Naoko Kawaguchi, MSc, MPhil

Violence against women, which often results in 

 (TBI) and other acquired brain injuries (ABIs), has intensified during the COVID pandemic. Violence against women is a clear violation of human rights and a legal and moral failure of society. It likewise contributes to the brain health gap as well as presents as a major economic problem. As the world struggles to emerge from COVID-induced health and economic decline, women are a major key to the economic recovery. A comprehensive and long-term strategy is required to shed light on and address this dire issue and to ensure the mental well-being women as well as unlock the power of women to drive the economic recovery.

During July 2021, social media influencer Gabby Petito, aged 22, and her fiancé Brian Laundrie, aged 23, embarked from New York on a cross-country road trip captured on Instagram and YouTube.

 In September, Brian returned early from the trip—and alone. Weeks later, Gabby’s remains were found. It was determined that Gabby died from strangulation, and her case opened a national conversation about 

Tragically, Gabby’s case is just one of many. There has been an increase in IPV, illuminating a shadow pandemic within the COVID-19 pandemic.

, 1 in 3 women (approximately 1.27 billion individuals out of the 3.82 billion women in the world) are estimated to have experienced IPV.

 Further, more than one-third (30,000) of the women killed in 2017 were killed by their current or former intimate partner.

 COVID-19 has escalated the rates of IPV. Calls to helplines have increased five-fold in some countries in 2020.4In numerous countries, there has been a 300% increase in police reports of IPV, likely fueled by COVID-19 mitigation strategies.

 UN Women had projected that an additional 15 million women would be affected by IPV for every 3 months of lockdown.

Although this increase in violence will have multipronged effects, the neurological effects and IPV-related acquired brain injury (ABI), including Traumatic Brain Injury (TBI), is particularly devastating. Despite the increasing attention in the last 10 years paid to sports-related TBI, little attention has been paid to TBI resulting from IPV.

 Up to 90% of survivors of IPV report head, neck, and face injuries, many of which result in TBI.

 One study examining brain injury in women who experienced IPV found that 74% of the women sustained at least one IPV-related TBI and 51% sustained repetitive IPV-related TBIs.11 Moreover, the study found a higher brain injury score from IPV was negatively associated with memory, learning, and cognitive flexibility and positively associated with a number of measures of psychological distress.

IPV-related ABI also includes nontraumatic brain injuries. Research has shown that 1 out of 10 women have been strangled by an intimate partner,

 which can cause a multitude of neurological problems, including hypoxic-anoxic brain injury, with long-term implications. As Gabby’s case emphasized, strangulation can result not just in hypoxic-anoxic brain injury but also in death. Indeed, prior non-fatal strangulation has been found to be associated with greater than 6-fold odds of becoming a victim of attempted homicide, and more than 7-fold odds of becoming a victim of completed homicide.

 The high-profile fatal strangulation murder of Gabby underscores femicide in IPV, which devastatingly remains commonplace.

In addition to TBI, hypoxic-anoxic brain injury, and other forms of acquired brain injury, women who experience IPV also are more likely to suffer from anxiety, depression, posttraumatic stress disorder, suicidal ideation, and many other health problems that can last even after the violence has ended, potentially detaching them from the labor market.

There is also a growing concern that women who experience repeated TBIs from IPV may develop chronic traumatic encephalopathy (CTE), a progressive and fatal neurodegenerative disease that cannot be diagnosed until postmortem.

 Unfortunately, the literature tells their tales. For instance, a report from 1990 identified a case of a women who apparently developed CTE from partner abuse.

 In 2021, during a postmortem examination of a woman aged 29 who died following a domestic violence incident, immunohistochemical staining for phosphor-tau revealed evidence of CTE-type pathology.

 This marked the first case of CTE pathology in a young woman who experienced IPV. However, there remains a lack of research investigating the long-term neurological consequences for women who have experienced IPV; research is needed to understand the potential for misdiagnosis, nondiagnosis, or the development of dementia and Alzheimer disease as a result of IPV.

 The latter is especially important since TBI has been identified as a modifiable risk factor for dementia.

