Richer, happier, fitter? Not for female executives.

The new health-wealth paradox

Ghislain & Marie David de Lossy/Getty Images

The richer you are, the healthier you are. That maxim is hammered home in studies conducted by everyone from the World Health Organization to StatsCan, which reveal that income is the greatest determinant of health. Affluence and education are routinely linked to longevity and better fitness, nutrition and quality of medical care. As a medical truism, it’s right up there with “women are healthier than men,” based on the understanding that women visit the doctor more, are more concerned with nutrition and fitness, and are less likely to engage in risk-taking behaviour.

It would follow, then, that women who earn the most should be, and feel, healthiest of all. But that arithmetic may not add up. Women who shatter the glass ceiling are encountering a new gender gap, one that can affect their health in a one-two punch. First, they get equal access to the stress-related illnesses and habits that make male CEOs prime coronary candidates. Then, throw in a second, exacerbating factor: that pernicious “work-life” balancing act that has women, far more than men, contorting themselves like Cirque du Soleil performers to meet the demands of work and home. The upshot is a new female wealth-health paradox: earning enough to afford a trainer, an acupuncturist and a nutritionist, but not having the time to go to them.

A new Australian study, in fact, reveals that female executives don’t even have time to go to the doctor. The survey of close to 400 chief financial officers released last month by research firm East & Partners found most male respondents—77 per cent—had visited their doctor in the past year; only 34.8 per cent of women had. More astounding: 43.2 per cent of female CFOs couldn’t recall the last time they had.

That’s troubling, considering that upper-income women are now prime candidates for stress-related diseases, according to the British government’s new Health and Safety Statistics Report. It found far higher rates of work-related stress for women than men, higher rates for middle-aged workers (ages 35 to 54), and the highest rates in managerial and professional jobs for both genders.

It seems even women who work in health care aren’t immune. A 10-year study of 22,000 female health care professionals at Boston’s Brigham and Women’s Hospital released in July—the first of its kind—spells out the peril: women with high job strain had a 38 per cent higher risk of experiencing a “cardiovascular event” than women with low job strain, and a 70 per cent higher chance of a heart attack.

Health malaise among high-income women was also evident in the annual Symptom Profiler survey of 5,000 Canadians conducted by the Executive Health Centre (formerly Scienta) for Maclean’s. As one would expect, health scores rose steadily with income for both men and women until the $150,000 level. Men earning above that benchmark had the highest health scores of all; women in the same bracket, a group with an average age of 47.7, not only did worse than their male counterparts, but scored lower than women earning $80,000 to $150,000 (and more comparably to women earning between $60,000 and $80,000), reporting difficulty losing weight, more migraines, less sexual satisfaction and greater pressures in their marriage or relationships.

Granted, the total sample of top earners was small—91 women and 194 men—but that’s in its own way representative. Janet Beed, the CEO of Markham-Stouffville Hospital, who does try to make health a priority, suspects there’s limited data on the subject, with reason: “I would not take the time to do a questionnaire on this,” she points out.

Physician Elaine Chin is blunt on the subject: “Executive women don’t look after themselves,” she says. Chin, who used to work in a general practice in a low-income area, witnessed a radical gender reversal when she began working at a private clinic geared to upper-income executives. In her old practice, female patients were more diligent about their health than men. Now, it’s the opposite, she says: “Women cancel appointments and diagnostic tests all the time.”

Women also suppress symptoms more, she says: “We learn when we’re young to suck it up.” And that’s problematic as women enter perimenopause or menopause, just as they’re hitting their professional stride, she adds.

Women are also far more likely to cancel workout sessions than men, says a Toronto personal trainer whose practice is now 90 per cent female. She floats two theories: men are more used to fitness structured into life via group sports; and they also have wives who make sure everything’s taken care of. “You see wives and nannies walking in and out with the kids all the time,” she says about training men who earn $1 million and more a year. Female clients, on the other hand, feel they have to be on the front line of family crises, even when there is a nanny.

The spectre of affluent females missing Pilates class may seem a decidedly First World problem, but these women are also canaries in the corporate coal mine. As women inch slowly into top jobs, something we want to see more of, the emergence of health imbalances in the executive suite signals entrenched systemic inequity—and rigid structures designed for married men with stay-at-home wives. Women have been occupying the corner office for decades, but corporations have yet to fully adapt to the reality that wives and mothers (who lack their own wives) now work there too.

What we know about women’s tendency to be more adaptive than men suggests they may be more vulnerable to the ill effects of the CEO lifestyle. Recent research that had nothing to do with women in corporate life nevertheless raises an interesting point: a 2012 study from the Behavioural Science Institute of Radboud University Nijmegen found that women echo the habits of their dining partners, eating more when their companions eat more, and less when the person across the table eats less. “Eating and drinking with male clients can take a toll,” says Carol Willson, an associate partner in a Toronto accounting firm.

Cathy Preston, who operates a Toronto-based executive-search firm, says she’s increasingly running into high-earning women who are pre-diabetic or on blood-pressure medicine, conditions traditionally associated with low incomes. Weight is a common complaint. “A lot of my contemporaries are not healthy,” the 54-year-old says. It’s no surprise: women working 10- to 12-hour days are forced to perform a sort of triage, she says. “Women focus on work and family; they put themselves a distant third. Intellectually, they know better, but still do it.”

Willson, the mother of two girls under the age of 12, counsels younger female colleagues on the risks of ignoring their health. It’s common, she says: “When you’re younger, you can get absorbed in the hours and client demands and let go of personal things.” It’s a Catch-22, she says: “As you become more senior, you want to be in the best health to meet the demands of the job. But until you’re more senior you don’t realize how important that is.” Willson counts herself lucky her workplace offers “flex-time,” allowing her to work a “compressed” four-day week: “I can’t see balancing everything—including my health—if I didn’t have that.” Even then, it’s tough.

In the broader culture, female executive stress is increasingly entrenched as a norm—fodder for comedic novels like Allison Pearson’s I Don’t Know How She Does It and day-long “women’s” seminars like one American Express held last month in New York City titled “Overworked, Overwhelmed and Over It!” A female motivational speaker talked to the crowd of 250 about reclaiming “white space” and taking control of their time, as they texted busily to keep up with the demands of work and home. But perhaps that day might have been better spent by going to the doctor—or to Pilates.

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