causes their diagnosis and medical care to be delayed, and the existence of protocols applied equally in the health system, when "not all symptoms are the same in men and women and the care and attention processes must therefore also be different."

These are some of the central ideas of the study, entitled “Gender inequalities in healthcare in health crises: when uncertainty can lead to inequality”, which has been carried out by the Health Services Research Group of Aragon (GRISSA) and in which the researchers of the University of Zaragoza and the Aragon Health Research Institute Foundation (IIS Aragón): Isabel Aguilar Palacio, Sara Castel Feced, Sara Malo Fumanal, and Maria Jose Rabanaque Hernandez; Julia Teresa Lopez and Blanca Obon Azuara. The conclusions and the full content can be consulted at this link: https://rdcu.be/dDrVA

«We also observed that, in people over 80 years of age, the percentage of sick people was much higher in women than in men. Women were older, had lower income levels and more illnesses. On the other hand, took longer to enter Since they were diagnosed, they were admitted less frequently to hospitals and Intensive Care Units and when they were, The number of days they spent in hospital was lower than that of men.

Among the data on which the research is based for to show the lower admission of women to hospitals and their shorter stay in intensive care areas figure that the 77% of men who died from COVID-19 disease within 30 days of diagnosis had been admitted; while in the case of women this figure It is reduced by eight points: 69% of women who died within 30 days of diagnosis had been in a hospital. Regarding the ICUs were also more frequent in terms of admission of men than women., with greater differences in the first wave (10,7% in men versus 3,6% in women).

"These inequalities -the authors of the work assure- were higher in the first waves of the pandemic, but they did not disappear." In this regard, the researchers point out that "in the first phase of the pandemic it was decisive that people lived in residences, since were less diagnosed and admitted to hospitals less"And - they say - "women live in nursing homes longer than men."

The social role of caregivers

There is another structural element in society that makes the women are in a vulnerable situation, point out the researchers of the GRISSA group.

«Women are more reluctant to demand care in general because they are clear that they have a role, a social role of caregivers, in which they put the entire family first, remaining in last place. In the end, women take care of their families, their husbands, but then they become widows and when they start to get sick and need care, they have less family support, they are more alone, and they are sent to nursing homes more frequently.

The work delves into the socioeconomic causes in which these data are based and its authors state that "the lower socioeconomic level of Spanish women, retired and widowed, could also explain a large part of the differences that we observe" and emphasize that "women and men are using health systems differently, something that is observed in other studies of this nature."We know that people with lower socioeconomic status use health services differently, they are usually diagnosed later and their stays are shorter.

The research draws attention to the fact that the absence of guidelines in a context of great uncertainty and the health crisis can generate a inequitable use of health services and lead to less therapeutic effort in groups that are in vulnerable circumstances.

For this reason, they claim that to reduce health inequalities, and in the services received, between women and men, it is essential to have clear guidelines and definitions of health care that take into account the gender perspective, therefore, in order to prepare for future pandemics and health crises, attention to the needs of the population must be considered as a primary focus. groups in the most vulnerable situations, to avoid increasing existing inequalities.

Source: University of Zaragoza

Photos: From left to right: Sara Malo Fumanal, Isabel Aguilar Palacio, Maria Jose Rabanaque Hernandez and Blanca Obon Azuara.