 Thus, more research is needed to evaluate IPV as a potential risk factor for dementia.

The neurological effects of IPV extend to the entire family and remain under researched. A recent Brain Injury Australia report of the country’s first research into domestic and family violence (DFV) and ABI found that, out of the 16,000 survivors of family violence attending Victoria hospitals over a decade’s time, 2 in every 5 survivors had sustained brain injury.

 Further, nearly 1 in 3 of the survivors of family violence were children and, of those, 1 in every 4 had sustained a brain injury. Because this was not a study of IPV but instead a study of hospitalizations, it likely represents the tip of the iceberg. Similarly, a study of more than 100 clients of 5 domestic abuse shelters in Arizona found 9 in every 10 individuals reported a head injury with loss of consciousness from family violence in the preceding 12 months.24 Of those, 9 in every 10 reported “too many head injuries to quantify.” Yet only 1 in every 5 ever sought medical attention. Thus, community rates of IPV ABI remain radically under researched.

Currently, most domestic violence shelters and emergency department settings do not assess for TBI, non-fatal strangulation, or other brain injuries from IPV, despite the significant number of studies that demonstrate brain trauma among IPV survivors as well as those that show non-fatal strangulation as an important risk factor for homicide of women.

 Additionally, many women do not seek medical care for their IPV-related ABI.

 However, even when women do interact with social workers, physicians, or domestic violence advocates and shelter staff, there is a lack of training in these professions to adequately screen for and address IPV-related ABI.

Further, when developing criminal justice policy, histories of abuse and brain injury should be addressed. A study of women in prison found that 78% had significant head injury; 84% of these women had experienced repeated head injury largely as a result of domestic abuse that had occurred over many years.

 Yet screening and care for brain injury is not adequately accounted for in criminal justice. The staggering statistics of the number of women who have experienced abuse and are now in prison also further necessitates the development of a trauma-informed criminal justice system.

IPV-related ABI add yet another injustice to the Brain Health Gap, which highlights and frames the sex and gender gap in outcomes for brain health disorders across the lifespan, with strikingly negative outcomes for women.

 To address the Brain Health Gap, research institutions are calling for more women participants in preclinical development of medications, clinical trials, and clinical practice, as well as the expansion of research designed to focus on culturally relevant experiences specific to individuals who identify as female. This will enable more robust and representative data to be collected. Big data, real world evidence, and precision medicine approaches should be the tools used to respond to the call to action above. Furthermore, investing in leaders in health care and public health efforts is imperative to translate these data and perspectives into action. Women remain underrepresented in health care leadership, underlining the lack of gendered consideration in care. These efforts and initiatives are especially important for research, clinical care, and training related to IPV. The Brain Health Gap must address issues related to IPV-related ABIs.

Likewise, we have previously noted that the world is suffering a global brain capital collapse.

Brain Capital is a novel econometric asset that puts a premium on brain health and brain skills in our brain economy.

form of capital relevant to a complex, interconnected, and fragile global economy. Brain Capital needs to be integral to a new narrative of growth and progress that puts people and their well-being, health, interaction with others, and psychological resilience at the center of our economic system. Female empowerment—which includes preventing and addressing violence against women and better identifying and caring for the neurological effects in survivors—is a public and brain health imperative as well as the most effective way to build Brain Capital globally.

Addressing gendered violence and related ABIs can be remedied by integrating the social, medical, political, policy, and diplomatic levels. Taking sex and gender into account—including structural and social determinants—is critical for equality in brain health and precision medicine. The 

Organisation for Economic Co-Operation and Development 

Unit’s Neuroscience-inspired Policy Initiative

 We aim to find new ways to reconceptualize and revitalize the economy and how it works, laying the groundwork to identify relevant metrics while building a transdisciplinary network of stakeholders. The effort draws on experts from medicine, neuroscience, gender analysis, economic policy, philanthropy, and business. The Initiative will rapidly refine and advance women’s brain health via a series of research projects, seminars, and clear policy analyses and recommendations. In doing so, we hope to address the Brain Health Gap, leading to greater health justice for all people and a new era of innovation and progress. We hope to help build a future where both men and women are equipped with the support, resources, and care they need to thrive and in turn build more a resilient society and world.

