Why does the gender pay gap in healthcare persist across Europe?
The gender pay gap in healthcare is driven by structural undervaluation of female-dominated roles rather than simple differences in working hours or experience. According to a WHO report analyzing 43 countries, women represent approximately 77% of the workforce in the health and social care sectors within the WHO European Region, yet they face significant wage disadvantages.
A critical finding of the report is that the disparity is not uniform across all income levels. In lower-paying positions, the gap is relatively small, with women earning roughly 2% less per hour than men. However, as income levels rise, the inequality widens significantly; in higher-paying roles, the gap expands to nearly 23%.
Furthermore, women in the healthcare sector tend to hold a higher proportion of managerial positions compared to other industries, yet these leadership roles are paradoxically remunerated at lower rates. On average, managers in health and social care earn €22 per hour, whereas managers in other sectors receive approximately €24.70 per hour.
Comparing regional disparities in Europe
The severity of the wage gap varies considerably depending on the European nation in question. The WHO report identifies Spain and Portugal as having extreme disparities, with gender pay gaps ranging between 20% and 30%. In contrast, countries such as France, Italy, and Greece show relatively lower gaps within the healthcare sector. However, it is important to note that the average wage gap in other economic sectors typically stays within the 10% to 15% range, suggesting that healthcare remains a uniquely challenged field for gender parity.
How does the situation compare in the Greek labor market?
Greece does not escape the systemic issues identified by the WHO, although its healthcare-specific gap is statistically smaller than the extremes seen in the Iberian Peninsula. Despite this, Greek female healthcare professionals continue to face a persistent undervaluation of their labor.
According to ELSTAT data, the overall gender pay gap in the Greek labor market remains stagnant at 13.4%. Within the medical field, highly educated Greek doctors and nurses encounter an invisible "glass ceiling" that limits their earning potential. Even though these professionals possess exceptional training and expertise, the underlying structure of the health system tends to suppress their wages, reinforcing the idea that inequality is deeply embedded even in sectors where public health relies heavily on female labor.
What are the primary drivers behind these wage inequalities?
Much of the gender pay gap in healthcare remains unexplained even after adjusting for standard variables such as age, education, working hours, and specific sub-sectors. The WHO emphasizes that these traditional metrics do not account for the full scope of the problem.
Natasha Azzopardi Muscat, MD, PhD, Director of the Health Systems Department at the WHO Regional Office for Europe, stated that the gap is not merely a result of women working fewer hours or being younger. She noted that the issue ultimately stems from how the sector values women's work, asserting that factors like education and public versus private sector employment only explain a portion of the disparity.
Supporting this view, a 2026 study published in the International Journal of Nursing Studies suggests that "unadjusted wage gaps alone are insufficient for understanding inequality in these highly feminized professions." The study highlights that when gaps persist after adjusting for variables, they point toward structural and institutional factors involved in how salaries are determined and how career progression is managed.
What are the long-term consequences of the healthcare pay gap?
The consequences of the gender pay gap in healthcare extend far beyond immediate monthly earnings, impacting the lifelong financial stability of female professionals. Because women are paid less throughout their careers, they face cumulative economic disadvantages that manifest in later life.
As noted by Dr. Azzopardi Muscat, this systemic inequality leads to lower pension payouts and reduced financial security during old age. This creates a heightened risk of poverty for women who have spent their entire professional lives providing essential care to others. The WHO warns that this is not a coincidence of qualifications but a structural failure where women are paid less for the same work and are frequently overlooked for the highest-paying roles.
What measures can be taken to close the gap?
Closing the gender pay gap in healthcare requires a multi-faceted approach that addresses both visible wage differences and deep-seated structural barriers. The WHO report proposes several strategic interventions to move toward parity.
One primary recommendation is the implementation of mandatory national reporting on gender pay gaps. This includes the systematic collection and publication of wage data categorized not just by age and sector, but also by gender, profession, race, and ethnicity. Such granular data is essential for identifying where specific biases occur.
Additionally, the report calls for:
- Strengthening equal pay legislation and ensuring rigorous enforcement mechanisms are in place.
- Removing structural obstacles that prevent women from accessing high-paying leadership positions.
- Improving access to mentorship and professional guidance for female staff.
- Addressing the unequal expectations regarding caregiving responsibilities that often hinder career advancement.
The WHO concludes that addressing both observable and structural factors is the only way for EU member states to improve the motivation and retention of their healthcare workforce.
Frequently asked questions
How much less do women earn in the EU healthcare sector?
According to the WHO report, women in the EU health and social care sector can earn up to 28% less per month than their male colleagues. While the gap is only about 2% in low-wage roles, it climbs to approximately 23% in higher-income positions.
Is the gender pay gap in Greece higher than in other EU countries?
No, the healthcare wage gap in Greece is lower than the 20% to 30% gaps seen in Spain and Portugal. However, Greece still faces a general labor market gap of 13.4% according to ELSTAT, and female healthcare workers still face systematic undervaluation.
Does education level affect the gender pay gap in nursing and medicine?
While high education and experience should theoretically lead to higher wages, the WHO report finds that the gap actually widens in higher-paying roles. This suggests that education alone does not protect women from the structural inequalities present in the healthcare hierarchy.
Why are healthcare managers paid less than managers in other sectors?
The WHO report indicates that healthcare and social care managers earn an average of €22 per hour, compared to €24.70 per hour for managers in other industries. This reflects a broader trend of the healthcare sector's professional roles being undervalued relative to other economic sectors.
What are the long-term risks for female healthcare workers?
The primary long-term risks include significantly lower pensions and increased poverty during retirement. Because the pay gap accumulates over a lifetime, women face reduced financial security in old age, despite having spent their careers in essential, high-responsibility roles.
Key takeaways
- Women represent nearly 77% of the EU health and social care workforce.
- The gender pay gap in healthcare reaches up to 28% in some regions.
- Wage disparities widen in higher-income roles, reaching nearly 23%.
- Healthcare managers earn roughly €2.70 less per hour than managers in other sectors.
- The gap leads to lower pensions and higher poverty risks for women in old age.
Conclusion
The gender pay gap in healthcare is a structural crisis that threatens the sustainability of the European health system. As the WHO report demonstrates, the issue is not merely about individual choices or hours worked, but about a systemic undervaluation of female labor. From the immediate loss of monthly income to the long-term threat of poverty in retirement, the implications are profound. Addressing this requires more than just policy adjustments; it demands a fundamental reassessment of how essential care work is valued and compensated across the continent.
