Women are poised to become half of all paid employees in the country by the end of this year, making them primary and co-breadwinners in more households than ever before. It is clear that women at all economic levels work in paid employment, either because they choose to or because they have to, and that change is here to stay.
Just last week the Center for American Progress and Maria Shriver released a sweeping report titled, “The Shriver Report: A Woman’s Nation Changes Everything,” which examines the consequences of this change and seeks to answer the question of what we are going to do about it. How will—indeed, how must—our institutions adapt to this transformation?
A still-inequitable workplace continues to pose threats to women’s physical and mental health. We think of male-dominated occupations such as mining and construction as dangerous, but we often overlook the hazards inherent in many female-dominated occupations. Health care workers lift heavy patients, are exposed to viruses, and work with radiation in x-rays; migrant farm workers breathe in pesticides; and beauty salon and dry cleaning employees inhale noxious chemicals and handle skin irritants.
Even when the workplace itself does not pose direct hazards to women’s health, employment policies that fail to acknowledge the caregiving duties of today’s workers result in poor health outcomes for many women and their children—forcing women to return to work too soon after giving birth, pressuring them to cease breastfeeding infants, or denying them paid leave (or even unpaid but protected leave) to care for a sick child. And inflexible jobs with unpredictable schedules increase the stress, anxiety, and fatigue for those juggling caregiving responsibilities, the majority of whom are women.
To make all this worse, our health insurance system is still based upon the outdated model of the male breadwinner—the idea that everyone lives in a nuclear family, the husband works for the same job his whole life, the wife stays home and raises the kids, and the husband’s job provides benefits for everyone. Do you know one family that fits this complete profile today? Probably not, and that is why the health insurance system no longer works, especially for women.
Approximately 18% of women, and 37% of Latinas, are uninsured. Another 6% of women purchase their insurance in an unregulated and costly individual market. Companies on the private market can charge women higher premiums than men for the same health plan (a practice known as “gender rating”), deny coverage for so-called pre-existing conditions such as having a Cesarean section or suffering from domestic violence, and often fail to offer comprehensive coverage that includes maternity services.
Even women who have insurance are more likely than men to spend over 10% of their income on out-of-pocket costs, delay seeking care because of affordability concerns, and go bankrupt from medical expenses. And women spend 68% more on health care than men during their reproductive years.
In short, just because women are equal in number to men on employer payrolls does not mean we have achieved equality in the workplace.
But there is nevertheless reason to celebrate. This shift in reality, culture, and attitude means that there is no going back. The profile of the U.S. worker has changed definitively, and our institutions are slowly but surely realizing that they must adapt to it or simply cease to be relevant.
Jessica Arons is the Director of the Women’s Health & Rights Program at the Center for American Progress and co-author of “Sick and Tired: Working Women and their Health,” in The Shriver Report: A Woman’s Nation Changes Everything.”