 is an Atlantic Fellow for Equity in Brain Health at the Global Brain Health Institute (GBHI) (at the University of California, San Francisco (UCSF) and Trinity College Dublin), a Thiel Fellow at Stanford University and Steering Committee member for NIPI ( OECD, Meadows Mental Health Policy Institute (MMHPI) and the PRODEO Institute).

is an associate professor in psychiatry at Harvard Medical School and a research scientist at Massachusetts General Hospital. 

is head stakeholder, Engagement Alzheimer's disease at Biogen and Pro Bono CEO and Co-founder of the Women's Brain Project.

is head of the OECD New Approaches to Economic Challenges Unit, Senior Advisor to the OECD Secretary General and co-lead of OECD NIPI.

is advisor to the chief of staff and gender advisor at OECD.

 is a Senior Clinical Advisor for Cohen Veterans Bioscience’s Trauma Research Programs. She serves as Strategic Advisor co-leading CVB’s Suicide Strategy Initiative. 

 is co-lead of OECD NIPI, strategic advisor to the HEKA Fund (Newfund Capital and Fondation FondaMental), steering committee member for the Brain Health Nexus at Cohen Veterans Bioscience, and holds adjuncts roles with IMPACT at Deakin University, GBHI and Baylor College of Medicine.

How the case of Gabrielle Petito galvanized the internet

October 20, 2021. Accessed November 20, 2021. https://www.nytimes.com/2021/09/20/style/gabby-petito-case-tiktok-social-media.html

Gabby Petito was strangled. Experts say such an assault is a red flag for intimate partner homicides

 October 12, 2021. Accessed November 20, 2021. https://www.usatoday.com/story/news/nation/2021/10/12/gabby-petito-strangled-experts-say-its-common-intimate-partner-violence/8426282002/

A Pandemic within a Pandemic - Intimate Partner Violence during Covid-19

When pandemics clash: Gendered violence-related traumatic brain injuries in women since COVID-19.

5. Breiding MJ, Smith SG, Basile KC, et al. 

Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization--national intimate partner and sexual violence survey

6.United Nations Office on Drugs and Crime. 

Global study on homicide: Gender-related killing of women and girls

. 2018. Accessed November 20, 2021. https://www.unodc.org/documents/data-and-analysis/GSH2018/GSH18_Gender-related_killing_of_women_and_girls.pdf

Gender-based violence: We must flatten the curve of this shadow pandemic

. November-December 2020. Accessed November 20, 2021. https://www.un.org/africarenewal/magazine/november-december-2020/gender-based-violence-we-must-flatten-curve-shadow-pandemic

Concussion in sport: Domestic violence victims show same brain injury trauma as athletes with CTE

Intimate Partner Violence and Traumatic Brain Injury: State of the Science and Next Steps

10.Liu LY, Bush WS, Koyutürk M, Karakurt G. 

Interplay between traumatic brain injury and intimate partner violence: data driven analysis utilizing electronic health records.

12.Monahan, K., A. Purushotham, and A. Biegon, 

Neurological implications of nonfatal strangulation and intimate partner violence

13. Glass N, Laughon K, Campbell J, et al. 

Non-fatal strangulation is an important risk factor for homicide of women

Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review

. 2014;5:10.3402/ejpt.v5.24794. Published 2014 Sep 12.

Intimate Partner Violence, Traumatic Brain Injury, and Social Work: Moving Forward

Intimate partner violence and traumatic brain injury: a public health issue

17. Stern RA, Daneshvar DH, Baugh CM, et al. 

Clinical presentation of chronic traumatic encephalopathy

18. Baugh CM, Stamm JM, Riley DO, et al. 

Chronic traumatic encephalopathy: neurodegeneration following repetitive concussive and subconcussive brain trauma. 

