The Time Is Ripe for Addressing Gender Inequalities in the Authorship of Scientific Papers

COVID-19 has brought about dramatic changes to the way we live as individuals, families, and societies. The response to the pandemic across the world, and particularly in Western countries, has been unprecedented. When lockdown was implemented in many European countries and some US states, academic institutions closed their doors, and staff, other than those directly involved in the response to the pandemic, were asked to work from home. However, schools, businesses, and day care centers also closed down. For most researchers, this required conciliating home schooling and caring responsibilities with working remotely in unfamiliar and often challenging circumstances. Public health researchers and practitioners are not immune to this, and many, if not most, have been working from home since the beginning of the pandemic. In this scenario, Bell and Fong (p. 159; published in this issue of AJPH) investigated the effect of the pandemic and the drastic changes associated with it on the number of articles submitted to AJPH by men versus by women.

Overall, the authors showed that there was a 25% increase in the daily number of articles submitted during the pandemic period. However, the pattern of article submissions differed by gender. The rate of submissions (articles/day) for corresponding authors increased by 11% for women and by 42% for men. The gender imbalance was even more striking for countries other than the United States, with a 113% increase for men and a 27% increase for women. As expected, the gender gap was higher for corresponding author than for first author (36% vs 12% increase for men and women, respectively), as it is not uncommon for the corresponding author to be the last (i.e., the most senior) rather than the first author of an article. This is in keeping with previous research suggesting that the underrepresentation of women is more marked in senior than in junior authorship positions.^1,2

Although this study lends further support to the detrimental impact of COVID-19 gender inequalities, its findings need to be interpreted in light of some methodological limitations. First, the authors used country-specific dates to define the pandemic period, thus accounting for the different evolution of the pandemic in each country. However, there was substantial heterogeneity even within countries, particularly where policies, such as school closures and stay-at-home orders, were enforced at local and regional rather than national levels.

Second, generalizability to countries other than the United States, which accounted for nearly 70% of all submissions during the study period, is questionable. Indeed, the small number of studies submitted from countries outside North America and Europe precluded subgroup analysis by country or region. Considering how gender roles and women’s participation in society and research vary across countries, the findings of this study are unlikely to be applicable to low-income countries, where gender inequalities have been shown to be staggeringly worse than in high-income countries.³

Third, this study was unable to explore whether there was a generational effect on gender inequalities. Although women have made progress toward greater equality in the workplace, a gendered distribution of housework prevails in most countries, and, even in the workplace, gender inequalities persist in reward, recognition, and pay.⁴ To what extent this is transferrable to academia and research is unclear. However, studies have shown that there has been hardly any progress toward gender parity in authorship, particularly for senior positions.⁵

In addition, this article provides critical insight into gender inequalities in COVID-19–related research. The finding that more than a third of the articles submitted during the pandemic period were related to COVID-19 compellingly demonstrates how COVID-19 reframed and reshaped priorities in public health research and practice across the world, and the worrisome implications of this for noncommunicable diseases and other infectious diseases are starting to emerge. It would have been interesting to understand what proportion of the increase in journal submissions was accounted for by COVID-19–related articles. This would have illustrated whether COVID-19 research was simply added to the research that was already being carried out or it actually replaced research in other areas. In fact, specialized journals in areas directly linked to health care provision reported a marginal increase in submissions from men and a decrease in submissions from women.⁶ It is uncertain to what extent the increase in submissions observed in this study reflects greater gender parity in public health or the fact that public health was more involved in generating evidence than specialties at the forefront of the response to COVID-19.

On the other hand, for COVID-19 articles, only about a third of the corresponding authors were women, whereas 52% of all articles had a female corresponding author before the pandemic. This secondary result of the study is arguably one of the most relevant findings. First, the proportion of authors of COVID-19 articles confirms that women are not contributing equally to the COVID-19 pandemic response. Ensuring that women’s voices are heard is crucial for improving our understanding of the far-reaching and gendered effects of COVID-19, which will benefit women and men alike.⁷

Second, the fact that there was gender parity in journal submissions before the pandemic raises the question of whether parity was also observed in actual publications. Indeed, this study provides a novel insight into gender inequalities related to research article authorship. Previous studies focused on published articles, whereas this study looked at submissions, irrespective of the outcome. If there are gender imbalances in published but not submitted articles, this suggests that men are more likely to get articles published than women. This hypothesis, if confirmed, is puzzling, considering that gender is not disclosed at any point during the submission and peer-review process. However, unconscious bias may still play a part if reviewers or editors infer the gender of the author from the name, when peer review is not blinded, as is often the case. This hypothesis deserves a thorough investigation, as currently available evidence is sparse.

It is high time that the scientific community, in general, and scientific journals and publishers, in particular, adopt transparent practices regarding gender equality, for instance by making publicly available the proportion of submitted versus accepted articles by age, gender, race, and country of origin of the first or last authors. This would be a major cultural shift in journal publications, and it would obviously require authors to voluntary disclosure those sensitive data. However, it would be a valuable addition to the citation-based impact factors that remain key for assessing the credibility and reputation of scientific journals. Demonstrating commitment to equality and diversity should be compulsory for any journal that claims or aspires to be world leading in science, medicine, and, especially, public health.

This interesting study adds to the pool of evidence supporting the fact that COVID-19 has exacerbated preexisting inequalities between women and men in academia and research. It is another call for individuals, institutions, and society at large to take the necessary steps to promote gender equality in all spheres of life, as this is an essential requisite for enabling women to achieve their full potential. As we emerge from the pandemic, our key priority should be to rebuild a world where all human beings are truly equal and fairness trumps inequity, discrimination, and prejudice.