Tuesday, November 11, 2008

The Real Gender Gap? Count the Dads in the Pediatrician's Office

Author's note: This piece originally ran in November, 2007, at The Huffington Post. As the "runny-nose season" hits us again, I thought it was worth resurrecting. Jasper is home sick today -- a fever of 101, a runny nose (which was bloody when he woke up) and some GI issues. Fun stuff.

A few weeks ago, the World Economic Forum released a report documenting the "Global Gender Gap." Each country was ranked according to the parity it had achieved on a number of dimensions such as workforce participation and health outcomes. To no one's surprise, the Nordic countries topped the list. The US was ranked 31st, below such countries as Belarus and Sri Lanka. As the study authors pointed out, parity does not imply that either gender is doing well.

It's interesting food for thought. But the question of whether girl and boy babies are vaccinated at equal rates is one thing. A more germane question for the average woman in a developed country -- where almost all children are vaccinated -- is who takes those girl and boy babies to get their jabs? The answer offers a lot of insight into the reality of gender equity here in America in 2007.

I've got vaccinations on the brain because this morning my son, Jasper, went to the pediatrician's office for his six-month visit. I tagged along this time for moral support, but my husband does a lot of work with vaccines, professionally, so pediatrician visits are his thing. He chose our doctor. Generally, he goes solo.

As usual, he emailed our son's stats (18 lbs 6 oz!) to the relatives. His pediatrician brother was suitably impressed with our kid's size, but was surprised that my husband had been present for the weighing and measuring. Seeing a dad at the pediatrician's office, he wrote, is a "rarity." Statistics back him up. One recent study of six community practices in New England found that only 9% of pediatrician visits featured a father attending alone. A 2002 study in Pediatric Nursing looking at outpatient visits to pediatric cardiologists found that mothers made 64% of visits, solo, with their kids. In 29% of cases, both parents came together, and in 5% of the cases, the father visited, solo, with his child.

I have been trying to figure out why this is. Sure, Bureau of Labor Statistics figures show that in 30% of married couple families with children under age 18, only the husband works outside the home (in 4%, only the wife works). But both are working in 64% of the cases. That's a much bigger number than nine. Indeed, roughly a third of married women with children under age six work full-time. If only 5-9% of doctor visits involve a father showing up, solo, that means the majority of married women who have small kids and work full-time are still doing doctor duty.

Maybe, in these families, the wife earns less than the husband or has a more flexible job. But this is a chicken and egg question. While a number of pediatricians' offices do offer evening or weekend hours (in which case, why aren't the dads there then?), taking a kid to the doctor generally involves taking time off work. You come late. You leave early. You race over on your lunch break and watch the clock the whole time. There is some evidence that women optimize for different things in life than men (a balanced life, vs., say, status). Also, kids don't go to the doctor that often. But if you are the one who always has to take time off work for doctors' visits or other events during the day, or take time off when kids are sick, it does affect your availability for work. The fact that many fathers do not arrange their work lives to accommodate this - because they trust that their wives will pick up the slack - is one of the reasons men earn more than women. Yes, the vast majority of women who work full-time enjoy caring for their kids (which is why working moms and stay-at-home moms report spending roughly the same amount of time tending to the emotional needs of their children; working moms compensate for having two jobs by sleeping less and doing a lot less housework). But no one really enjoys holding a wriggling baby's arms while the doctor jabs the kid in the leg.

Yet someone has to do it. The truth is, there is a certain amount of work associated with parenthood that simply has to be done. You can outsource a lot of it. You can hire folks to do meal prep, laundry, vacuuming, and so forth. But almost no one would send anyone but a parent to the doctor's office. If fathers refuse to do half of the visits, and stay home with their kids half the time that they're sick, that means we're a long way from domestic equality.

We may never reach parity. Anyone who's managed an office knows that men can be very good at getting out of work that they don't perceive as high value, or don't want to do. Indeed, the study from Pediatric Nursing found that one of the major reasons fathers missed pediatrician appointments is that they anticipated a lengthy wait at the office. Of course, someone had to deal with that wait -- clearly, these men were stating, in not so many words, that their time was more valuable than their partners' time.

But things are changing. Fathers spend 153% more time on child care each week than they did in 1965. It's still less than moms, but not as much less as it used to be. More women than men now go to college which, over time, will change the dynamic in families of who has the breadwinning job. And hey, my husband takes our baby to the doctor. This morning at the office, I saw two other dads with kids in Baby Bjorns. That's reason for optimism - even if the US never overtakes Sweden (or Belarus) atop the World Economic Forum list.

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