19. Roberts GW, Whitwell HL, Acland PR, Bruton CJ. 

20. Danielsen T, Hauch C, Kelly L, White CL. 

Chronic Traumatic Encephalopathy (CTE)-Type Neuropathology in a Young Victim of Domestic Abuse

21. Livingston G, Huntley J, Sommerlad A, et al. Dementia

 prevention, intervention, and care: 2020 report of the Lancet Commission

Evaluating spousal abuse as a potential risk factor for Alzheimer's disease: rationale, needs and challenges

The prevalence of acquired brain injury among victims and perpetrators of family violence

. 2018. Accessed November 20, 2021. https://www.braininjuryaustralia.org.au/wp-content/uploads/BRAININJURYAUSTRALIAfamilyviolencebraininjuryFINAL.pdf

Traumatic Brain Injury in Domestic Violence Victims: A Retrospective Study at the Barrow Neurological Institute

Head Trauma in a Community-Based Sample of Victims of Intimate Partner Violence: Prevalence, Mechanisms of Injury and Symptom Presentation 

[published online ahead of print, 2021 May 15]. 

. Brain injury in women experiencing intimate partner-violence: neural mechanistic evidence of an "invisible" trauma

27. McMillan TM, Aslam H, Crowe E, et al. 

Associations between significant head injury and persisting disability and violent crime in women in prison in Scotland, UK: a cross-sectional study

28. Aragam GG, Kawaguchi N, Hynes W, et al, Highlighting brain-based inequalities for women: from bedside and boardroom to policy. 

. May 5, 2021. Accessed November 20, 2021. https://www.psychiatrictimes.com/view/brain-based-inequalities-women

29. Smith E, Kawaguchi N, Chapman SB, et al. 

Closing the brain health gap: addressing women’s inequalities

. Oxford University Press Blog. August 21, 2021. Accessed November 20, 2021. https://blog.oup.com/2021/08/closing-the-brain-health-gap-addressing-womens-inequalities/

30. Smith E, Ali D, Wilkerson B, et al. A Brain Capital Grand Strategy: toward economic reimagination. 

31. Eyre HA, Ayadi R, Ellsworth W, et al. 

32.Ellsworth W, Smith E, Champman SB, et al. 

Move over data, brain capital is the new oil

. 2021. Accessed November 20, 2021. https://www.psychiatrictimes.com/view/move-over-data-brain-capital-is-the-new-oil

. January 13, 2021. Accessed November 20, 2021. https://www.oecd.org/naec/brain-capital/

Articles

In honor of the International Day for the Elimination of Violence against Women on November 25, 2021, let’s consider the impact of IPV on the neuropsychiatric health of women. 

Shedding Light on the Shadow Brain Pandemic: The Devastating Effects of Gendered Violence-Related Acquired Brain Injury

The impact of the COVID-19 pandemic on women around the world has been both troubling and illuminating. Record numbers of women have had to drop out of the workforce, and 

 There has been a 25 to 300%increase in reported cases of domestic violence against women

 Although death and hospitalization rates related to the pandemic have been higher for men than women, the COVID-19 brain health crisis (everything from depression and anxiety to neurological disorders like Alzheimer disease) has disproportionately affected women. What are the reasons underlying this inequity, known as the “The Brain Gap”? What are the impacts on children, families, communities, and future generations?

Closing the gap will require a comprehensive and systematic approach to the addressing gender equality. Getting more women in research and health care is a good first step, but it is not nearly enough. To improve women’s mental health, we must incorporate new data: namely, the perspective and experience of women. Solutions that consider the experience of women are more likely to create structural change across sectors, from neuroscience and health care to racial equality, public policy, and workplace norms.

Biological, sociocultural, and economic factors are relevant to understanding and promoting gender health, and to elucidating and reducing gender disparities. At the most fundamental level, neuroscience and clinical research have not sufficiently incorporated sex and gender-based differences into their understandings the disease development, or the subsequent treatment considerations. Accounting for sex and gender differences is a must if we want to move from a one-size-fits-all medical model towards precision medicine, where big data and artificial intelligence may enable personalized solutions.

