Last Updated Mar 1, 2024
This guide is intended to help donors gain a deeper understanding of the issues facing women and girls and outlines opportunities to address the root causes of inequitable outcomes. See the entire series. By Kelly Macías, Ph.D.
From expanded contraception options to increased female representation in politics, we have made many strides toward gender equality over the last few decades in the United States. Still, we have plenty of work to do in order for everyone to achieve equal rights. Every day, millions of women, girls, and transgender individuals lack access to basic health care, quality education, and routinely experience violence because of their gender.
Gender equality is important because when women and girls are healthy and have educational and economic opportunities, it has a positive impact on all of society. When more girls go to school, they increase their earning potential which strengthens the economy overall. And statistics show that women and girls spend 90% of their earned income on their families, which means that the more money women and girls make, the less likely their families are to experience poverty. Improving health outcomes for women and girls is also a racial justice issue. Black, Indigenous, Asian and Pacific Islander, and Latina women and girls are more likely to suffer from traumatic events (such as poverty, sexual trauma, suspension from school, and interactions with the juvenile justice system) which cause negative physical and emotional impacts. Women and girls of color are more likely to live in poverty and have their psychological needs overlooked and misunderstood. They are also less likely to receive the appropriate help and support when they experience childhood problems that are associated with toxic stress (such as depression, learning difficulties, and challenges with self-regulation).
Healthy girls and women are the cornerstone of healthy societies. Provide girls and women access to health throughout their lives and they will deliver a healthier and wealthier world. - Women Deliver
Women hold two-thirds of student loan debt in the U.S. at a staggering rate of $929 billion. Black women carry more of this debt than any other group. This debt, combined with the pay gap, means that women may struggle to provide for their families and have economic consequences for buying a home, starting a business, and saving for retirement.
World Bank reports that if women made as much as men the global economy would benefit to the tune of $160.2 trillion.
Without access to quality health care, including mental health, and education, women and girls are at increased risk of poverty, discrimination, and disease — all factors that lead to poor health outcomes and health disparities. Health is not just limited to biology or what happens in the body. Studies show that health is greatly impacted by social circumstances. Housing, access to food and proper nutrition, safety, and education all play a role in the health and well-being of women and girls. Health disparities occur when differences in health are linked to social and economic disadvantages, which typically impact people who have historically experienced obstacles based on race, gender, gender identity, socioeconomic status, and sexual orientation.
Donors can do many things to invest in the health of women and girls like financially support direct services for women and girls, advocate for policies that lead to better health outcomes and greater equality, and amplify the stories and work of organizations that are making a direct impact.
If you care about important social issues like racial justice, climate change, education, and economic inequality, the good news is that investing in the health of women and girls also makes a difference in these areas. In nearly every health indicator, other factors such as race, access to quality schools, and jobs and the environmental conditions where one lives, determine success for women and girls. All of these issues are interconnected. And by advocating for women and girls' health, you can multiply your impact on some of the most important issues of our time.
Clear health disparities exist across gender and race. For example, the rates for obesity among women and girls are higher than men and boys.
Heart disease is the number one cause of death in the United States for women and women of color are often at greater risk.
Black women are also more likely to develop high blood pressure at a young age. One-third of Native American women have three or more risk factors for cardiac disease. South Asian women have the highest rates of heart disease among Asian Americans.
High blood pressure is one of the major risk factors for heart disease. More men have high blood pressure than women, until age 45, when women begin to develop high blood pressure at similar rates. Black women are 60% more likely to have high blood pressure compared to white women. Some researchers believe that this is due to the fact that racial and gender discrimination causes chronic stress which raises blood pressure. Studies show that when transgender women receive hormone therapy, which helps align their physical characteristics with their gender identity, it actually lowers their blood pressure.
The number of Black and Latina women with HIV has dropped over the last seven years but is still alarming. In 2018, 57% of women diagnosed with HIV were Black and 18% were Latina. Rates of HIV are up 5% in women over the age of 55.
