Introducing the GenderSci Lab COVID Project
Authors: Sarah S. Richardson and Heather Shattuck-Heidorn
In most places, men are dying at higher rates than women of COVID-19. Seeking to explain the disparity, multiple think-pieces attribute the disparity to “sex differences in every tissue and organ system in the human body”; one commentator even used COVID-19 to claim that “when it comes to survival, men are the weaker sex.” Experimental trials are already administering estrogen patches or progesterone injections to men with COVID-19, or lowering testosterone.
It’s not all biology
In an Op-Ed featured in today’s New York Times, GenderSci Lab directors Heather Shattuck-Heidorn, Meredith Reiches, and Sarah S. Richardson outline the problems with this quick recourse to biological explanations. As we document in our US Gender/Sex COVID-19 Data Tracker, apparent sex differences in case and fatality rates vary widely from place to place. We unpack some of these differences in our Data Highlights blog post, examining variability across states and how rates shift over time. The substantial variation across time and place that we find strongly suggests that gender/sex differences in COVID-19 vulnerabilities are mediated by social context.
What past pandemics tell us
The pattern of higher male mortality from respiratory disease epidemics is a familiar one, largely driven by gender-segregated occupational exposures and higher comorbidity rates among men. Past pandemics, including the 1918 influenza epidemic and the recent SARS-1 and MERS coronavirus pandemics, tell us that gender and other factors, not biological variables, largely explain sex differences in outcomes. If COVID-19 also follows these patterns, then the overwhelming focus on biological sex (with an occasional mention of higher male smoking rates) is misguided.
As scholars who work at the nexus of gender, sex, and biology, we posit that understanding gender/sex disparities in COVID-19 outcomes will not come from simple comparisons between all females and all males in aggregate. To tackle these disparities, researchers will need to consider subsets of men and women, specific gender-related occupational exposures, lifestyle behaviors, and associated comorbidities such as heart disease, diabetes, liver disease, or cancer. Shifting how we understand gender and sex in relation to COVID-19 disparities could lead to radically different risk profiles, interventions, and public health messaging.
Gender/Sex: An Explanation
The term “gender/sex” offers a crucial starting construct for the GenderSci Lab’s work on COVID-19 disparities between men and women. Sari van Anders coined gender/sex as “an umbrella term for both gender (socialization) and sex (biology, evolution) and reflects social locations or identities where gender and sex cannot be easily or at all disentangled.”
Using “gender/sex” rather than “sex” or “gender” calls attention to two critical points. First, even in cases where it is theoretically possible to do so, we currently lack the data needed to disaggregate gender and sex. Without such disaggregation, the term gender/sex is more appropriate than sex (or gender) to describe these findings. Second, gender/sex highlights the need to insistently pair sex-disaggregated COVID-19 data with social variables and other demographic variables such as age in order to identify tractable points of intervention into disparities in COVID-19 outcomes.
The GenderSci Lab’s COVID Project
Since the onset of the pandemic in the United States, the GenderSci Lab, working remotely, has been comprehensively tracking and analyzing COVID-19 morbidity and mortality data from around the world and in detail within the United States. Like others have reported, we find that, in many places, the COVID-19 data is frustratingly incomplete. In the United States, a lack of testing has impeded accurate case counts. Mortality data is inconsistent in ways that systematically bias such data; for example, reported COVID-19 deaths often do not include deaths that occur at home or in nursing homes, which are majority female.
Our COVID Project is pursuing multiple lines of research and outreach to address the challenge of gender/sex disparities in COVID-19 outcomes:
US Gender/Sex COVID-19 Data Tracker
Today the GenderSci Lab is publishing the most comprehensive currently-available database of US State-level data disaggregated by sex. Available on our website, this resource reports currently available and historical, longitudinal state-level sex-disaggregated COVID-19 data for the United States. We report the following: cases and deaths disaggregated by sex; case and death rate per 100,000 disaggregated by sex, and age-adjusted death rates disaggregated by sex. We examine how trends change over time, and make available our full, weekly data tables for researchers, journalists, and the general public.
Our blog post “Highlights from the GenderSci Lab’s US Gender/Sex Covid-19 Data Tracker,” unpacks the most important take-homes from our initial analysis of the sex-disaggregated state data. Among our findings is that there is great variability in the gender/sex disparity in COVID-19 case and mortality rates nationally, globally, and over time.
Communication About COVID-19 and Sex Disparities
It’s not enough to assemble the numbers for men and women and display them. Numbers need to be contextualized to avoid contributing to sex stereotypes and to promote an accurate understanding of their meaning for individuals’ COVID-19 risk. In “Communicating About COVID-19 and Sex Disparities: A Guide for Media, Scientists, Public Health Officials, and Educators,” we offer concrete tips for journalists, researchers, and others interested in communicating ethically and responsibly about gender/sex and COVID-19. This project was inspired by the excellent guide “Communicating About Racial Inequality and COVID-19,” produced by the Berkeley Media Studies Group.
State-Level Socially-Relevant COVID-19 Data “Report Card”
While most US states are now reporting data by sex/gender, we do not know how these variables interact with age, race/ethnicity, comorbidity status, and other variables. In our recent Health Affairs blog, we document how states compare in the reporting of socially-relevant intersectional COVID-19 data, with the aim of improving surveillance reporting that can help reveal inequities in COVID-19 outcomes.
Ongoing Data Analysis
Over the coming months, the Lab will work to analyze these data and others. We aim to produce accurate, nuanced, and contextualized analyses of gender/sex disparities in COVID-19 and to better understand COVID-19 as a disease affecting people in interaction with their social identities. Areas of interest include analyzing sex disparities against the backdrop of baseline mortality rates for men and women, querying how sex disparities vary across occupation, race/ethnicity, age, and comorbidities, and modeling how potential underreporting of deaths by elderly individuals at home or in facilities may influence the completeness of our picture of gender/sex disparities.
The bigger picture: Addressing COVID-19 inequalities
As others have documented, most significantly in the case of inequalities linked to race/ethnicity and socioeconomic status, COVID-19 is not simply a biological agent with biological outcomes. Social context matters for interpreting exposure risk, preexisting health conditions, treatment options, and outcomes. In applying gender analysis to the COVID-19 pandemic, the GenderSci Lab aims to contribute to a broad-based effort to elevate the consideration of social variables in COVID-19 outcomes, improve theoretical frameworks and data quality for evaluating gender/sex hypotheses, and identify meaningful interventions to address gender/sex disparities.
Questions or interested in collaborating with the GenderSci Lab, or media inquiry? Email us at: genderlab@fas.harvard.edu.
Statement of Intellectual Labor:
This post was equally created by Richardson and Shattuck-Heidorn, with edits from the broader GenderSci Lab.
Recommended Citation:
Richardson, Sarah S., Shattuck-Heidorn, H. “Introducing the GenderSci Lab COVID Project” GenderSci Blog, June 24th, 2020. retrieved from: https://www.genderscilab.org/blog/covid-intro