For example, as of 2019, Alzheimer disease and other forms of dementia are the 7th leading cause of death globally, with women accounting for 

 Unfolding research demonstrates that current strategies to address the ever-growing care burden and cost of dementias have not adequately considered sex and gender differences in the molecular presentations of the illness.

 Nor have they considered the gender-specific biological and socio-cultural risk factors, rates of disease progression, or considerations for community management to ensure equity in care.

The interactions with the reproductive system are crucial for brain health and aging in women. Menopause, surgical menopause, preeclampsia, higher rates of depression, primary caregiving, and lower education levels are risk factors for developing dementia.

 These findings, however, have not changed the way we contextualize and treat these conditions. Decreasing levels of estrogen in perimenopause can contribute to issues with cognitive performance that sometimes resolve post-menopause, but have also been found to increase rates of dementia-related cognitive decline.

 Such insights can influence the way we tailor and prescribe treatments to women with Alzheimer disease.

The conversation about women’s equality must not be limited to cisgender white females. Because brain health disparities are exacerbated in racial-ethnic minorities and other underserved and marginalized groups, accounting for the impacts of interpersonal violence, racism, casteism, poverty, trans and homophobia is the only way to truly achieve gender equality and, ultimately, economic and social prosperity. For example, posttraumatic stress disorder (PTSD) was originally considered to be an illness of combat veterans, but it is much more likely to develop in women as a result of sexual assault and intimate partner violence.

 The latter is unfortunately highly prevalent in minoritized communities, and studies have shown that women of color and of lower socioeconomic status have very high rates of PTSD.

 These discrepancies exist for other mental illnesses and syndromes, including depression, anxiety, attention-deficit/hyperactivity disorder, substance use disorders, migraine, and trauma-related disorders.

 Such insights must be taken into account in next generation health care solutions for women.

Research institutions are calling for the inclusion of a more diverse array of women in preclinical development and in clinical trials, and the expansion of research design to focus on culturally relevant experiences in order to collect more 

 Furthermore, in order to translate this data into action, we must promote female leadership in health care and public health efforts. Although the majority of the long-term care workforce is female and the majority of residents in nursing homes are women, women remain underrepresented in health care leadership, underlining the lack of gendered consideration in 

Unfortunately, while the number of women employed and promoted in the workplace had been slowly trending up prior to the pandemic, COVID-19 may have halted that 

 In the United States, more than 2.2 million women have dropped out of the labor force in the 

 Women of color have been disproportionately laid off or furloughed, while others have had to tend to caregiving and primary provider responsibilities at home.

Unfortunately, these trends will have lasting consequences. For example, markers of scientific productivity decreased by 30% for women during the pandemic, whereas productivity for men 

 This could significantly set women back from professional growth for the next decade. Moreover, in the business sector, 

 found that “This is not just a ‘she-cession,’ but a devastating loss of contributions.”

 Women who voluntarily left their work reported burnout and difficulty balancing work and personal responsibilities. In the study, 70% disclosed they do most of the cooking, household shopping, and cleaning, and 80% of women who plan to reenter the workforce are concerned about limited economic opportunities and obtaining jobs that do not take full advantage of their training and skillsets. These concerns have led to a push for expanded childcare options, paid time off or medical leave; government-approved stimulus packages for childcare providers. In addition, there should be support for flexibility for employees who have multiple roles and responsibility in and out of the office. These benefits, however, are not often inclusive of the most marginalized groups, who are overrepresented in sectors that require face-to-face interactions, forcing them to choose between work and domestic care as we continue our work/study-from-home pandemic lifestyle. 

Roles for women at home range from primary caregiver for children, elderly parents and relatives, to chef, housecleaner, therapist, and educator. According to some studies, the wellbeing of women has directly correlated to the wellbeing of their families, from children, to spouses, to parents and extended community.

 A recent study showed that the state of Texas lost $2.2 billion due to untreated maternal mental health issues, not only due to effects on the mother’s productivity and health, but also due to downstream effects on the health and development of the 

 Not surprisingly, untreated mental health conditions occurred in 18.2% of Black women, and 11.4% of non-Hispanic white women, again demonstrating the importance of breaking down the data to accurately reflect the relative impact on marginalized communities.

