LEADERSHIP FOR HEALTHY SYSTEMS CHANGE

Healthy systems change is critical and urgent if we are to transform to a more sustainable and equitable society. As we reimagine and reshape our world in the aftermath of COVID-19, whilst grappling to address complex global challenges, the systemic nature of health crises is coming to the fore. We can no longer afford to treat health as an individual issue, and without addressing other determinants of health such as peace and climate change.

Health was a key thematic pillar at the 2022 Women’s Forum Global Meeting, alongside climate and peace – highlighting the links between all three. Discussions amongst our ​​worldwide community of business leaders, lawmakers and changemakers painted a vivid picture of the state of women’s health, and speakers advocated for leaders to take urgent action to implement healthy systems change.

Non-medical factors like climate change, discrimination and violence can have a major impact on health

As our health is intrinsically connected to our economic and social context, women around the world face disproportionate health risks. For women experiencing intersecting forms of marginalisation – from poverty to racial discrimination – these risks are even higher.[1]

Environmental and economic factors exacerbate women’s health challenges. Pressure on health systems during the COVID-19 pandemic exacerbated pre-existing issues, putting the link between health and the economy into sharp focus. Climate change, period poverty and gender-based violence are among the non-medical factors that increase women’s health risks, as outlined by the Women4Health Manifesto: Gender and a Healthy, Green Economy. Catherine Bouvier d’Yvoire, Managing Director for Public Sector & Development Organizations, Standard Chartered Bank raised the issue of global inequality: “There is a wide gap in women’s conditions and health if you compare how we sit in advanced economies – with social security and check ups – versus how a lot of women sit in low income societies where 80% of the population have no health cover.”

Stigma around women’s physical and mental health is a critical issue, with severe impacts for women around the world. Gendered health challenges – including menopause, fertility and menstruation – carry stigma which restrict access to treatment, research and economic inclusion, with dangerous consequences. Research by Standard Chartered has found that 25% of women experiencing menopause are more likely to leave financial services before retirement, reducing the number of women in senior leadership positions.[2] These stigmas hold true for mental health; the ubiquity of mental health challenges, with people of every gender facing different experiences and stigmas, makes the urgent need for systemic change clear.

Public health and the choices we make as a society have immense power to improve women’s health. Equally,failing to proactively include gender considerations in decision making can exacerbate women’s health challenges. For example, recent US legislation that limits women’s reproductive rights could lead to a 24% increase in maternal deaths. This could reach 39% for Black women, highlighting the need to consider equity alongside gender in policy choices and decision making across the public and private sectors.[3]

Businesses have a critical role to play in creating inclusive, healthy systems for their employees

Companies are increasingly recognising their responsibility and imperative to support their employees’ health. A 2022 Deloitte study found an increase of 25% in the cost of poor mental health to employers compared to 2019; absenteeism, presenteeism (attending work while ill and underperforming) and labour turnover cost UK employers up to £56 billion per year.[4] For businesses to support effective, healthy systems change, their approaches must be rooted in equity and inclusion to ensure that women’s health needs are being met. The results of the UK government’s 2022 ‘Women’s Health – Let’s talk about it’ survey reveal the bleak state of workplace support.[5] Of women with health conditions or disabilities: 62% reported that their health impacted their experience in the workplace and 25% said it affected their opportunities for promotion 67% reported that it had impacted their mental health and 76% said it had increased their stress levels ⅓ of respondents said women feel comfortable talking about health issues in their workplace.

Teams are ill-equipped to provide support : Even for something as commonplace as parental leave, 1 in 3 Human Resources professionals admit they don’t know what conversations to have with women before or after maternity leave.[6] This can lead to women leaving work prematurely and result in significant costs for companies who lose valuable talent. For example, 60% of professional women leave their organisation within a year of returning after maternity leave, resulting in £1.65 billion per year in replacement costs.[7]

Speakers at the Women’s Forum Global Meeting shared some key actions for businesses to promote systems change by creating a healthy, inclusive company culture , including:

• Integrate health & health equity as a strategic focus. Consider opportunities to promote health equity, and the risks of inaction, in decision making by putting health on the C-suite agenda, including Chief Sustainability Officers. As Alexis McGill Johnson, President and CEO, Planned Parenthood Federation of America said: “When you centre equity in your decision and bake it into the centre of your work, the ripple effect will transform your organisation.”
• Implement inclusive programmes, policies & resources. Employee resource groups, inclusive health insurance, and training can equip employees with critical tools. Werner Baumann, CEO, Bayer AG shared that their House of Health platform aims to raise awareness and offers tools and materials for employees and leaders, including dedicated programmes for women’s health.
• Open dialogues, especially around stigmatised health issues. Provide training and create spaces for discussions around health to improve understanding amongst teams and uncover solutions. As Emma Codd, Global Inclusion Leader, Deloitte said, “knowing you can have a conversation about health is about culture and employers can be part of the solution. We need policies, but whether people use policies and resources comes down to how they feel in the moment.”
• Collect gender-disaggregated data. Create solutionsrooted in data and evidence around employees’ health experiences at work; disaggregate by gender to reveal the particular challenges facing women.

Leaders can spark transformative cultural shifts

Health is both a systemic challenge and a deeply personal reality for many. Leading with sensitivity can start dialogues and cultural shifts. Increasingly, leaders are being called on to speak candidly about their lived experience. Research has found that leaders perform emotional labour at similar levels to front-line service workers,[8] while facing an authenticity paradox : pressure to share personal insight into their struggles, while maintaining an outwardly calm and stable image to their teams. Leading by example and turning to others for support when needed is critical for sustainable, empathetic leadership within an integrated inclusive health strategy.

If we are to realise a healthy, equitable future, the time to act is now. Businesses and leaders cannot afford to wait or take siloed, ineffective approaches when it comes to health. To create truly inclusive and equitable workplaces and economies, women’s health and health more broadly must become a priority for leaders’ across industries and sectors.

The opportunities to take action, shift mindsets, and empower leadership for healthy systems change are there. It’s time for businesses and leaders to embrace this transformation, building resilience in both the short and long term.

[1] World Health Organisation, 2021. Gender and health

[2] Standard Chartered Bank, 2021. Menopause in the Workplace: Impact on Women in Financial Services.

[3] University of Colorado Boulder, 2022. The maternal mortality consequences of losing abortion access.

[4] Deloitte, 2022. Mental health and employers: The case for investment – pandemic and beyond.

[5] UK Government Department of Health & Social Care, 2022. Results of the ‘Women’s Health – Let’s talk about it’ survey.

[6] HR Magazine, 2019. Workplace maternity discrimination rife.

[7] MMB Magazine, 2018. MMB Maternity Returner Survey Results 2018.

[8] Brotheridge, C. M., & Grandey, A. A., 2002. Emotional labor and burnout: Comparing two perspectives of “people work”.