Countries led by women have seen fewer COVID-19 cases and fewer deaths related to the pandemic, a finding that new research suggests could be because the leaders prioritize public health care spending more than their male peers.

An article published March 1 in Feminist Economics found fewer cases and deaths per million people among the 19 countries helmed by women heads of state in 2020, noting that these states also had higher rates of universal health care coverage for their citizens.

That’s a sign that women leaders may be more attuned to, and bigger champions of, health care investments, which have become crucial in the ongoing fight against the pandemic, according to authors Ana Abras, Ana Fava and Monica Kuwahara of Universidade Federal do ABC.

“Providing a quality universal health care system is a smart policy to fight pandemics and other health issues that have social and economic externalities,” they wrote.

As nations around the world began social distancing and lockdown measures amid the early days of the pandemic, anecdotes about which countries were handling the outbreak best began to swirl. 

Women-led countries, including Germany and New Zealand, were cited as particular standouts, leading Abras, Fava and Kuwahara to wonder how gender was impacting public health outcomes in the minority of sovereign states where women currently hold the highest office.

The researchers, who specialize in applied microeconomics and share an interest in gender, said they decided to investigate what would drive countries with female leaders to perform better in the pandemic.

Using data on COVID-19 infections and deaths from 144 countries on six continents between January and July, the researchers discovered a statistically significant negative link between COVID-19 outcomes and the presence of a woman head of state. On average, countries led by women had 324 fewer daily expected cases and 18 fewer daily expected deaths per million. 

Even controlling for population size and a range of socioeconomic factors, it seemed to be women leaders’ public spending priorities that bolstered their countries’ responses to COVID-19.

These outcomes aren’t the result of faster action on social distancing measures, the researchers said, but were likely linked to universal health care access. A comparison between women-led and men-led countries didn’t find a difference in COVID-19 outcomes when the states led by men had universal health care access equivalent to that of women-led states.

“We conclude that, if the countries led by men had similar levels of investment in a widely available health care system as countries led by women, their infections and deaths rates during the pandemic would be similar,” the researchers wrote.

The findings aligned with their expectations that in countries where women were positioned to direct policy, a greater emphasis on public health care spending was likely. 

“The assumption behind this mechanism is that as women gain more public voice and agency, the government is more likely to make investments in public care services,” the researchers told The Academic Times. “As women are responsible for family care and are also health care workers, [they] are more likely to demand and value universal health care services.”

That hypothesis could account for the relatively strong public health profiles researchers observed among the women-led countries they studied. In countries with women at the helm of government, the researchers observed on average higher shares of universal health care coverage, more doctors and nurses per 1,000 people, lower levels of air pollution and deaths due to poor sanitation, and more female legislators as compared to the rest of the sample — suggestive evidence that women representatives are directing resources toward a range of public health priorities.

Their distinct preferences play a major role in explaining why countries led by women on average saw better outcomes in their fights against the pandemic, Abras, Fava and Kuwahara noted, though the findings also resonate outside the context of the pandemic.

“In our opinion, this research reinforces the importance of women’s empowerment,” they said. “By [giving] voice and agency to women as citizens, workers or politicians, countries can benefit from … economic development that is more inclusive and equitable.”

The article “Women Heads of State and Covid-19 Policy Responses,” published March 1 in Feminist Economics, was authored by Ana Abras, Ana Claudia Polato e Fava and Monica Yukie Kuwahara, Universidade Federal do ABC.