Despite women’s central role in family wellbeing, domestic violence against women has risen during the pandemic. Prior to the crisis, 1 in 3 women around the globe experienced physical or sexual violence at least once in their 

 Since the onset of the COVID-19 pandemic, there has been a reported surge in the number of calls to violence-against-women-and-girls 

 The United Nations projected that an additional 15 million women could be affected by violence every 3 months of 

 This type of trauma decreases women’s sense of empowerment and self-worth, further burdening women with symptoms of depression, anxiety, and keeping them locked in cycles of oppression.

It is clear that women carry the major weight during times of crises, a point that is becoming even more apparent during the current brain health crises. Solutions that include women are more likely to have success and create structural change across sectors, from neuroscience and health care to racial equality, public policy, and workplace norms.

To that point, evidence indicates that women are more proactive in taking advantage of opportunities to improve, rebound, and strengthen their brain health and resilience, and translate this charge to their families, communities, and the workplace. In a recent telehealth study, women across the lifespan enrolled in the BrainHealth Project (a landmark scientific study to define, measure, and enhance brain health and performance) at 3 times the rate of men.

 The results showed comparable gains between men and women in 3 factors contributing to global brain health: 1) clarity (innovation, reasoning, optimism, compassion), 2) fortitude (emotional balance), and 3) resilience (social support, purpose). These gains were achieved at a time when so many were experiencing heightened depression, anxiety, social isolation, and brain fog. These results suggest that, while women carry the weight during times of crises, they also are ready to build brain health for themselves, their families, and their communities. Giving major attention to the pivotal role of women in boosting economic and societal resilience may help shore up the weakening foundation of our families, communities, and workforces.

To close the brain gap, we must work to identify and quantify the mental health issues facing women, with the goal of identifying data-driven levers for change. These levers can include clinical research and care, policy and process changes, as well as investing in female-identifying entrepreneurs and companies focusing on menopause, fertility, trans health, and postpartum depression. Closing the brain gap will prepare our socioeconomic systems for future shocks and will also make for stronger communities in times of peace. Doing so will require a transdisciplinary effort that is committed to building the infrastructure required to support the diversity of women in society. In order to develop successful solutions, we must work toward better understanding the underlying problems. We cannot afford to do otherwise.

is a psychiatrist with the Massachusetts General Hospital at Harvard Medical School, and co-founder and chief clinical officer of the Brainstorm Lab for Mental Health Innovation at Stanford University.

is advisor to the chief of staff and gender advisor, Office of the Secretary-General, Organisation for Economic Co-operation and Development (OECD)

is special advisor to the OECD secretary general and head of the OECD New Approaches to Economic Challenges Unit.

is an associate with the PRODEO Institute and a Thiel Fellow at Stanford University. 

is director of the Monash Alfred Psychiatry research centre and head of the Central Clinical School Department of Psychiatry at Monash University

is professor and chief director of the Center for BrainHealth at the University of Texas at Dallas and co-lead of The BrainHealth Project.

CEO of the Women’s Brain Project and head of stakeholder liaison (Alzheimer disease) for Biogen.

is a fourth-year psychiatry resident at Yale Department of Psychiatry. She is the chief resident of digital psychiatry and the chief resident of quality improvement, and she is also the co-founder of the Women’s Mental Health Conference, the first academic and trainee-led conference on women’s wellbeing in the country.

is co-founder of the PRODEO Institute, co-lead of the OECD Neuroscience-Inspired Policy Initiative, president of PRODEO, adjunct associate professor with the Institute for Mental Health and Physical Health and Clinical Translation at Deakin University, instructor in brain health diplomacy and entrepreneurship at the Global Brain Health Institute (University of California, San Francisco and Trinity College Dublin).

