Women in science, medicine, and global health: call for papers

Volume 390, No. 10111, p2423–2424, 2 December 2017 Comment lancet/article/PIIS0140-6736(17)32903-3/fulltext Jocalyn ClarkEmail the author Jocalyn Clark , Elizabeth Zuccala , Richard Horton Published: 02 December 2017 PlumX Metrics DOI: https://doi.org/10.1016/S0140-6736(17)32903-3 | s Women are rising. Recent reports of sexual harassment and assault of women by men in powerful positions have regalvanised solidarity around women's rights, and remind us that disadvantage, discrimination, and sexism are a regular part of the lived experience of many women. These reflect broader and unjustified inequalities between men and women that have persisted across time, culture, and geography. That disadvantages exist for women in science, medicine, and global health is thus unsurprising—and yet wholly unacceptable. The renewed visibility of women in these areas, such as the Twitter campaign #allmalepanel, offer hope for change. As part of this movement we are dedicating a special theme issue to women in science, medicine, and global health in late 2018 or early 2019. The reasons for shining light on women and inequalities are clear. Women earn less for the same types of work and are vastly under-represented in senior-level positions across occupational sectors.1 In science and medicine, the glass ceiling is still intact. According to a 2015 UNESCO report, for example, women undergraduates outnumber men but 72% of the global scientific workforce is male.2 In Europe, only 36% of mid-ranking professors and 18% of full professors were women in 2013,3 and just 13% of advanced grants went to women.4 In south Asia, a mere 17% of researchers are women2 and women in China comprise only 25% of the country's scientists and engineers.5 In health, where women make up most of the global workforce, they hold a small fraction of leadership positions.6 Just one of 18 global health organisations has gender parity on its governing board,7 and only two UN agencies have a female head.8 The situation is worse if taking into account the representation of women of colour or of women across ethnicity, class, sexuality, or other categories. Sadly, recent statistics affirm past trends of a leaky pipeline that show women's education and potential are being lost, at great cost to science and society: a waste of intellectual capital, lack of diversity in agenda setting, and the restriction of women's goals and rights.1, 9 This gender gap challenges the Sustainable Development Goal 5 to achieve gender equality and empower all women and girls by 2030. Poor career progression and low representation of senior women leaders in science, medicine, and global health are due to a combination of factors,2, 3, 6, 7, 8, 9, 10, 11, 12, 13 including penalties for motherhood, unconducive graduate research environments, lack of recognition, lack of support for leadership bids, fewer promotions and resources, and exclusion of women from the “old boys' club” cultures of science and medicine that nurture the fraternity, networking, and promotion of men. Women can also find it more difficult to travel for conferences and fieldwork.8, 14 A report on women scientists in Africa identified further barriers such as gender-based violence, higher rates of HIV and tuberculosis, and the burdens of unpaid work.14 Many solutions have been recommended including gender-positive imagery, mentoring, quotas on hiring and review committees, and anti-harassment and diversity training in workplaces. Better enabling maternity leave is a commonly advocated strategy but on its own does not disrupt the system imbued with gender bias: performance standards that require women to work harder than men to prove themselves, cultural norms that expect women to assume most domestic duties in addition to growing professional ones, and rigid expectations of masculinity that also constrain men's choices and contributions. These are not only women's issues—they require the full participation of everyone in deeper explanations and solutions. Gender bias is powerful and insidious. It is an expression of unequal distribution of power within societies and of the low value placed on women's work and contributions to public life. A host of evidence shows women are viewed as less competent and less valuable than men—from creativity to entrepreneurial skills to leadership—and these biases are exhibited by both male and female raters.11, 15 This bias can translate into discrimination in the workplace. In the UK, female doctors earn 40% less than their male counterparts.16 In the USA, 30% of women clinical researchers report experiencing sexual assault versus 4% of men.17 And despite achieving better patient outcomes, a recent analysis showed that female academic physicians were less likely to be full professors, received far less funding, and were paid less than men.12 Clearly, fundamental societal change is required alongside stronger institutional policies and commitments within the areas of science, medicine, and global health. What can a journal do? The Lancet prides itself on our focus on health equity, justice, and action. Here we commit to a specific project to uncover and highlight the representation, experience, and promotion of women in science, medicine, and global health. We call for papers reporting original research, analysis, and commentary to help create a set of transformative explanations and actions (panel). Panel How to submit your paper • Submissions to the women in science, medicine, and global health theme issue should be marked as such and submitted to The Lancet's electronic submission system. • The deadline is March 1, 2018. • All submissions will undergo normal peer review. We are assembling a group of advisers to assist with review of submissions and development of the theme issue. • We invite readers to join our Twitter Chat on Dec 5, 2017, at 1700 h GMT/1200 h EST to share your ideas on how we can make this theme issue most relevant, impactful, and action-oriented. Use #LancetWomen to join the conversation and post your questions. Our focus is on looking forwards. We are not interested in descriptive pieces that cover known ground or describe the problem, but instead papers that extend understandings and best practices for science, medicine, and global health. If we recognise gender bias as a root cause, for example, how can we create change? What interventions, programmes, and incentives work? How do broader issues of inclusivity, intersectionality, social justice, and cultural norms of masculinity and femininity influence the place of women and their advancement, and how can they be harnessed for change? What are the best ways for men to promote gender equity? We recognise relevant best practices can lie in areas such as business, government, and the social sciences, and we also welcome submissions that use the lens of critical and feminist theories to impart new understandings and practices for advancing all women in science, medicine, and global health. Appreciating the wealth of valuable work done to date, we must also recognise that the rate of change is too slow and, in many areas, has stalled. Therefore, above all, we encourage submissions proposing new explanations and solutions that are bold, creative, and disruptive. Although we acknowledge that some issues will be different across the sciences (including the life sciences), medicine (academic and clinical), and global health areas, we expect many to cross-cut. We also recognise that barriers and solutions manifest at many levels—individual, social, institutional, cultural—and hope to receive multidisciplinary work that explicates and interrogates how gender bias is embedded. Recognising that women's experiences are not universal and to broaden the conversation that has favoured the experience of white women and elite organisations, we explicitly seek work that shows the diversity of women's lives and experience, and explores how gender intersects with race, class, sexuality, disability, and other categories of disadvantage.18 Alongside issuing this call for papers, we assert our own commitment to examining the representation of women within the processes and practices of The Lancet, including women's inclusion in peer review and authorship, and the barriers preventing inclusion, building on previous work that shows gender bias in peer review and publishing.19, 20 The Lancet has a long-standing dedication to supporting work that contributes to the ability of women and girls around the world to live safer, healthier, and more empowered lives. We look forward to your submissions. We declare no competing interests. References UNFPA. 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