Healthcare continues to outperform other industries in female representation at all levels of the talent pipeline. Women account for 66 percent of all entry-level healthcare employees compared with 49 percent across all US industries. While the share of women declines in more senior roles, moving to 30 percent of C-suite positions, healthcare still outperforms all industries.
In healthcare, the sharpest decrease in the share of women occurs at the jump from manager to senior manager. This pattern diverges from other industries, where the steepest decline happens earlier in the talent pipeline, at the first step up to manager—also known as the “broken rung” of the ladder.
Despite the obstacles to advancement, women in healthcare have a relatively positive outlook on their careers: nearly 75 percent of women report being happy with their careers compared with around 69 percent of men. This sentiment increases as women rise through the ranks: at entry levels, 71 percent of women report being happy. The perception of equal opportunity may be a contributing factor. While 18 percent of women report that gender may have played a role in missing out on promotions, raises, or chances to get ahead, 68 percent do not believe gender had an impact.
Moreover, organizations are taking action at the top to increase female representation. The external hiring of women rose in the C-suite across healthcare organizations, from 33 percent in 2017 to 42 percent in 2018, a significant year-on-year increase. This progress may align to last year’s call to action, since external hiring is one of the quickest levers to improve female representation, especially at the top.
This progress is encouraging, but it should not be assumed that obstacles have been dismantled. Indeed, trends such as external hiring may be a bandage over more systemic barriers—such as promotion and the imbalance of line and staff roles—that are preventing women from parity, especially at senior levels. Consider that across the healthcare industry, women are promoted at similar but slightly lower rates than men until the Senior VP level. While these differences might seem negligible, they compound and can result in the much lower female representation at more senior levels. Promotion rates of women for senior roles seem to reverse this trend, but they belie the fact that there are far fewer women to consider for promotion.
The types of positions that women hold—and the distribution across line and staff roles—may also play a part. In providers, for example, women represent approximately 80 percent of entry-level frontline workers, such as nursing positions, which are often predominantly female. However, this representation decreases across the pipeline, until women make up only about 30 percent of line roles in the C-suite
In healthcare, the biggest obstacle to women’s progression comes when making the leap from manager to senior manager, where female representation falls by 10 percentage points overall. The discrepancies in promotion rates create significant barriers for representation of women in more senior roles that cannot be adjusted with external hiring alone. To compound the challenge, attrition is fairly even by level across men and women, but a gap of around 1.5 percentage points exists for women at the SVP and C-suite levels.
The challenges that women as a whole face are magnified for women of colour. Across healthcare industries, the share of white women in entry-level positions starts at 46 percent, gradually declining to 25 percent at the C-suite. Women of colour account for 20 percent of entry-level representation, but by the C-suite their share has dropped to just 5 percent. As with women overall, the sharpest decline for women of colour is seen at the transition from manager to senior manager. Compare that with the figure for white men, who are able to increase their share of roles nearly two and a half times as they move from entry-level to senior positions. By contrast, the percentage of men of colour at roles throughout the industry stays flat, at about 11 percent. While men of colour have the lowest representation initially and are likely an “only” more often, their career paths do not narrow across the talent pipeline in the same way as white women and women of colour.
This lack of representation among women of colour can have a far-reaching impact: fewer executives who are women of colour translate into fewer role models for women just starting their careers. The C-suite sets the tone for an organization, especially as champions of diversity initiatives and the embodiment of values and priorities. Racial and gender diversity also has a direct connection to performance. Companies in the top-quartile for gender diversity on executive teams were 25 percent more likely to have above-average profitability than companies in the fourth quartile. Further, organizations with top quartile ethnic and cultural diversity on executive teams outperformed those in the fourth quartile by 36 percent in profitability. Last, greater diversity throughout the organization can help healthcare companies more closely reflect the patients and customers they serve, thus strengthening the healthcare ecosystem.
As the coronavirus pandemic has caused entire nations to adopt remote work, healthcare companies need to increase flexibility to enable employees to fit work into their lives. Many HR leaders have been excited by the prospect that COVID-19 may accelerate organizational acceptance of flexible working, which would benefit employees with more diverse needs. However, COVID-19 may disproportionally and negatively affect women and communities of colour, a pattern that should be closely monitored and addressed.
Recent research suggests that women are working a “double double shift” as a result of the coronavirus pandemic —equal to 20 hours of additional work—compared with men. Surveys conducted in April 2020, by LeanIn.org and Survey Monkey, found that 31 percent of women with full-time jobs and families say they have more to do than they can possibly handle, whereas only 13 percent of working men with families say the same.
This burden and negative impact are particularly felt by women of colour. Black women and men are disproportionately represented in frontline and essential care workers. In addition, even though Black women are already twice as likely to perform housework as Black men, they still shoulder more than half of caregiving responsibilities. Compared with Black men, Black women spend 2.7 times as many hours on unpaid work caring for household members and children and 1.3 times as many hours caring for non-household adults.
Once healthcare executives become more familiar with the challenges their organizations and subindustries face through rigorous analyses of the talent pipeline and leakage points, they can start to devise and implement targeted interventions. Employers can continue to make promotion practices fair and emphasize communications and transparency to prevent negative attitudes from taking hold and impeding diversity efforts. Fixing the step up to senior manager will set off a positive chain reaction across the entire pipeline, as more women will be available to promote and hire at each subsequent level. Put another way, more entry-level women will rise to middle management, and more women in management will rise to senior leadership.
Piece by-
Ishta Kaushal
ishta020@gmail.com
About the Author:
Ishta is currently pursuing her Bachelors in Commerce (Honors) with Minors in English Literature from Daulat Ram College, University of Delhi. She comes from the hills of Shimla, which is where she took to reading really early on moulding her into the ardent reader that she is today. According to her it would be quite unfair on her part to call herself a feminist, if she couldn't contribute to a feminist community right in her college i.e. the Women’s Development Cell.
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