Disclosures: Dr Chadha is currently an employee of Biogen International; her involvement in the Women’s Brain Project that she cofounded is pro-bono. Dr Aragam is a scientific advisor at BetterUp and has consulted for HealthyGamer, Tik Tok, and TASF. The opinions expressed in this manuscript are that of the authors and may not reflect the views of the organizations with which they are affiliated.

Women are leaving the labor force in record numbers

. The Rand Blog. November 24, 2020. Accessed May 5, 2021. 

2. Evans ML, Lindauer M, Farrell ME. A Pandemic within a pandemic - intimate partner violence during Covid-19. 

3. Tanaka T, Okamoto S. Increase in suicide following an initial decline during the COVID-19 pandemic in Japan. 

. World Health Organization. December 9, 2020. Accessed April 27, 2021. 

5. Ferretti MT, Martinkova J, Biskup E, et al. Sex and gender differences in Alzheimer’s disease: current challenges and implications for clinical practice: position paper of the Dementia and Cognitive Disorders Panel of the European Academy of Neurology. 

6. Sourial N, Arsenault-Lapierre G, Margo-Dermer E, et al. Sex differences in the management of persons with dementia following a subnational primary care policy intervention. 

7. Bove R, Secor E, Chibnik LB, et al. Age at surgical menopause influences cognitive decline and Alzheimer pathology in older women. 

8. Fields JA, Garovic VD, Mielke MM, et al. Preeclampsia and cognitive impairment later in life. 

9. Albert PR. Why is depression more prevalent in women? 

10. Kilpi F, Soares ALG, Fraser A, et al. Changes in six domains of cognitive function with reproductive and chronological ageing and sex hormones: a longitudinal study in 2411 UK mid-life women. 

11. Salcioglu E, Urhan S, Pirinccioglu T, Aydin S. Anticipatory fear and helplessness predict PTSD and depression in domestic violence survivors. 

12. Hong S, Burnett-Zeigler I. The frequency of PTSD and subthreshold PTSD among African-American women with depressive symptoms in a disadvantaged urban neighborhood: pilot study. 

13. Mauvais-Jarvis F, Bairey Merz N, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. 

. McLean Hospital. July 22, 2020. Accessed April 27, 2021. 

Long-term care workforce: caring for the ageing population with dignity

. Organisation for Economic Co-operation and Development. Accessed April 27, 2021. 

. McKinsey & Company. September 30, 2020. Accessed April 27, 2021. 

Nearly 2.2 million women have left the labor force since February

. National Women’s Law Center. November 2020. Accessed April 27, 2021. 

 April 21, 2020. Accessed April 27, 2021. 

Verizon announces women’s co-lab as continued commitment to supporting women through current ‘she-cession.’

 Dallas Innovates. March 17, 2021. Accessed April 27, 2021. 

20. Richter N, Bondü R, Spiess CK, et al. Relations among maternal life satisfaction, shared activities, and child well-being. 

Texas losing $2.2 billion by not treating mothers’ mental health, report says

. Austin American Statesman. March 21, 2021. Updated March 22, 2021. Accessed April 27, 2021. 

Addressing the impact of COVID-19 pandemic on violence against women and girls

. November 27, 2020. Accessed April 27, 2021. 

Domestic violence is a pandemic within the COVID-19 pandemic

. February 3, 2021. Accessed May 5, 2021. 

Gender-based violence: we must flatten the curve of this shadow pandemic

 November-December 2020. Online November 25, 2020. Accessed April 27, 2021. 

25. Chapman SB, Fratantoni JM, Robertson IH, D'Esposito M, Ling GSF, Zientz J, Vernon S, Venza E, Cook LG, Tate A, Spence JS. A novel BrainHealth index prototype improved by telehealth-delivered training during COVID-19. 

The COVID-19 pandemic has exacerbated mental health and gender inequalities around the world. Understanding the causes is the first step toward finding solutions. 

Naoko Kawaguchi, MSc, MPhil

Articles

Shedding Light on the Shadow Brain Pandemic: The Devastating Effects of Gendered Violence-Related Acquired Brain Injury

Highlighting Brain-Based Inequalities for Women: From Bedside and Boardroom to Policy