Lipstick and COVVI-19

« Mon rouge à lèvres me protégera-t-il contre le Covid-19 ? » Cette question se classe parmi celles les plus intrigantes que nous ayons reçues par courriel depuis que nous avons commencé à coordonner le plus important traqueur au monde de données par genre sur la pandémie. De fait, cette question met en évidence une vérité importante en matière de santé publique.Le rouge à lèvres et le Covid-19 Le rouge à lèvres et le Covid-19

We developed this tracker in March 2020, because we thought it was unlikely that COVVI-19 is equally spreading within any population.This intuition has proven to be correct.Our data show, by way of example, that women are more inclined to be tested (and to be vaccinated) for the COVVI-19 than men, that they are less likely to be hospitalized and to contract an infectionvirulent requiring admission to an intensive care service, and that they had 30 % less risk of dying of the disease.

More generally, the pandemic highlighted the unequal conditions in terms of health and quality of life, as it has exploded in broad daylight the relationship between inequality and disease.It revealed the disparity of health risks within societies, the marginalized populations, and those which have undergone past and current injustices displaying a higher risk of contracting COVVI-19.She also underlined the burden of the disease undergone unevenly by societies.

Even if our main objective is to determine the role of gender in the list of health inequalities, the tracker clearly shows that in low-income countries, men/women mortality from COVID-19 is greater than that observed inHigh income countries.It is obvious that economic inequalities and other disparities cannot be ignored, especially since they often interact and reinforce gender inequality.

The problem posed by social and health inequalities is not new.In the middle of the 19th century, Friedrich Engels described to what extent the deplorable conditions of life and work of the English proletariat contributed to "excessive mortality, to an endless series of epidemics" and to "progressive deterioration in the state ofphysical health of the working population ".A few decades later, the German doctor, pathologist and politician Rudolf Virchow contributed to founding "social medicine" which considers that health and disease are intrinsic phenomena to social structures.

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At the end of the 1930s, the Chilean Minister of Health (and Future President), Salvador Allende, one of the architects of social medicine in Latin America, proposed political and economic reforms likely to improve the health of thepopulation.Go advocated fundamental changes in social structures and work environments instead of dwelling on diseases or their specific treatments.

Le rouge à lèvres et le Covid-19

The gender factor

The differences between the genres observed in our data tracker are better explained by relying on the link between social circles and health environments.While biological factors play an obvious role, the structural relationships between genres and social construction also determine the unequal impact of COVVI-19.

The question of gender is overlooked in the institutional structures which dominate our lives, such as the family, the legal and economic framework, religion, finance, the world of education and the world of work.It is experienced and adopted in everyday standards, representing what it means to be a man, a woman, a transgender person or even multiple sexual identities in a given society.

The question of gender determines expectations and perspectives, as if it is socially acceptable for a person to smoke, drink, drive a bus or work in a factory, or even if putting lipstick is lipstick isbehavior deemed transgressive or socially acceptable.It also influences the health checks of everyone.

As women most often occupy jobs that require contact with the public, such as care, sale and hotels, they are more likely to be exposed to COVID-19-especially if their personal protective equipment isDesigned to be carried by men and, therefore, is poorly adjusted to their bodies.On the other hand, the COVVI-19 has largely spread among migrant workers in several places.This reflects the difficult and not very hygienic conditions in which most foreign workers live and, in a more general way, the economic globalization which is based on unequal power relations between low -income countries and high -income countries,as well as between nationals and non-resources.

After being exposed to the coronavirus, gender -related factors can influence the probability that a person can have access to screening and care.When screening takes place in a clinical environment with limited working hours, formal workforce, which in several countries has more men than women, there is little access to it.Conversely, women whose movements are rather restricted in society will have limited access to health services.

When admitted to the hospital for COVVI-19, men suffer from a more serious form of the disease and are more likely to die.In addition to underlying biological differences, the high level of exposure of men to harmful environments is likely to increase their risks of chronic diseases.This has the consequence of increasing the risk of succumbing to the COVVI-19.

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These "gender-based environments" are linked to harmful sexo-specific standards for production and consumption (including professional exposure to carcinogenic substances and materials).Two of the largest fatal plagues in the world-tobacco and alcohol-have been put into market by exploiting sexo-specific standards, often explicit, since at least the 1920s.This has contributed to higher rates of heart and pulmonary diseases-correlated with mortality due to COVVI-19-in men.

Another question is that the gap in mortality due to COVVI-19 between men and women is more important in low-income countries.A plausible explanation remains that of the appalling rates of registration of the deaths of women in certain countries.

Relaunch social medicine

The world does not lack concrete evidence that inequalities have aggravated this last pandemic and those which preceded.Our tracker collects data from 195 countries in order to explore the differences between genres in connection with the COVVI-19.Other more localized data evaluate the impact on the pandemic of racial or ethnic factors, of the profession and other inequalities.

Despite this, the interventions to counter the pandemic mainly focused on biosecurity instead of attacking inequalities.COVVI-19 should rather serve as a alarm signal to revitalize a social medicine strategy and what we call the new public health movement.

Given the deeply anchored, universal and historical nature of most inequalities, make societies more just - and therefore in better health - in full pandemic will be a Herculean task which requires changing the modes of thought and intervention.

Above all, political leaders must recognize that the health and well-being of individuals are essential to the development of society.This requires leaders of the public, private and civil society sectors that they attack the social, political and economic factors which leave such a large number of exposed and vulnerable people.We must stop putting all our attention on the treatment of diseases, and opt for a more radical reform likely to make us evolve towards environments and living conditions where we all have equal prospects to remain healthy and fulfilled in thedignity.

Even if lipstick is perhaps a harmless reflection of sexo-specific standards in certain societies, carrying it symbolizes a powerful determining of the deeply anchored individual health, and this in all societies.The pandemic highlighted the need to make everyone understand that gender equality is a public good - which will open the way to the societal health objectives that we are looking to achieve.

© Project Syndicate, 2021.Translated from English by Pierre Castegnier.

Sarah Hawkes is a world public health professor at College University in London and Codirector of Global Health 50/50.

Kent Buse is Director of the "Healthy companies" program at the George Institute for Global Health and Codirector of Global Health 50/50.

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