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Breaking Down Barriers
March 4, 2020

By Melissa Kvidahl Reilly

Researchers at Rutgers School of Social Work are identifying the most significant barriers to advancement that women face – and what needs to be done to overcome them. 

The field of social work enjoys a rich tradition of female leadership, whether women are holding historical positions (Frances Perkins, first female cabinet member 1933-1945, and architect of the New Deal), winning landmark awards (Jane Addams, Nobel Peace Prize, 1931), or fighting for equality (Dorothy Height, founder, YWCA Center for Racial Justice, 1965). It’s no secret: women have been historically prominent in the field of social work, breaking glass ceilings and helping other women advance past barriers that previously held them back.

Today, a cohort of female researchers carries the torch at Rutgers School of Social Work, where they address some of the most prominent barriers to advancement that women currently face. Here are just a few.

Workplace Segregation
When it comes to workplace advancement, women face overt barriers like sexual harassment and pay disparity. But they also face systematic barriers, which are a bit harder to recognize since they’re not perpetuated by just one colleague or supervisor. Instead, they represent many factors, which together prevent women from reaching their full potential.

Associate Professor Jeounghee Kim says one of the more significant systematic barriers in preventing women’s advancement in the workplace is gender segregation – which refers to the fact that some occupations are primarily held by women – and the disparities that result. Overall, occupations primarily held by men tend to be well paying and highly respected, while female-dominated professions are often undervalued by society and, therefore, underpaid. “As you start to look at people without a college or graduate school education, gender segregation and associated barriers become even more evident,” Kim says. “It’s in these jobs that we see a microcosm of what’s happening in the larger economy.”

That’s why Kim’s research centers on low-wage home healthcare, a gender-segregated occupation where 90 percent of workers are women, largely without higher education. “These jobs are feminized, pink-collar jobs, so we don’t value them very much and the compensation is therefore very low,” she says. “This goes to the heart of gender segregation in occupation: Why are female workers so much poorer than their male counterparts? Because they’re in a gender-segregated sector that doesn’t pay well.”

Indeed, the pay gap is magnified in gender-segregated occupations. These workers generally face wage and hour violations, meaning they don’t get paid for overtime, aren’t afforded breaks, and often don’t make minimum wage. In fact, Kim estimates that 20 to 30 percent of direct-care workers are subject to wage theft on the part of individual family members who unknowingly hire them below minimum wage, or third-party agencies who knowingly cut labor costs to increase profit margins.

Yet another barrier to women’s advancement in the workplace surrounds their health and safety. Again, in the segregated direct-care sector, these barriers are clearly on display: these jobs are physically and emotionally draining; they are around-the-clock; and they rarely afford employees a way to better their conditions or get justice. As a result, employees in these sectors stay silent on issues like harassment and assault in the workplace, or health concerns like long hours. Or, they simply quit, says Kim.

In addition to conducting research that identifies these barriers, Kim encourages those working in public policy to offer solutions, for example, raising price caps in Medicaid and child-care subsidy programs, or providing incentives like higher rates for care producing positive outcomes. But this is just the beginning.

The truth is that in identifying the inequities in pink-collar jobs, research on gender segregation highlights issues impacting female employees across the board. “This sector itself is important,” Kim explains. “It represents a manifestation of what’s going on in the larger economy in the sense that the barriers they face are magnified, but mirrored in the general female workforce.”

Violence
Violence against women falls into a number of different categories, including domestic and dating violence, campus violence, sexual assault, stalking, and others. What they have in common, though, are similar negative outcomes. And they all tend to prevent advancement in one way or another.

Violence of any kind against women negatively impacts their mental and physical health, which is a significant barrier in and of itself. However, health impacts lead to a variety of related consequences when it comes to women’s academic and professional advancement. Students in school are more likely to fail or drop out. Attending medical appointments or following up with the criminal justice system can require women to miss work or school, and result in poorer performance when they do attend. “Plus, when it comes to workplace harassment or dating violence, women may try to avoid the person doing it to them, which can lead to additional missed opportunities for advancement within their professional lives,” explains Sarah McMahon, Associate Professor and Director of the Center on Violence Against Women and Children.

In addition to the acute consequences suffered by victims, a generalized culture of violence also presents a barrier to women overall. “Girls and women experience a barrier when they perceive their safety to be at risk, and have to continuously consider their safety and wellbeing because there’s a constant threat of violence out there,” McMahon says. “Studies say just the threat of violence can affect women’s choices, from where they’re walking at night to where they should go to school or accept work.”

