When Sue Heller was diagnosed with multiple-sclerosis (MS) at the age of 33, she knew that her employer’s support was vital. She was offered a higher-paid job a few years ago, but she turned it down: “When I asked what would happen if my health deteriorated, they couldn’t make any guarantees. At that point I realised I was better off where I was, even at a lower wage.”
Women in the UK are three times more likely to get MS – often during their 20s and 30s, when most are navigating the early stages of their career. There are many chronic illnesses, like heart disease, that affect men more often than women: but a range of additional factors come into play with regards to women’s health problems and the workplace.
Given the fact that they already work more flexible or part-time hours, often return to less well-paid jobs after maternity leave, that they undertake more childcare in general, act as (often unpaid) carers for unwell relatives and suffer discrimination before, during and after the menopause, it’s no surprise that women are more likely to be adversely affected work-wise when they fall ill.
Women represent the majority of workers on exploitative zero-hours contracts in the UK: such contracts are widely used in the care sector, of which women make up 80%. Such forms of insecure employment will therefore hit them harder following diagnosis of a serious illness.
For women in senior positions the picture is no less bleak. Government regulations calling on firms with 250 employees or more to publish data on their gender pay gaps came into effect in April. Ahead of time, the asset management company Schroders revealed a 31% gap between male and female salaries, ascribing this figure to the lower proportion of women in senior management roles. The lack of women in such positions means that those who do fall ill will experience added pressure to retain jobs they have had to fight disproportionately hard for.
Under the Equality Act, employers are required to make “reasonable adjustments” to the workplace. This is a duty, but there’s no fixed description of what these adjustments can include. And if they’re not complying, recent changes to discrimination tribunals means that hearings now carry a hefty £1,200 price tag. Which deters those on lower incomes (those working in the less well-paid “feminised” sectors, for instance) from making claims when .
Illnesses specific to women create added awkwardness. Sophie Baker* who was treated for abnormal cells after a routine smear test. She thinks she would have been treated differently if she was a man, or if she’d had an illness that affects both sexes: “my colposcopy wasn’t seen as a major procedure: I wasn’t suffering from any physical symptoms, so I was made to feel like it should just be brushed under the carpet.” Sarah Vining works as a self-employed marketing consultant, and was diagnosed with stage 1 cervical cancer in 2012: “Older men in particular were embarrassed about it; it carries a real stigma,” she said.
One of the biggest challenges also lies in “hidden illnesses” – about one in five women have a mental-health problem compared with one in eight men, and they are almost twice as likely to be diagnosed with an anxiety disorder. “Poverty is also closely linked to poor mental health,” says Katharine Sacks-Jones, director for the Agenda campaign. “The stress of living under financial strain can increase this likelihood, which can in turn affect women’s ability to retain jobs.”
Emma Mamo, head of workplace wellbeing at Mind, agrees: “Too often we hear from people who feel pressurised to return to work and do so prematurely, often leading to further spells of sickness absence. It can then become a vicious cycle and can even lead to falling out of work altogether.” And this returns us to the issue of under- and over-representation: women are employed in more lower-paid, lower-skilled jobs than men – jobs that might not necessarily offer sick pay or time off for therapy. And the few women at management level may not feel able to request the time they need, due to fear of a change in attitude towards them or demotion.
The choices, career or family, work or motherhood, that women are still presented with are tedious, but they are still choices. With sickness and disability: there’s no choice. The lack of empathy around the different healthcare needs of male and female employees, the need to ban zero-hour contracts, not to mention the prohibitively expensive tribunal fees, renders women vulnerable in an already uneven playing field.
*some names have been changed to protect identities