FemGevity was created with the idea of exploring gender medicine in depth, and in particular longevity medicine that respects female differences: physical and physiological, hormonal, in biological aging, in symptoms and in response to drugs. Awareness, prevention, screening and treatment are fundamental to making our longevity sustainable. But perhaps they are not enough. We discuss this with Emanuela Notari, a longevity strategist working on gender longevity.
Dr. Notari, lifespan is getting longer and longer, including for women, who however face many more difficulties than men. What are the main challenges they face?
“Longevity brings a lengthening of the time spent in menopause, which, although we live 20 years longer than in 1950, continues to arrive at more or less the same age. In addition, some glaring oversights of the past in research on and treatment of women’s health, together with greater longevity, have led to a worse state of health in the female population at older ages, with more chronic diseases than men, even at the same age. I like to start precisely from here, from health. The most recent data say that in Italy there is still a considerable difference in longevity between North and South, and, as it happens, this difference to the disadvantage of the South coincides with lower coverage of prevention policies, especially those for women, the inadequacy of some hospitals, but also with lower out-of-pocket, spending, that is, what families spend on private care or consultations. In an ideal country, out-of-pocket spending should be zero, but, since our National Health Service is faltering, being able to count on financial resources to supplement the public service can be a great help in protecting oneself from the ailments of age. Living well for so long, comfortably and safely, unfortunately costs money.
And here one cannot avoid considering women’s economic and financial capital. In Italy, women on average receive 40% less annual income from work (“unadjusted” figure – INPS Report 2022) and 37% less pension income than men (INPS Report 2022). For decades we have fought for equal pay, celebrating the current gap of only 17% in the private sector (which rises to 22% for women graduates – INPS Report 2022) and 4% in the public sector. Even leaving aside the fact that in some sectors and for fixed-term contracts the pay gap can still exceed 30%, what should worry us is not so much the difference in pay as the difference in annual income. On this indicator, the difference is made by the hours worked, which for women are often reduced because of part-time work, which accounts for over a third of that meager 51% of Italian women who work. A figure strikingly lower than the EU average”.
Women and work: what is the current scenario?
“Although it may seem paradoxical, the countries where female employment is highest are also those with the highest birth rates. The lack of nurseries, of a wider use of equal parental leave, of fairness in the division of care and domestic work, and of a non-penalizing approach to part-time work in companies holds back women’s employment but also discourages having children. Add to this that 75% of so-called family caregivers, people who look after a non-independent older family member, are women, with a greater concentration in the 45-55 age group, precisely the one in which careers take off and incomes with them. It is not surprising that all this also translates into lower pension income, for which women make provision with supplementary pension schemes even less than men. The gender gap in pension income today is over a third less for women, and many women already advanced in years still have no pension. In 2019, 82% of recipients of a top-up to the minimum pension were women (Istat). And tomorrow, when pensions are purely contribution-based, it will be women and young people, more exposed to precarious work, part-time and informal work, who will pay the price in everyday life and all the more so in retirement. In 2022 Progetica published a simulation that quantified at 330,000 euros the work and pension income lost over the working life of a woman employed full-time on an average salary who had interrupted her career for 3 years at the birth of a child and 4 to care for a dependent parent. How many things can you do with 330,000 euros?”
What other dimensions weigh on women’s longevity or put its sustainability at risk?
“Certainly the risk of loneliness and isolation. The increase in life expectancy is a trend that is still growing and that by 2050 will already bring us to an average female longevity of 90 years. Of the more than 900,000 people over 90 today, the majority are women. And half of them suffer from dementia.
In Italy there are 4.5 million women over 65 who live alone. Many of them are widows, some separated or divorced, with a growing trend in so-called silver divorces that further jeopardizes the financial stability of a mature woman. Statistics say that men who divorce later in life tend to remarry; women do not, they remain alone. But a divorce is not needed to end up alone: putting together the extra years of survival and the average age difference within a couple, even happily partnered women face on average 6/7 years of life alone, those preceding age 85 — the future 90 — often in homes that were not designed for ninety-year-old occupants”.
What can women and families do to protect women’s longevity?
“The only thing to do is to get organized by planning this very long second half of life, in which we will necessarily have to take on more responsibility for our future standard of living: contribution-based pensions will provide for our subsistence, but we are increasingly responsible for the quality of our standard of living. It is not easy, but neither is it impossible, as long as we have clear ideas. We must not undervalue work, when it is there and we think that a babysitter or a nursery costs us what we would earn and so it is better to stay at home. In this calculation we never count the contributions or the professional growth that are lost, nor do we think about the importance of financial independence. First of all, we must calculate our capacity to save case by case and draw up a list in order of priority: a pension fund and a policy or a health mutual fund and Long Term Care as soon as financial resources allow. Independence is everything in life, and in the second half of it even more so, especially for a woman.”
