Foreword: Alice Wiseman, Gateshead Director of Public Health

It is a pleasure to welcome you to my 6th annual report as Director of Public Health in Gateshead. 

I have used my previous annual reports to highlight a range of issues impacting on health in Gateshead. I've written about health harming products, like tobacco and unhealthy food, as well as ageing well, health and social inequalities (who it affects and where) and of course the impact of the pandemic. 

This year, I have decided to write about a subject that I am personally invested in - the inequalities faced by women at all levels of society. 

I know that in many ways, I'm in an incredibly privileged position, yet I have still faced certain challenges as a direct result of being female. Some of my experiences have been tangible, some a bit more discreet and some probably unintentional due to cultural norms. I gave birth to my first child aged just 17 and had to take time out of education to care for him, I have experienced everyday sexism in social situations, and have faced discrimination in the workplace. I've juggled parenting with my career and not always been able to get the balance right.

I realise that these experiences may appear as comparatively small issues faced by a relatively privileged white woman, but my concern is, what about other women who aren't as fortunate? How many women and girls are truly able to reach their full potential? And what more can we do to ensure all young women and girls across Gateshead have equal opportunities to live long, healthy and fulfilling lives? 

It's important to acknowledge that boys and men also face gender-specific challenges as well as inequalities created by socio-economic factors. Some of these issues are discussed in my previous annual reports, particularly  and'Inequalities: It never rains but it pours' (2017).

However, the focus of this year's report is on women and girls. It should be noted that inequalities are not linear, and some women will experience multiple and overlapping issues.

For instance:

• We know that from birth, boys and girls are treated differently and this impacts on their life opportunities, influencing subject choices in education and career aspirations.
• Women more likely to be carers for both children and others, which affects their earning potential. Women have a 50:50 chance of providing care by age 59, men by 75.
• Women are, on average, more likely to enter the workforce with higher qualifications than men but subsequently earn less per hour. They are more likely to take on unpaid work or part-time jobs with fewer progression opportunities.
• There remains a pay gap and women are more likely to have less in their pensions.
• Despite having a strong legal framework, too many mothers say that they experience harassment or negative comments related to pregnancy or flexible working from their employer/colleagues.
• Over one in five women and three in 20 men live in persistent poverty. This gap had been narrowing over the last 20 years but there is evidence that it has started to widen again. For men the route to poverty is often through economic inactivity and, while this is also true for women, women face additional risks because of lower earning power, caring responsibilities and changing family structures.
• The 'onset of parenthood' is identified as a driver of gender inequalities in the labour market. In practice, this means motherhood, which results in a range of factors, including, access to a narrower range of jobs, in less productive firms closer to home, prioritising of family-friendly conditions over high pay and lower bargaining power, resulting in lower remuneration. The impact of having more than one child is also important, with employment falling for mothers of larger families.
• Family type also has implications, with 45% of single parents living in poverty. 90% of single parents are women.
• Women have also been affected during the pandemic in other fundamental ways, including an increased risk of homelessness. In England, homelessness due to domestic abuse went up by 12% between April and June 2021 compared to a year before, which is approximately 30% higher than the figure during the same period in 2019. 

There are also big concerns about the safety of women in our communities which was particularly highlighted in the tragic 2021 case of Sarah Everard. Whether it's real or just perceptions of safety, many women feel they have to alter their behaviours to accommodate this fear. There needs to be a much more explicit focus on the development of inclusive environments where women can feel safe. 

We want girls and women to have the opportunity to reach their true potential and do what they want to do, with the appropriate environment around us all to enable this to happen. We want to be explicit about the unconscious biases that exist in our society, to change decision making so that girls and women are central to this and therefore are part of the solutions. 

I strongly believe that achieving gender balance benefits all of us, including men and boys, and in order to achieve that, we need to do things differently. 

The recommendations in my report deliberately focus on the environment around women and girls, rather than the women and girls themselves. Girls and women are strong and creative individuals with so much to offer and there is lots of evidence which demonstrates that there can be greater equality and better outcomes for the whole community.

Continue to read the full report online - Introduction: gender inequalities