At Rutgers School of Social Work, McMahon’s academic research about campus sexual violence brings about real change. First, it helps identify the challenges right here on campus: 20 to 30 percent of Rutgers students surveyed said they’ve experienced some kind of sexual violence since coming to campus; half said they experienced dating violence specifically, which includes not just physical abuse but also psychological, digital, and financial abuse. McMahon’s survey also found that victims hesitate to come forward because they worry about the response they might get. “We need to think about how we respond, and that victims are aware of that response,” McMahon says. “We need to provide a confidential space where people feel comfortable coming forward.”

To that end, McMahon and the Center on Violence Against Women and Children are playing a key role in a $2 million federal grant awarded to Rutgers, intended to facilitate additional support for victims of sexual assault and dating violence. The Center will help oversee the delivery of services, from crisis intervention to counseling, advocacy, education, and training, to ensure they’re effective.

“We know this type of violence impacts women and prevents their advancement,” McMahon says. “We also know this type of violence has a ripple effect across their families, communities, and society as a whole.” Indeed, domestic violence increases the chance that there’s also child abuse in the home, affecting children’s wellbeing and ability to advance. And, community perceptions of health and safety are negatively impacted in the presence of violence. “This points to the fact that these types of violence have short and long term impacts,” she adds, “affecting girls’ and women’s ability to move forward in the short and long term.”

Gender Bias in Healthcare
For many women, the inability to access healthcare is a barrier to their advancement, putting them in a position where they’re not getting preventive care or are unable to treat a condition or afford a prescription. But what about women who have access? Even then, says Associate Professor Shari Munch, gender-based barriers still exist.

Generally, gender bias in healthcare refers to the notion that somatic complaints by female patients are more likely to be labeled by physicians and other healthcare professionals as psychosomatic or “all in their head.” Munch’s research confirms that this can represent a significant barrier for those seeking care. In terms of outcomes, if a doctor harbors a gender bias (e.g., a presumption that females are hysterical or weak), women may experience delays in diagnosis or treatment, and unnecessary exacerbations of an illness.

At the same time, Munch explains, “women are also unwittingly part of this construct and contributing to it,” since societal, cultural, or personal influences can put pressure on them to be “good patients,” meaning they want to be liked and they won’t want to “bother” their providers with complaints of symptoms. “This can prevent them from seeking care in the first place, or may cause them to resist pushing back in any way should a doctor minimize their symptoms,” she says. “There’s an interplay here.” Munch’s findings come from a study with high-risk pregnant hospitalized patients conducted with her School of Social Work colleagues Associate Professor Judith L. McCoyd and Associate Professor and Associate Dean for Academic Affairs Laura Curran.

In all, gender bias in healthcare impedes women’s advancement, she says, since their quality of life can deteriorate and impact their home and work lives. This is supported in her research, which focused on pregnant women with hyperemesis gravidarum (HG), a condition characterized by severe nausea, vomiting, weight loss, and dehydration. “Because pregnancy is so prevalent, and women commonly get nauseous and vomit, health professionals and others in society often minimize these symptoms,” she says. “The truth is that even ‘normal nausea and vomiting during pregnancy’ negatively impacts their work life, home life, and social life, not to mention their physical comfort.” In terms of advancement, Munch cites one woman in her study as a prime example: “She hid in the bathroom at work, vomiting, because she was an hourly worker and unable to take sick time,” Munch says. “If she missed her job, she missed her paycheck.”

Negative outcomes can be even more significant when race is factored in. According to the Centers for Disease Control and Prevention, Black mothers are more than three times as likely to die from pregnancy-related causes than White mothers. “A significant driver in these disparities is racism, which includes how Black lives are devalued in the healthcare system and in society,” explains Assistant Professor Qiana L. Brown. “The negative effects of racism on health, to include maternal and child health, are well documented in scientific literature and most recently in U.S. News & World Report. As scientists, researchers, and practitioners, we need to resolve this issue in order to promote the health and advancement of all women and children.”

Brown, who is also Director of the School of Social Work’s Substance Use Research, Evaluation, and Maternal and Child Health (SURE MatCH) Group, says the barriers are even more pronounced when it comes to women with substance-abuse disorders. “Problematic substance use can impact many
areas of life. For example, prenatal substance use is associated with a host of poor maternal and child health outcomes. Often, substance-use treatment centers are not designed to address the unique needs of women, such as counseling for intimate partner violence, prenatal care, or childcare. The lack of women-centered services is a major barrier to treatment and thus a barrier to the health and well-being of women trying to recover from substance use or substance-use disorders,” she explains.

SURE MatCH Group aims to be a leading authority in improving the health and wellbeing of women, youth, families, and communities as it relates to recovery from and preventing substance-use disorders. The group works to achieve this vision by conducting and disseminating research that informs practices and policies that help prevent substance-use disorders and aid people in recovery.

Together, Rutgers School of Social Work faculty, staff, students, alumni, and friends are playing an important role in addressing these and other barriers that affect women, their families, their communities, and beyond. 

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