While diabetes is more common in men, women often have greater complications and are more at risk to die from diabetes complications. The prevalence of diabetes is also higher among women who have less than a high school education compared to women who have a college degree and women living in households with an annual income of $25,000 or less. Diabetes is also more prevalent among Black, Latino, Asian and Pacific Islander, and Indigenous women than among white women.
Latina and Black women have the highest rates of cervical cancer compared to women of other ethnicities. Black women have the highest rates of death from cervical cancer out of all women.
Women of color face significant challenges to accessing healthcare and insurance.
This lack of access particularly impacts reproductive health outcomes. Low-income women and girls often do not have access to quality reproductive health care, and as a result, are more likely to experience unintended pregnancies, have higher rates of abortion, and are at greater risk for sexually transmitted infections. And these rates are higher for poor women, women of color, immigrant women, and transgender women. 34% of non-citizen immigrant women are uninsured and only half of immigrant women report receiving contraceptive services or information compared to two-thirds of U.S.-born women.
To be clear, these issues are life-threatening. Due to lack of access to quality and culturally competent care, Black and Indigenous women are three to five times more likely to die from complications related to childbirth or pregnancy than white women. Living in a just and equal society includes quality reproductive education and health care, access to family planning, maternal health care and safe, and accessible and affordable childbearing options.
Did you know that racial bias has a direct impact on access to quality health care and health outcomes? Racial and ethnic bias in the medical system can lead to more illness, worse outcomes, and even death.
Medical providers are not exempt from having negative stereotypes and assumptions about women and girls of color. When experiencing pelvic pain, a woman’s race and ethnicity can impact her diagnosis and treatment. Black and Latina women are less likely to be diagnosed with endometriosis and Black women are more likely to be misdiagnosed as having sexually transmitted diseases. For all people, but especially transgender women and gender nonbinary individuals, this is why gender-affirming care is so critical. Gender-affirming care is when a health care provider recognizes each person and their unique gender identity and pursues treatment options that support and recognize each person’s individual journey. It is considered a standard of care and a necessity by most major medical associations in the United States. All of us deserve to feel seen, heard, and understood by the doctors and medical professionals we interact with.
Because of the stress of systemic racism, poverty, and lack of access to quality prenatal care, women of color are more likely to die in childbirth, a factor that increases with age, and babies of color are more likely to be born pre-term and underweight.
Due to high maternal mortality rates and racism in the health care system, women of color are seeking alternative models of prenatal care and birthing options. According to the Center for American Progress, “midwives and doulas can significantly improve health and birthing outcomes for people of color.” This is particularly true when those caregivers are people of color since they can administer culturally competent care, advocacy, and support to those at risk of bias and discrimination in hospitals.
The environments where girls are born, live, and learn ultimately impact their quality of life well into adulthood. Neighborhoods play a key role in health and safety. Low-income women and girls of color are more likely to live in places with unclean water and air and with high rates of violence.
Racial discrimination and sexism also play a role as they add additional emotional and social trauma, impact access to health and social resources, and increase exposure to violence and harm. Statistics show that domestic violence incidents in the U.S. increased 8% during the COVID-19 pandemic. Additionally, more people followed quarantine and stay-at-home orders, the stressors that lead to domestic violence increased such as unemployment, childcare stress, and increased alcohol and substance abuse.
Transgender women of color, in particular, experience higher rates of poverty, homelessness, unemployment, and violence, which means they are less likely to have health insurance, access to regular care, and are more likely to be unable to afford sufficient, quality food.
Studies show that repeated exposure to discrimination and marginalization cause premature biological aging and can lead to long-term health risks and even premature death.
Black and Indigenous women are 1.1-2.1 times more likely to be killed by police than their white counterparts.
All women and girls deserve to live long, healthy lives. With access to culturally relevant, quality health care, we can begin to reduce the racial and gender disparities that leave so many women, girls and transgender people behind.
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