International Women’s Day: Why We #Choosetochallenge

Wouldn’t this be a fantastic world if the International Women’s Day (IWD) did not exist? Or, better phrased, if the IWD did not have to exist. If that world would be a world where being a woman would not entail having fewer chances or being treated unequally. Oh, what a wonderful world this would be.

Yet, even in a world-class economy such as the UK, even in the XXI century, being a woman still comes with a number of disadvantages. For example: same work with lower salary; increasingly under-represented when moving up the stages of an academic career; gender bias in teaching evaluations; unequal share of household chores; and the highest uptake of home schooling in lockdown during the Covid-19 pandemic. As tough as it sounds, the United Nations reminds us that despite the world having made unprecedented advances, no country has achieved gender equality. As such, the International Women’s Day is a global day to celebrate all the achievements of women, in every dimension: social, economic, cultural and political; and it is also a day to reflect on the existing (sometimes invisible) barriers, and call for change.

Through this blog we want to reflect on the achievements of women in the landscape of Health Economics and Outcomes Research (HEOR); and call for change in the areas where inequalities still exist. We illustrate this with data on gender diversity among speakers at well-known HEOR associations: the International Society for Pharmacoeconomics and Outcomes Research (ISPOR), and the Health Economist’s Study Group (HESG), the main health economics association in the UK.

ISPOR’s ‘Women in HEOR initiative’ provides an insight in their journey towards gender diversity (we invite you to visit their slides as presented at ISPOR Europe 2019). In that session, Nancy S. Berg (CEO and Executive Director of ISPOR) showed that of all plenary speakers at ISPOR Conferences the percentage women increased from 26% in 2016 to 42% in 2019.  Similarly, good progress had also been achieved among programme committee members, up from 23% women in 2016 to 53% in 2019. The most positive piece of news perhaps is related to panel gender diversity. In 2019, all accepted panels were gender diverse. Among abstracts submitted, 11% were men-only (‘manels’), and 2% women-only (yeah, that exists).

Source: slides from ISPOR Forum ‘Women in HEOR initiative’ (ISPOR Europe 2019)

While we do not have exact data on the gender diversity of its members, the HEOR field in general does not strike us as particularly men-dominated, in terms of the relative proportion men and women working in this field. So, encouraging as they are, these results may still reflect some under-representation of women presenting their work at conferences. In perspective however, the results are not that bad: another report analysed events across 23 countries over a 5-year period (2013-2018) and found the uncomfortable truth that, of more than 60,000 event speakers, less than one-third were women (about one-fourth in the UK, we’re afraid). To further improve this, event organisers should ‘mind the gap’, while women should be encouraged to present their work and be a leader as much as men are. While this may sound like a daunting task given where we are today, HESG shows that achieving good representation of women is very well possible even at the highest ranks, with 54% of Heads of Health Economics Units in HESG identifying as women (boosting the UK’s gender diversity reputation in one go, thank you very much!).

International Women’s Day also calls for a shout out to all the great men out there, our allies, who actively advocate for and support gender diversity (and other types of diversity for matter). These are smart men too, as they understand that all of us, regardless of gender, will be better off with more diversity. Also, we would not be economists if we did not point out that, aside from gender equality being a value in and off itself, there is also a diversity dividend to gain from it. Diversity has been shown to significantly improve financial performance on measures such as profitable investments and overall returns. How so? Diverse teams make better decisions. As an organisation that exists to inform better decision- and policy-making in health, what could be more important?

Finally, though, a confession: at OHE, gender diversity is not actually top of mind every single day. The reason? It does not have to be. Mostly, gender equality seems a given to us, as it is ingrained in our organisational culture. Across the team, across roles and in the management team, women are equally represented if not outnumbering men. Pay is equal and career chances are too. Today at International Women’s Day, the OHE team celebrate this feat and realise to never take it for granted. We, still, are the exception, not the norm.